Diabetes treatment beyond medications
Dr Chakshu Chandel *
It is a common thought, if you have developed diabetes or your sugar levels are high. You are to take medicines lifelong. It's partially true. One important part of therapy is Nutrition therapy and exercise.
Nutrition Therapy: Before the discovery of insulin, diabetes management was achieved predominantly through dietary intervention, a low calorie diet with significant carbohydrate restriction. After the discovery of insulin therapy in 1921, nutrition therapy was quickly displaced as a cornerstone of diabetes treatment.
But, recently, Nutrition therapy has returned as one of the most effective methods of diabetes management especially in early/pre-diabetes.
Nutrition therapy includes some interventions, which emphasize a variety of minimally processed nutrient dense foods in appropriate quantities as part of a healthy eating pattern and provide the individual with diabetes with practical tools for a day to day food plan and behavior change that can be maintained over the long term.
Before nutrition therapy is initiated a nutritionist is to evaluate a person's suitability for dietary intervention. This process involves reviewing dietary history, understanding patient's previous experience with lifestyle management and reviewing their adherence to dietary plans during past attempts to lose weight.
Also aim is to find out potential barriers to follow a nutrition plan earlier, including personal and cultural preferences, health literacy and access to healthful food choices. Based on evaluation, patients can be advised on a meal plan.
Few Meal Plans are:
1. Structured meal plan: These are designed to facilitate optimal macronutrient composition with fixed percentage of carbohydrate, fats, proteins and fibers. Reduction in protein while planning a meal is discouraged as low protein can accelerate lean muscle loss.
So meal plan should be having enough protein portions. It also contains diabetes specific formula (DSF) for meal replacement in early weight management. It can be used once / twice along with natural food choices.
2. The Mediterranean Diet: It is a diet rich in fruits, vegetables, whole grains, and fatty fish. These diet use low fat dairy products, olive/canola oils, nuts (walnut, hazelnuts, almond, and blended with rape seed or flax seed oil). Calorie restricted Mediterranean style eating pattern leads to improvement in glucose lipid abnormalities.
3. The Dash Dietary Pattern: These diets are high in vegetables, fruits, low fat dairy products, whole grains, poultry, fish and nuts, rich in potassium, magnesium, as well as protein and fiber. These are low in sodium, saturated fats, total fat, cholesterol and red meats. Along with diabetes it is also helpful in managing Hypertension.
One of the meal plans can be chosen for a person after evaluation, discussion with him/her and the family members. It can make a huge difference in managing diabetes and preventing those with risk factors for developing diabetes and pre-diabetes.
We must also focus on regular exercise or physical activity level as part of comprehensive diabetes care.
* Dr Chakshu Chandel wrote this article for The Sangai Express
The writer is MD (General Medicine) Postgraduate Course in Advanced Diabetes (Harvard Medical School) and Consultant Physician, Shija Hospitals
This article was webcasted on January 15 2023.
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