Diabetes Essay, Research Paper

December 6, 2000

In our world today, there are many people that have diseases and disorders. One dominant, extremely common disease is diabetes. There are two major forms of diabetes, type 1 and type 2, share a central feature: elevated blood sugar levels due to absolute or relative insufficiencies of insulin, a hormone produced by the pancreas. Insulin is a key regulator of the body s metabolism. After meals, food is digested in the stomach and intestines; carbohydrates are broken down into sugar molecules, of which glucose is one, and proteins are digested into amino acids. Glucose and amino acids are absorbed directly into the bloodstream. Insulin, in turn, enables glucose and amino acids to enter cells and, more importantly, muscle cells. As blood sugar falls to pre-meal levels, the pancreas reduces the production of insulin, and the body uses its stores energy until the next meal provides additional nutrients.

In type 1 diabetes, also known as juvenile-onset diabetes, the cells in the pancreas that produce insulin, known as beta cells, are gradually destroyed; eventually insulin deficiency is absolute. Without insulin to move glucose into cells, blood sugar levels become excessively high, a condition known as hyperglycemia. The sugar, which the body cannot use without insulin, spills over into the urine and is lost.

In type 2 diabetes, also known as maturity-onset diabetes, is the most common type of diabetes. Most type 2 diabetics produce large amounts of insulin, but are insulin resistant, which indicates that they have abnormalities in the liver muscles and muscle cells that block its action. However, many type 2 diabetics seem to be incapable of secreting enough insulin to overcome this resistance. Obesity is the common in type 2 diabetes, and this condition appears to be related to insulin resistance.

For most people with diabetes, diet control is necessary to manage the disease. There is no single diet for every individual that has diabetes. However, there are dietary guidelines that are constant for every diabetic patient. All people with diabetes should strive to have healthy lipid (cholesterol and triglyceride) levels and control blood pressure. People with type 1 diabetes, or type 2 diabetes on insulin, or oral medication must focus on controlling blood glucose levels by coordinating calorie intake with medication or insulin, and exercise. Adequate calories must be maintained for normal growth in children as well as in pregnant women, but for overweight type 2 diabetes, weight loss is encouraged.

Food Labels

Every year, there are thousands of false advertisements for new food that are supposed to be beneficial. It is very important that a diabetic distinguish between good foods and false advertisements. Current food labels show the number of calories of fat, dangerous nutrients, as well as useful nutrients. In addition to food labels are not required to show the trans-fatty oils. Labels also show the daily values, but the daily values are based on a 2,000-calorie diet, which is much higher than most diabetics should have.

Timing

The timing of meals is a very important factor for people taking insulin. The types and amounts of food as well as meal and snack times must be carefully determined so that blood glucose levels are properly regulated. In general, people with type 1 diabetes should eat about 30 minutes after taking an insulin injection. Three meals should be eaten a day at about 4 or 5 hours apart.

Carbohydrates

Type 2 diabetes that tends to be overweight and insulin-resistant overproduces glucose after carbohydrate intake, which in turn requires more insulin to process it. This leads to appetite stimulation and production of fat. Some diabetics may have problems with cholesterol and triglyceride levels when carbohydrates constitute over 50% of the diet. If triglycerides are high, carbohydrates should be reduced to 45%.

Complex Carbohydrates found in whole grains and vegetables are preferred over those found in starches- such as pastas, white-flour products, and potatoes. Diabetics can add fresh fruit to their diets regardless of the sugar content because simple sugars along with complex sugars do not raise blood glucose.

Protein

Studies are showing that reducing proteins in the diet help slow the progression of kidney disease in both diabetics and nondiabetics. Some experts recommend that anyone with diabetes except pregnant women should restrict protein to about 0.4 grams for every pound of their ideal body weight.

Fats and Oils

Fats should provide no more than 30% of the diet, with saturated fats at a 10% maximum. Those trying to lose weight should reduce fat to 20% to 25% of their caloric intake with no more than 7% from saturated fats. People with diabetes should avoid fried foods. Fish oil, which contains omega-3 fatty acids, may improve triglyceride levels, although some studies show that fish oils may raise the blood sugar levels.

Fiber

Fiber is an important dietary component in the fight for a healthy cholesterol balance and is found in vegetables, fruits, and whole grains. Recent studies on both men and women reported that diets rich in fiber from whole grains reduce the risk of diabetes 2. Fiber is good for the heart and helps improve blood glucose and insulin levels. The best sources of fiber are insoluble, found in whole grains, nuts, fruits, and vegetables. Pectin, a fiber found in apples, grapefruit, and oranges, may also protect against heart disease.

Vitamins and Other Nutrients

Many researchers are studying vitamins and other nutrients for their role as antioxidants, which contain particles of oxygen-free radicals. The unstable particles are by-products of many of the normal chemical processes. They can damage the cell membranes and interact with genetic material, possibly contributing to the development of a number of disorders including cancer, heart disease, and complications of disease. Antioxidants act as scavengers to help move these free radicals. Vitamin C, E, and A are powerful antioxidant vitamins that continue to be researched further. Vitamin E may also offer some protection against beta-cell deterioration in diabetes type 1 and help the nerve damage that occurs in diabetes.

Magnesium may have some role in insulin resistance and high blood pressure, but no supplements are recommended unless patients are found to have low levels of this mineral. Many type 2 diabetics are also deficient in zinc but more studies are needed to establish the benefits or risks of taking supplements. Sodium can raise blood pressure, and people with diabetes should limit their salt intake, especially if they have hypertension.

Alcohol and Caffeine

Wine appears to have some health benefits if used in moderation. A hypoglycemic reaction may occur if taking insulin. Caffeine elevates blood pressure, and caffeine may have a greater effect on people who already have high blood pressure. Drinking coffee also causes the excretion of calcium; so coffee drinkers should maintain a high intake of calcium. Studies have also indicated that unfiltered coffee raises LDL levels.

In conclusion, a diet for diabetics should be carefully monitored and contain mostly grains and vegetables. In researching a diet for diabetes, I have found that the diet is very similar to that of heart disease. Both diseases encourage a healthy lifestyle of exercise, and healthy eating which should have been these patients diet from the beginning. The timing, monitoring, fat and nutritious content, of foods are all important to a diabetic.

References

Eating disorders and diabetic complications. The New England Journal of Medicine, 6/26/97

No apparent benefit of liquid formula diet in NIDDM. Exp Clinical Endocrinal Diabetes 1997; 105(3): 134-9

The Facts About Fat. Consumer Reports on Health. March 1997