1, the development ofDiet control is one of the most important and basic methods in the treatment of diabetes. In the past 80 years, there h
1, the development of
Diet control is one of the most important and basic methods in the treatment of diabetes. In the past 80 years, there has been a dramatic change in the concepts and principles of application. For example, from the beginning of the 20s of last century, the principle has been advocated strict control of carbohydrates (sugar) intake. Only 20% of the total calorie intake. In the 50s of the last century, due to the large number of complications of diabetes, resulting in this ratio was modified to account for 40% of the total thermal energy, while the proportion of fat was changed to 40%, the protein was 20%. In the 70s of last century, the proportion of carbohydrates (sugar) in total heat energy increased again, reaching 45% of the total heat energy. At the same time, the proportion of fat in the total heat energy decreased again, which was 35% of the total heat energy, while the protein remained at about 20%. In 1987, the American Diabetes Association (ADA) issued a dietary guidelines for diabetes, suggesting that fat intake should be controlled below 30% of total heat. Among them, saturated fat should not exceed 10% of the total heat. In 1994 this guide further modification, protein intake recommendations should be accounted for 15% of the total energy of ~ 20%, saturated and polyunsaturated fat should each accounted for 10% of the total energy of, monounsaturated fat and carbohydrate (sugar) for 60% ~ 70%.
Combined with the latest research achievements of world medical field and the specific situation of diabetic patients in China, the basic principles of China's treatment of diabetes mellitus for diabetic patients: the protection of basic life activities need a variety of nutrients and metabolic balance; try to improve and reduce blood glucose toxicity and risk after meal; has been trying to correct the energy and water, electrolyte metabolic disorder; when necessary, should be combined with the direct use of hypoglycemic drugs or insulin, to improve and improve diabetes appeared disorder and low carbohydrate (sugar) metabolism, and control of blood glucose to normal or relatively safe level; the prevention and treatment of diabetic complications.
2, the proposed control objectives
According to the above principles, diabetic patients in China: dietary recommendations target for the control of total energy should meet and maintain ideal body weight case, need the normal life activity; among them, carbohydrates should occupy the total heat energy ratio of 55-60%; protein should account for 15-20% or 1-1.5 grams per kilogram of body weight per day, and high quality protein should not be less than 1/3 fat; general total heat ratio of 25% - 30%. Among them, the proportion of saturated, monounsaturated and polyunsaturated fats should be 1:1:1. Other nutrients, such as vitamins and minerals. Specific intake, can generally be based on diabetes patients height, weight, exercise or labor intensity, into a special formula for estimation. Special circumstances or when necessary, can also be the basis for patients with metabolism, exercise or labor intensity, disease stress, food digestion actual consumption, as well as fat and muscle for body weight proportion of nutrition evaluation index of fine calculation.
3, compared with the normal diet requirements
Compared with the dietary requirements of healthy people, the recommended protein intake increased by 5%, while carbohydrate (sugar) intake decreased by 5%. Fat and other nutrients needed by the human body.
This is because: (1) under the condition of diabetes, carbohydrates (sugars) are often lack of energy, so it is very easy to lead to excessive consumption of protein as an alternative energy source. Because the protein in the human body reserves are very limited, can not be added in time, it is very easy to lead to negative nitrogen balance or constitute the human body tissue, cells and various types of immune substances in the lack of raw materials protein. Therefore, the intake should be appropriately increased; (2) although carbohydrate (sugar) is an important risk factor for diabetic patients with elevated blood glucose and small vascular complications. However, patients still need to be converted to heat energy and related metabolites to maintain normal life activities and metabolic balance, and drugs and other clinical treatment can not be replaced. Therefore, it is necessary to maintain a certain amount of intake, although it may help to reduce or control postprandial blood glucose in diabetic patients. Otherwise, it will lead to or exacerbate energy metabolism disorders. A large number of clinical practice research and several adjustments, the consensus now is its intake should be accounted for the total energy required for patients with 55%60% is appropriate. If the patient had elevated blood sugar, it should be timely with drugs or directly instead of using insulin, to ensure that the intake of carbohydrates (sugar) can be converted into energy needed by the human body, and control blood glucose to normal or relatively safe; (3) fat is the condition of diabetes and another is very easy to be used as alternative energy excessive consumption and burning of human nutrition. At the same time with a reserve of human energy and protect the organs, organizations to prevent and reduce heat loss, cell membrane, tissue cells and some hormones, helps the body absorb and carry the fat soluble vitamins are very important physiological function and effect. Different from the protein, the body's fat reserves are generally more abundant, and carbohydrates (sugar) in the conversion of heat energy can not be consumed or released in time, will be converted to fat. Therefore, the minimum demand is relatively easy to meet. However, excessive intake or excessive combustion can lead to and induce atherosclerosis or plaque formation. So, such as heart and brain vascular disease can be due to the long-term intake of fat or total energy caused by excess; at the same time due to carbohydrate (sugar) intake or diabetes cases, carbohydrates (sugar) reduce the amount of energy conversion, which caused by excessive fat burning caused as alternative energy. Occurs in diabetes, known as diabetic complications. The incidence is about 70% - 80% of diabetic complications. Therefore, diabetes patients need to limit or reduce fat intake, but also need to prevent the excessive use of alternative sources of energy as a result of burning. The most important and effective way to prevent it from being used as an alternative source of energy is to have enough carbohydrate (sugar) to convert the heat energy to meet the needs of human life. Otherwise, even if there is no intake, the body will mobilize the reserves of fat to burn. Therefore, diabetes must be treated comprehensively, in order to achieve good results. In terms of fat intake, there is no difference between the demand and the normal healthy people.
As a matter of fact, excessive intake of fat and total heat has become a widespread and serious problem in the world. All kinds of chronic non infectious diseases caused by it have become the main cause of human death. The high incidence of diabetes and the high incidence of diabetes, but also has a very close and important causal relationship. Therefore, the core of the diabetes diet, the first manifestation of the basic principles of dietary nutrition balance. In other words: its control and management requirements are not very different from the standard of healthy eating. Therefore, the goal is also suitable for high blood lipids, high blood pressure is equivalent to the treatment of metabolic disorders of energy metabolism, as well as health needs of the elderly and other groups. The difference is that, in addition to the implementation of the diabetes diet control target, at the same time reduce the diet to affect blood glucose and postprandial blood glucose, and keep all kinds of energy substances in the diet every meal is relatively stable, so with hypoglycemic drugs and other clinical treatment to lower blood sugar to form a mutual matching or coordination etc..
It should be pointed out that there is a class of drugs which can be used to reduce the blood glucose of the patients, which can be achieved by preventing and reducing the absorption and utilization of carbohydrates (sugars). For example: mainly through the inhibition of the body to break down the components of polysaccharide essential substances of a-glucosidase secretion, so as to realize the acarbose blood glucose decreased in patients with postprandial (thanks to Tang Ping), V (Basen) Gayle wave sugar and migltol etc.. However, because these drugs in inhibiting polysaccharide decomposition and digestion, often will also lead to protein, vitamins and minerals is also very important for the patients with inadequate absorption of other nutrients, even may cause diarrhea and intestinal disorders. Therefore, the application process should pay special attention to, and timely adjustment or correction of various nutrients intake target.