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Idiopathic
Genetic Factors
Risk Factors (physical inactivity, olderage, obesity) Type 2 Diabetes Mellitus (insulin resistance; insulin deficiency) 90 % all cases
Environmental factors
Genetic Syndromes, malnutrition, infections, drugs, hormone---- insulin resistance ,7% of pregnancy
Pre-Diabetes : Fasting or glucose tolerance test results above normal.
Diagnosing Diabetes: Fasting blood glucose (mg/dl) 1. Normal 100 2. Pre-diabetes 100-125 3. Dm 126 1. 2. 3. Random blood glucose: Normal 140 Pre -diabetes 140-190 Dm 200
Risk factors for diabetes: 1. Family history of type 2 2. Overweight , BMI 25 3. Cardiac Risk factors : LDL , Cholesterol ,hypertension HDL.
Protein glycosylation : When blood glucose remains elevated 1. Overtime, tissues become glycosylated. 2. Glucose (sticks) to tissue. Glycosylation damages blood vessels and contributes to long-term complication associated with poorly controlled diabetes.
A1 C 5 6 7 8 9 10 11 12
1. 2. 3. 4. 5.
Long term complication HBG conc.: Blood vessels (CVD) Eyes (retinopathy) Kidneys (nephropathy) Nerves (neuropathy) Noun-healing wounds.
Damage
insulin / medication
BG monitoring
Exercise
Dont use items that contain fat delays absorption (no chocolate ,ice cream ,cookies).
Nutrition Management
Type 1 Diabetes:
1. Depend in insulin injection with food intake , consistency in timing and amount of CHO eaten if on fixed insulin doses. Adequate energy & nutrient in take to promote growth & development in children .
Type 2 Diabetes: 1. lifestyle strategies (food /eating and physical activity ) that improve glycemia , dyslipidemia and blood pressure. 2. Nutrition education. 3. 5% -10 % weight loss 4. Blood glucose monitoring.
NUTRITION THERAPY:
Balanced Diet
CHO Protein 45-65% Kcal 20-35% Kcal Starch ,milk, fruit ,Vega Meat , eggs, cheese
Fat
10-35% kcal
LOW GI 55
Watermelon Cornflakes
French fries Wafer biscuits Rice cakes Corn chips Watermelon Chips, potato
GLYCOMIC Effect of Food Highest blood sugar is typically 1-2 hours after eating the meal. However: 1. Liquids (juice)digest quicker. 2. High fat & fried foods digest slower 3. Highly refined grains & cereals digest quickly 4. High fiber foods (legumes & whole grains ) have glycemic response.
Immune-mediated Circulating Auto-antibodies Type 1 Diabetes Melllitus (absolute insulin deficiency) Idiopathic (Autoimmunity) (viral infection,toxic chemicals, ect.)
Risk Factors
(physical inactivity, olderage, obesity)
Environmental factors
Intake of
Excessive calories