The diets used as part of the treatment of diabetes mellitus are based on the control of the intake of calories, proteins, fats and carbohydrates.
Additional considerations include the regularity of the meal schedule, the uniform distribution of kilocalories and carbohydrates between meals and the control of the intake of kilocalories, saturated fat and cholesterol.
Specific dietary recommendations and the importance of additional considerations vary according to the patient and the comprehensive medical treatment program.
The objectives of the Nutritional Treatment, according to the recommendations of the American Diabetes Association (ADA):
- Maintain blood glucose and HbA1c levels within the normal range.
- Achieve and maintain an optimal lipid profile.
- Maintain normal blood pressure numbers.
- Ensure an adequate caloric intake for each circumstance (growth, gestation, old age), avoiding both malnutrition and obesity.
- Prevent and / or reduce the incidence of chronic and acute complications.
- Achieve a good general condition and a good quality of life.
- All this by assessing the individual nutritional needs and taking into account personal and cultural aspects, as well as the preferences of the patient.
- Prevent hyperglycemia and hypoglycemia.
- Try to improve the dietary habits of diabetic patients.
The necessary calories should be provided to maintain an adequate nutritional status based on age, nutritional assessment, work activity and physical exercise. In situations such as pregnancy and lactation or if there is an associated pathology, it is necessary to increase the energy intake.
Calculation of caloric needs:
- Determine previously the nutritional status of the patient by calculating the body mass index (BMI).
- The WHO tables calculate the needs based on the maximum acceptable weight based on physical activity and sex.
- In case of overweight an additional reduction will be practiced:
- Basal Calories: 20-25 Kcal / Kg of weight.
- Calories added by activity: Moderately active (50% more), very active (100% more).
- Adjustments according to nutritional status: Denutrition (500 Kcal / day extra to gain 450 gr weekly, overweight (decrease 500 Kcal / day), pregnancy (add 300-350 Kcal / day in the second trimester and 400-450 Kcal / day in the third trimester).