Role of diet in the management of Diabetes Mellitus.

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 Diet is the pivot on which the success in management of Diabetes Mellitus depends. Good glycaemic control is unlikely to be achieved with insulin or oral therapy when diet is neglected, especially when the patient is also over- weight. But I like to mention here clearly that the diet for a diabetic patient is no different from the diet considered healthy for the population as a whole. The only thing to be kept in mind is that obese patients are to be given a reducing diet, on the other hand lean and thin subjects should receive a weight- gaining diet. Patients who are underweight because of untreated diabetes may require energy supplementation. The actual height and weight of the patient are to be noted prior to selection of diet therapy. Calories should be tailored to the needs of the patient. The total amount of carbohydrate in the diet should provide 50-55% of the total calories with fat 30-35% and protein 15%. Regarding fat, it is better to prescribe unsaturated fat to keep the cholesterol level under control. Carbohydrate consumed should consist of unrefined carbohydrate rather than simple sugars such as sucrose. Carbohydrate is absorbed relatively slowly from fibre-rich foods, preventing the rapid swings in circulating glucose seen when refined sugars are ingested. Unfortunately, most people find it extremely difficult to modify their eating habits and repeated advice and encouragement are needed if this is to be achieved. A diet history is to be taken, and the diet prescribed should involve the least possible interference with the life-style of the patient. It is important to stress that patients on insulin or oral agents should eat the same amount at the same time each day. Patients on insulin require snacks between meals and at bedtime to buffer the effect of injected insulin. Alcohol is not forbidden, but its energy content should be taken into account. Patients on insulin should be warned to avoid alcoholic binges since these may precipitate severe hypoglycaemia. So, try to keep these facts in mind if you are diabetic.



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