Ladies, did you know that diabetes mellitus is strongly related to diets? Therefore, interventions such as nutritional therapy or diet are important pillars to consider in the management of diabetes mellitus. The principle of meal arrangements for people with diabetes mellitus is almost the same as recommended meals for most people, which is a balanced diet following the caloric and nutritional needs of each individual.
However, people with diabetes mellitus should be stressed about the importance of schedule, the type, and the amount of food (3J), especially in those taking medications that increase insulin secretion or the insulin therapy itself. Also, make sure that the diet you are doing is a healthy diet to keep blood sugar levels in check. A healthy diet consists of consuming plenty of vegetables and fruits, consuming protein-rich side dishes, and limiting the consumption of sweet, salty, and fatty foods.
The provision of medical nutrition therapy for patients with diabetes mellitus is further regulated in the Guidelines for the Management and Prevention of Type 2 Diabetes Mellitus in Indonesia by the Indonesian Endocrinology Association (Perkeni), published in 2019. Caloric needs for people with type 2 diabetes mellitus are calculated by taking into account the basal caloric needs for 25-30 kcal/kg BW ideal. The number of calories given is at least 1000-1200 kcal per day for women and 1200-1600 kcal per day for men. In addition, the caloric needs calculation is calculated by taking into account the following factors:
- Gender
The calorie requirement for women is 25 kcal/kg BW ideal, while for men it is 30 kcal/kg BW ideal. - Age
For patients over 40 years, a 5% decrease was made for each decade. - Physical activities or work
The caloric needs are added by 10% at rest, 20% at light activity, 30% at moderate activity, 40% at strenuous activity, and 50% at a very strenuous activity. - Metabolic stress
Addition of 10-30% depending on the severity of metabolic stress in the form of sepsis, surgery, or trauma. - Body weight
Overweight (obese) people with diabetes mellitus get about 20-30% fewer calories, while underweight (thin) people with diabetes mellitus get 20-30% extra calories, depending on their weight and needs.
Aside from calories, the arrangements of the amount of each nutrient in patients with diabetes mellitus are regulated as follows:
- Carbohydrate
The recommended carbohydrate amount is 45-65% of the total energy intake and preferably high-fiber carbohydrates. Although people with diabetes mellitus should not consume too many carbohydrates, it is not recommended to completely restrict carbohydrates. The consumption of sucrose and simple sugars should not exceed 5% of the total energy intake. Meanwhile, the use of glucose is only allowed as a food seasoning. Alternative sweeteners can be given as long as they do not exceed the safe limit for daily consumption. - Fat
The recommended fat is about 20-25% of the caloric needs and should not exceed 30% of the total energy intake. The recommended fat composition is saturated fat <7% of calorie requirement, polyunsaturated fat <10%, and the rest is 12-15% monounsaturated fat, so the ratio of the three is 0.8:1:1.2. As for cholesterol consumption, <200 mg/day is recommended. - Protein
The recommended protein is 10-20% of the total energy intake, as long as there is no diabetic nephropathy. Patients with diabetic nephropathy should limit protein intake to 0.8 g/kg BW per day or 10% of the total energy requirement. Meanwhile, people with diabetes mellitus on hemodialysis need 1-1.2 g/kg BW/day. It is recommended that 65% of the protein sources have a high biological value and contain no saturated fatty acids. - Natrium
Patients with diabetes mellitus require a sodium restriction of < 1500 mg per day. Limit sodium consumption, especially in food ingredients such as salt, MSG, soda, and preservatives sodium benzoate and sodium nitrite. - Fibers
The recommended fiber intake is 14 grams/1000 kcal or 20-35 grams per day from food sources such as nuts, fruits, vegetables, and fiber-rich carbohydrates.
In general, foods with the above compositions are divided into 3 large portions for breakfast (20%), lunch (30%) and afternoon (25%), and 2-3 portions of snacks (10-15%). Patients are also motivated to use 3J or the right hour, type, and amount of food when doing their diet.
What do you guys think? Is it difficult or easy to do the diabetes mellitus diet? Read other articles about nutrition and health also on Newfemme!
Sources:
Soelistijo, S.A., Lindarto, D., Decroli, E., .... Sanusi, H., 2019. Pedoman Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 Dewasa di Indonesia. Jakarta : PB Perkeni