Diabetics and the Importance of Nutritional Values, Research Paper Example

Abstract

Nutrition is critically important to individuals with Diabetes. This is emphasized I the work of Schulman and Rienzo who state that medical nutrition therapy “…continues to be an essential component of diabetes management. Nonetheless, physicians have missed opportunities to provide nutrition counseling to their patients.” (nd) Since Type 2 diabetes is of epidemic proportions among patients and because of the severe potential consequences that results from poor nutrition it is important that physicians and patients alike are literate in the area of proper nutrition for individuals with diabetes.

Diabetes and the Importance of Nutritional Values

Proper Nutrition for Individuals with Diabetes

Nutrition is critically important to individuals with Diabetes. This is emphasized I the work of Schulman and Rienzo who state that medical nutrition therapy “…continues to be an essential component of diabetes management. Nonetheless, physicians have missed opportunities to provide nutrition counseling to their patients.” (nd ) Since Type 2 diabetes is of epidemic proportions among patients and because of the severe potential consequences that results from poor nutrition it is important that physicians and patients alike are literate in the area of proper nutrition for individuals with diabetes.

The American Diabetes Association states that medical nutrition therapy is “an integral component of diabetes management and of diabetes self-management education.” (2004) Understanding the dietary requirements of successfully maintaining proper nutrition for diabetes patients is paramount in their ability to achieve proper nutrition. The American Diabetes Association additionally states “evidence-based outcomes research that documents the clinical effectiveness of MNT in diabetes has been reported.” (2002) The following table lists a comparison between the ‘General’ Dietary Guidelines and a Summary of General Guidelines specifically for individuals with Diabetes.

Diabetes – Meal Planning for Proper Nutrition

Proper meal planning systems for the individual with diabetes includes: (1) exchange lists; and (2) counting carbohydrates. The exchange list is reported to group foods into the following categories: (1) carbohydrates which includes fruits, vegetables, milk, starches and other carbohydrates; (2) fats; and (3) meat and meat substitutes. (Diabetes.co.uk, 2010) The way that this system works is that within each of the categories a food may be exchanged for another food therefore the energy amount that a certain food in a specific serving size is approximately the same intake.

Carbohydrate counting involves calculating the amount of carbohydrates in the chosen foods. It is important to understand that the insulin or medication taken by the diabetic must necessarily be matched with the food intake of the individual. Carbohydrates may come from any food type that contains carbohydrates. This system makes a requirement of blood sugar testing multiple times daily and requires as well that good be measured and weighed. A report published in 2009 online the Internet Journal of Laboratory Medicine states that the prevalence of diabetes mellitus (DM) is on the increase across the globe at a rapid pace and many factors have been held to be contributors to the disease that is of epidemic proportions. (Kayode, Sol and Adelani, 2009; paraphrased)

Diabetes Mellitus is a disease that is related directly “to carbohydrate, lipid and protein metabolism” therefore, nutrition has a key role in management of Diabetes Mellitus. Medical nutrition therapy is focused on that prevention. University of Arkansas Extension Nutrition Specialist for the Cooperative Extension Service – Division of Agriculture reports that the management goals of diabetes include the maintenance of desirable blood glucose and blood lipid (fat) levels, the maintenance of optimal nutritional status and reaching and maintaining a healthy weight. (Rodibaugh, nd)

Diet and Control of Type II Diabetes

The work of Chan and Katz (2002) entitled “Diet in the Prevention and Control of Obesity, Insulin Resistance, and Type II Diabetes” states that the American College of Preventive Medicine (ACPM) states that it recognizes that factors, including diet as well as physical activity, genetics, exposures within the individual’s environment and public policy decisions affect the conditions of diabetes. In addition the evidence is reported to show that a diet “rich in complex carbohydrate from unrefined cereal grains, vegetables and fruits, moderate in total fat and restricted in saturated and trans fat; and moderate in protein is advisable for weight control, diabetes prevention and health promotion.” (Katz, 2002)  The prevalence of diabetes mellitus (DM) is increasing around the world and at a rate that appears as dramatic as to have been characterized as an epidemic. Many factors have been postulated to contribute to the DM epidemic. Environmental factors have drawn particular attention because of the rapidity of the increase in type 2 DM. Because DM is a disease directly related to carbohydrate, lipid, and protein metabolism, nutrition has always had an integral role in its management. The contemporary term used to describe the dietary prescriptions is medical nutrition therapy (MNT). ⁴¹ Before the advent of insulin therapy in the early 20th century, MNT was the only form of therapy for DM.  Kayode, Sol and Adelani (2009) report that in order for the individuals health to progress from a healthy condition to development of diabetes mellitus, a chronic disease, the changes occur in gene expression or alternatively by

