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NUTRITION THERAPY FOR DIABETES TYPE 2

DIABETES-NUTRITION THERAPY
Change in lifestyle is the important part of the management of people with diabetes.Initially, people find it difficult to accept that they have a disease that needs lifelong management.The aim of nutrition therapy is people learn what,when and how to change their diet pattern.Treating physicians are required to give advice related to diet and exercise to people with diabetes.Nutrition therapy  for diabetes type 2 is very important role in management of diabetes.
Dietary management -
Dietary management is the major part of diabetes care.This does not deviate from the normal diet but some modifications in normal diet are sufficient.
Before change in the diet plan and exercise regimen, some factors are important-
-age of the patient,                                                                                                                                       - type of diabetes, a presence of complications
-current drugs regimen
-treatment goals- weight loss,blood glucose level,prevention of  hypoglycemia,prevention of cardiovascular risk factors
-educational and psychological background of the patient
-willingness to follow advice.
Nutrition -therapy- diabetes- type 2
Nutrition therapy for diabetes type 2



 Aim of nutrition therapy for diabetes--
Educational and psychological support.
Improve overall health by proper nutrition.
Take adequate calories to maintain weight for adults and adolescents.
Maintain blood glucose and lipid levels.
                                                               THE ROLE OF EXERCISE IN TYPE 2 DIABETES

It is important to make people with diabetes understand the need for alterations in their dietary habits.
Planning the diet-
People with diabetes should know the relationship between their medications and intake of  nutrients and physical activity to prevent them from overdoing. based on the drugs that a person is receiving change in dietary plan.Some of these are-
-Metformin and glitazones-without fear of hypoglycemia total amount of macronutrients distributed over meals.
-Sulfonylureas,glinides and insulin therapy- they must be split-meal patterns to avoid hypoglycemia in late hours.                                                                                                                                                           -Bedtime glargine or detemir-most people don't need bedtime snack but this should not be ruled out.
-If bedtime insulin is NPH or insulin zinc suspension they need complex or high fibre carbohydrate in their bedtime snacks.
People receiving alpha-glucosidase inhibitors have a lower amount of fibre with a major meal with which drug was taken and snacks with more fibre.
                                        Useful Apps For Diabetes Manegement
Calorie requirement -For weight maintenance 30 kcal/kg/day with moderate physical activity.For weight loss start with 30 kcal/kg/day and then reduction up to 20 kcal/kg/day with moderate physical activity.Excess calorie intake is one of the main reason for metabolic derangements in type 2 diabetes.Short term use of very-low-calorie diets (VLCDs) has a positive impact independent of weight loss.But in long run VLCDs are not practical.Hence moderate calorie restrictions are the key to sustained weight loss and positive metabolic outcomes.In normal weight person with diabetes, self-selected calorie intake is sufficient.
Calorie requirement per day

                         WEIGHT
KILOCALORIES PER KG BODY WEIGHT
OVERWEIGHT
20
IDEAL WEIGHT
30
UNDERWEIGHT
40
 DISTRIBUTION OF NUTRIENTS IN THE DIET
NUTRIENT
% OF TOTAL CALORIES
CARBOHYDRATE
50-60%
PROTEIN
10-15%
FAT
<30%
CHOLESTEROL
<300 MG/DAY
FIBRE
25-40 GM/DAY
SODIUM
<2000 MG/DAY
ALCOHOL
Not more than 5% of total calories
VITAMINS AND MINERALS
Same as general

As diabetes is a lifelong disorder,nutrition and exercise therapy become part of self-care education.Taking an appropriate diet and maintaining adequate levels of  physical activity bring results equal to commonly used antidiabetic drugs.Therefore every patient of type 2 diabetes should modify their lifestyle with his or her management plan.


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