Diabetes and Nutrition
Diabetes, commonly known as diabetes, affects more than 500 million people worldwide. According to current data from the National Diabetes Federation, one out of every 11 people is currently suffering from diabetes, while in 2040, one out of every 10 people is predicted to have diabetes.
What is Diabetes?
Diabetes is a chronic and metabolic disease that is characterized by high blood sugar, which is caused by an absolute deficiency of insulin and the deterioration of the effect of insulin. In diabetes, the body cannot make enough use of carbohydrate, fat and protein.
Types of Diabetes
Type 1 Diabetes: It is a type of diabetes that occurs as a result of autoimmune beta cell destruction in the pancreas, usually in the child - adolescent group or in the first years of life. Insulin treatment is required throughout life.
Type 2 Diabetes: Adulthood, usually occurs after the age of 40 years. It usually develops with insulin resistance. Insulin release from the pancreas progressively deteriorates. It is a type of diabetes that can be treated with lifestyle regulation and drugs that prevent the formation of diabetes and does not require insulin use in the first years.
Pregnancy Diabetes: Gestational Diabetes in Medicine is the first type of diabetes that occurs during pregnancy and improves with birth. There is a high risk of recurrence at the next delivery. In women with a history of gestational diabetes, the risk of developing Type 2 Diabetes increases up to 50%, so it is recommended that this group of patients participate primarily in diabetes prevention studies.
Other Diabetes Forms: Gene damage due to; occurring in pancreatic diseases such as cystic fibrosis, pancreatic cancer, pancreatitis; stimulated with drugs and chemicals; infections, organ transplants and diabetes.
The most common form of diabetes is type 2 diabetes. While type 2 diabetes constitutes 90 - 95% of all diabetes, type 1 diabetes covers 5 - 10% and gestational diabetes covers 1 - 14%.
Symptoms of Diabetes
Dry mouth, very thirst, frequent urination, and frequent hunger are the main symptoms of diabetes. In addition, weight loss, blurred vision, numbness in the feet, tingling, burning, urinary tract infections, inflammation of the outer part of the genital area in women, fungal infections, itching, dryness of the skin, symptoms such as fatigue.
Complications of Diabetes
Microvascular complications can be defined as diseases that occur in the eyes, nerves and kidneys and affect the smallest blood vessels. Macrovascular complications include vascular occlusion, hypertension, ischemic heart disease, cerebrovascular attack.
How is diabetes diagnosed?
Diagnosis of diabetes at least 8 hours fasting at night followed by fasting blood glucose in the morning hours above 126 mg / dL, 75 grams of glucose-containing test (OGTT) at the 2nd hour of blood sugar measured above 200 mg / dL, HbA1c value> 6.5% or 200 mg / dL of blood sugar measured at a random time with the presence of symptoms of diabetes. Only one of these criteria is sufficient for diagnosis.
Frequency of Diabetes
Although the prevalence of type 1 diabetes is mostly in puberty, it may occur at almost any age. In all populations, the number of newly emerged individuals with Type 1 diabetes in childhood has doubled in the last 20 years. The Diabetes Atlas, published by the International Diabetes Federation in 2015, reported that the number of individuals with Type 1 diabetes under the age of 15 for the first time in the world exceeded half a million. According to this atlas, childhood diabetes increases by 3% per year and 86,000 children are diagnosed with new Type 1 diabetes each year. The increase in the frequency of type 1 diabetes is related to changes in lifestyle and the impact of environmental factors; There are some arguments that specific factors such as immunization, feeding with formula and vitamin D in the first years of life may also play a role in the development of Type 1 diabetes.
Modern lifestyle changes and globalization adopted in the last 50 years have affected all societies. Majority of countries are experiencing significant social and economic changes, urbanization is increasing, infant mortality decreases and life expectancy is prolonged. As a result, obesity and Type 2 diabetes have increased significantly in both developed and developing countries. Today, diabetes is considered an epidemic disease for many developed new industrializing countries. So the increasing frequency of diabetes poses a serious burden on health systems.
According to a study made important TURDEP-II diabetes results in Turkey compared to 12 years ago in our country, it is estimated that approximately starts earlier than 5 years of age. This situation shows that the productive population will struggle with complications at an earlier period in the future and the costs related to both treatment and labor loss will increase.
In addition to the increase in the incidence of diabetes, studies have found that diabetes awareness is low. It is known that in the Atlas of Diabetes, about half of adult diabetics are not aware of their disease. In the TURDEP II study, this rate was found to be 45%. For this, it is necessary for individuals to recognize diabetes and to develop diabetes prevention activities.
Risk Factors of Diabetes
The factors that increase the risk of diabetes are divided into two factors, which are modifiable and non-modifiable. Aging, gender, genetic predisposition, family history of diabetes, previous gestational diabetes or a history of impaired glucose tolerance are irreversible factors.
Obesity, sedentary lifestyle, smoking and alcohol consumption, low-pulp, refined carbohydrates and saturated fat-rich diet are possible risk factors.