“differences in activities of proteins and enzymes.” Chemicals ingested during dietary intake are stated to be direct and indirect participants in the regulation of gene expression therefore “…it follows that a  subset of genes regulated by diet must be involved in disease initiation, progression, and severity . The clearest example of genotype-diet interactions in chronic disease is type 2 diabetes…” (Kayode, Sol and Adelani, 2009)

After the individual has been diagnosed with type 2 diabetes, control of symptoms may be achieved by some  through the increase of physical activities and reduction of caloric intake thereby changing environmental or dietary values result in changing the expression of genomic information. It is reported that link between “high GI diets and diabetes may relate to glucose peaks and increased insulin demand.” (Kayode, Sol and Adelani, 2009) Kayode, Sol and Adelani (2009) report that low GI foods “tend to delay glucose absorption thereby resulting in reduced peak insulin concentrations and overall insulin demand.”

Summary and Conclusion

This brief study sought to examine the importance of nutritional values for the individual with diabetes. This study has ascertained that it is of critical importance that the individual be educated and possess the necessary knowledge to maintain diabetes and that the primary reasons this is so important includes avoiding complications such as blindness or amputations as well as avoiding development of kidney disease. Proper nutrition assist the individual with diabetes in maintaining a high level of control of diabetes through helping with maintaining blood glucose levels as close as possible to normal levels as well as maintaining or losing weight. Toward this end of proper nutritional maintenance of diabetes dietary intake the individual may use one of two systems: (1)  exchange lists; or (2) counting carbohydrates, both of which serve to enable the necessary nutritional principles necessary for successful maintenance of diabetes. It is important that today’s physicians and other health care workers ensure that diabetes patients are in receipt of the necessary information and knowledge to properly and safety maintain their diabetes and ultimately to avoid unnecessary complications to diabetes.

References

Chan, G. and Katz, D.L. (nd) Diet in the Prevention and Control of Obesity,
Insulin Resistance, and Type II Diabetes. American College of Preventive Medicine Position Statement Washington, DC 2005. Retrieved from: http://www.acpm.org/2002-057(F).htm

Rodibaugh, R. (nd) The Exchange List System for Diabetic Meal Planning, University of Arkansas Division of Agriculture. Family and Consumers Services. Retrieved frohttp://www.uaex.edu/Other_Areas/publications/PDF/FSHED-86.pdf

Diabetes Nutrition – Nutrition is Paramount (2010) Diabetes.co.uk. Retrieved from: http://www.diabetes.co.uk/nutrition.html

Schulman, J.A. (nd ) The Importance of Physicians’ Nutrition Literacy in the Management of Diabetes Mellitus. Retrieved from:  http://www.med-ed-online.org/f0000022.htm

Nutrition Principles and Recommendations in Diabetes (2010) American Diabetes Association. Diabetes Care. Jan 2004. Vol. 37 no. suppl 1 s36. Retrieved from: http://care.diabetesjournals.org/content/27/suppl_1/s36.full

Green, J.G. et al (2002  ) The Evidence for the Effectiveness of Medical Nutrition Therapy in Diabetes Management. American Diabetes Association. Diabetes Care March 2002, Vol. 25 no. 3 Retrieved from:  http://care.diabetesjournals.org/content/25/3/608.short

Kayode, A. Sola, A. Adelani, A. Adeyinka, O. Kolawole & O. Bashiru : The Role Of Carbohydrate In Diabetic Nutrition: A Review. The Internet Journal of Laboratory Medicine. 2009 Volume 3 Number 2