The pathological basis of diabetes is the carbohydrate (sugar) metabolism, therefore all physiological or pathological changes involving car
The pathological basis of diabetes is the carbohydrate (sugar) metabolism, therefore all physiological or pathological changes involving carbohydrates in the blood may influence or cause the change of blood glucose in diabetic patients. The determinants of changes and amplitude of blood glucose of patients with mainly: islet function or the patient still has the carbohydrate (sugar) metabolism, and dietary carbohydrates (sugar) and volume are two aspects of patients with digestive absorption rate. Therefore, as long as the control and improvement of one of the factors, it can have a positive impact on blood sugar in diabetic patients. However, due to the intake of dietary nutrients, must first meet the needs of patients to maintain their normal life activities and metabolic balance needs. Otherwise, it will not be possible to prevent or still induce various complications of diabetes. Moreover, by controlling the content of carbohydrate (sugar) in the diet of diabetic patients and the rate of absorption, it must be based on the patient still has a certain degree of islet function, in order to have the effect. Therefore, the rational use of dietary allocation methods to reduce the role of blood glucose in diabetic patients and the scope of application is very limited. In this case, the clinical medicine can improve patients with carbohydrates (sugar) metabolism treatment, has escort very important role and significance.
However, due to the development of history, and the lack of clinical treatments such as drugs. Dietary treatment of diabetes can only begin with lowering and improving blood glucose in patients. Therefore, since the beginning of the diagnosis and understanding of diabetes, has been used to strictly control and reduce the patient's carbohydrate (sugar) intake of treatment strategies. Only 20% of the total heat energy required by the patients, and the rest were fat and protein. Even, once advocated the use of alcohol to replace the patient's energy shortage. Obviously, such a dietary principle must be a problem. Sure enough, in the late 50s and early 60s of last century, a considerable number of patients with diabetes began to appear, and a large number of deaths from cardiovascular and cerebrovascular complications. Therefore, the dietary control objectives were revised as follows: carbohydrate (sugar) accounted for 40% of the total heat energy. At the same time, the proportion of fat in the total heat energy is 40%, protein is about 20%. In the 70s of last century, with the success of synthetic insulin, as well as the development of oral hypoglycemic drugs. Medicine has been able to significantly improve the carbohydrate (sugar) metabolic capacity of diabetic patients and control blood sugar through the use of drugs or insulin replacement therapy. The role and purpose of dietary therapy, began to be able to meet the needs of normal human life activities and metabolic balance, etc.. Therefore, the proportion of carbohydrates (sugar) in the total heat energy was increased again, reaching 45%. At the same time, the proportion of fat in the total heat energy decreased again, to 35%, while the protein remained at 20%. In 1987, the American Diabetes Association (ADA) released its dietary guidelines for diabetes, suggesting that fat intake should be controlled below 30% of total calories. Among them, saturated fat should not exceed 10% of the total heat. In 1994, the guidelines were revised, the proposed protein intake accounted for 15% ~ ~ ~ of the total heat energy, saturated and polyunsaturated fat accounted for each of the 10%, monounsaturated fats and carbohydrates (sugar) accounted for about 60% ~ 70%. So far, the method of diabetic diet treatment gradually improved and stable.
Combined with the specific circumstances of diabetic patients in China, domestic experts suggest that diabetic patients in China diet control objectives: total energy should meet the ideal and keep the normal life activity under the condition of weight; carbohydrates should occupy the total energy ratio of 55-60%; protein should be accounted for total energy ratio of 15-20% or 1-1.5 grams per kilogram of body weight per day. Among them, the high quality protein should not be less than the total protein of 1/3; fat should account for the total energy of 25% - 30%. Among them, the proportion of saturated, monounsaturated and polyunsaturated fats should be 1:1:1. Other essential nutrients, such as vitamins and minerals, are equivalent to those of normal persons.
Summarize the role of diet therapy for (1) to ensure the basic demand and balance in patients with a variety of energy nutrients, correct the disorder of energy, water and electrolyte metabolism; (2) blood glucose toxicity and risk protection of islet beta cell function, improve insulin sensitivity, target cells decreased in patients with postprandial, prevention and treatment of various energy metabolism disorder and diabetes complications; (3) to achieve and maintain ideal weight, promote the growth of adult children, guarantee the basic life of human activities, such as: all kinds of work, learning and exercise for energy substance; (4) to provide help for clinical treatment with other means.