Groups with high risk of diabetes
It is recommended that diabetes is included in routine health screenings in individuals older than 40 years with a BMI of 25 kg / m 2 or more. In particular, individuals with one of the following risk factors have a high risk of diabetes.
First-degree relatives with type 2 diabetes
Ethnic groups with high prevalence of diabetes
Women with large babies and previously diagnosed with gestational diabetes
Those with blood pressure of 140/90 mmHg and above
Dyslipidemics (HDL cholesterol below 35 mg / dL or triglyceride levels above 250 mg / dL)
Previously impaired glucose tolerance, impaired fasting glucose
Women diagnosed with polycystic ovary
Patients with clinical signs of insulin resistance (acanthosis nigricans)
Patients with coronary, peripheral or cerebral vascular disease
Low birth weight births
Individuals with a still life
Rich in saturated fats, poor fed from pulp
Schizophrenia patients
Individuals using anti-psychotic drugs
Cystic fibrosis patients
Organ transplantation patients
Medical Nutrition Therapy in Diabetes
Medical nutrition therapy is the most important part in the prevention of diabetes, the treatment of diabetes and the delay and treatment of diabetes-related complications. Nutritional therapy in diabetes is provided by a knowledgeable and experienced diet. It is recommended that individuals with Type 1 and Type 2 diabetes be referred to the dietician with laboratory findings within the first month after diagnosis, and gestational diabetes patients within one week after diagnosis. Medical nutrition treatment of diabetes consists of 4 steps.
Evaluation : Type of diabetes, presence of complications, blood glucose control, anthropometric measurements, laboratory findings, medical treatment, concomitant diseases and treatment, food consumption record, nutritional habits, physical activity level, nutrition information such as readiness and motivation for changes in behavior are evaluated and recorded.
Nutritional Diagnosis and Target Determination: The assessment results in the diagnosis of nutritional carbohydrate consumption, excessive consumption of fat, high consumption of foods with high glycemic index. Treatment target varies from individual to individual. In addition to providing the target blood sugar glucose for one individual, improving the lipid profile may provide weight control in another individual. A dietary process that can be applied and attained for nutritional diagnosis and individual treatment goals is entered.
Nutrition Intervention and Education: Nutritional intervention, which is the most important part of treatment, focuses on changing the individual's nutritional behavior. Meal planning methods (nutrition pyramid, plate model, change lists, carbohydrate count) are determined. The dietary recommendations are tailored to the individual's needs, habits, lifestyle and willingness. The training should include content that will facilitate the achievement of the set goal, support the implementation of meal planning methods, and at the same time provide knowledge and practical skills in diabetes and nutritional therapy.
Priority Issues in Education of Diabetic Individuals
The main determinants of fasting blood sugar control are food and drinks containing carbohydrates and insulin levels produced or taken from the body. It should be known that consuming carbohydrate-containing foods above the requirement levels will cause hyperglycemia; carbohydrate-containing foods and their carbohydrate content should be explained.
The ability to calculate the amount of carbohydrate consumed by a person with diabetes should be gained.
Portion control should be recommended for overweight and obese individuals to achieve ideal body weight.
Normally low-carbohydrate diets, which contain carbohydrates and restricted energy intake, or the Mediterranean diet may be effective in achieving short-term weight loss.
Patients should be informed about beverages flavored with sugar and high fructose corn syrup.
Instead of carbohydrate intake from processed / packaged foods supplemented with salt, sugar and fat, carbohydrates should be obtained from vegetables, fruits, whole grains and dried legumes and dairy products with high pulp and high nutritional value.
The type of oil consumed is more important than the amount. Unsaturated fats (olive oil, canola oil) should be consumed instead of saturated and trans fats.
The intake of foods containing 3 fatty acids, which are crucial for cardiovascular health, should be increased; fish consumption should be provided at least twice a week.
Salt consumption should be limited, less than 5 grams per day should be consumed.
Follow-up: Compliance with the treatment and laboratory findings are evaluated, existing problems are identified, and the problems are solved. The relationship between the patient's nutrient consumption records and fasting postprandial blood glucose monitoring results are explained. Meal time and content are re-planned if necessary.
Providing medical nutrition therapy to the patient ensures that blood sugar levels remain normal, reduces the risk of cardiovascular disease, and helps to maintain blood pressure at normal levels. With medical nutrition therapy and lifestyle changes, 60% of Type 2 diabetes cases can be delayed or prevented. When a 1% decrease in hbA1C is achieved with a lifestyle change that includes healthy nutrition in diabetic patients, the risk of heart attack is reduced by 14%, the risk of microvascular complications by 37%, and the risk of diabetes-related disease by 21%.
18AXX
Care Touch Diabetes Blood Sugar Kit – Care Touch Blood Glucose Meter, 100 Blood Test Strips, 1 Lancing Device, 30 Gauge Lancets-100 Count, Control Solution and Carrying Case
