daibetes by dr.amal haddad
TRANSCRIPT
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Nutrition for DiabetesAml HaddadPharmacy & Medical Sciences of
Clinical Nutrition
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Idiopathic
Type 1Diabetes Mellitus(absolute insulin
deficiency)
5-10 % of all cases
Circulating
Auto-antibodies
Immune-mediated
(Autoimmunity)
(viral infection,toxic
Diabetes: is a group of metabolic disorders byhyperglycemia
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GeneticFactors
Type 2 DiabetesMellitus
(insulin resistance;
insulin deficiency)90 % all cases
Environmentalfactors
Intake of
Excessive calories
Risk Factors(physicalinactivity,olderage,
obesity)
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Gestational Diabetes GDM (specific types):
Diagnosed during Pregnancy results from:
Genetic Syndromes, malnutrition, infections, drugs,
hormone---- insulin resistance ,7% of pregnancy
Pre-Diabetes :
Fasting or glucose tolerance test results above
normal.
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Diagnosing Diabetes:Fasting blood glucose (mg/dl)
1. Normal 100
2. Pre-diabetes 100-125
3. Dm 126
Random blood glucose:1. Normal 140
2. Pre -diabetes 140-190
3. Dm 200
Risk factors for diabetes:
1. Family history of type 2
2. Overweight , BMI 253. Cardiac Risk factors : LDL , Cholesterol ,hypertension
HDL.
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Protein glycosylation :
When blood glucose remains elevated
1. Overtime, tissues become glycosylated.
2. Glucose (sticks) to tissue.
Glycosylation damages blood vessels and
contributes to long-term complication
associated with poorly controlled diabetes.
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HEMOGLOBIN A1C LAB Test :
Measures the glycosylation of hemoglobin.
Indicates average glycemic control over past 3months.
Recommended: 7
A1 C BG
5 10
6 135
7 170
8 205
9 204
10 275
11 310
12 345
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Long term complication HBG conc.:
1. Blood vessels (CVD)
2. Eyes (retinopathy)3. Kidneys (nephropathy) Damage
4. Nerves (neuropathy)
5. Noun-healing wounds.
Pieces of the diabetes Puzzle:
insulin / medication Food / CHO
BG monitoring Exercise
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Hypoglycemia:
For BG 70 mg/dl
Take 15g of CHO:
1cup juice, 1 Tbsp sugar ,jam, honey
Recheck BG in 15 minutes.
Dont use items that contain fat delays absorption (no
chocolate ,ice cream ,cookies).
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Nutrition Management
Type 1 Diabetes:
1. Depend in insulin injection with food intake , consistency in timing
and amount of CHO eaten if on fixed insulin doses.
Adequate energy & nutrient in take to promote growth & development
in children .
Type 2 Diabetes:1. lifestyle strategies (food /eating and physical activity ) that improve
glycemia , dyslipidemia and blood pressure.
2. Nutrition education.
3. 5% -10 % weight loss
4. Blood glucose monitoring.
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NUTRITION THERAPY:
Balanced Diet
CHO 45-65% Kcal Starch ,milk, fruit ,Vega
Protein 20-35% Kcal Meat , eggs, cheese
Fat 10-35% kcal Oils, butter, nuts
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TABLE GLYCEMIC INDEX:
LOW GI 55 Medium GI 65-69 HIGH GI 70
Low-fat yoghurt with
sweetener
Rice Dates
Apples Honey White bread
Tomato soup, canned Cheese and tomato
pizza
Watermelon
Nuts Digestive biscuit Cornflakes
Beans Ice cream French fries
Fruits Pineapple, fresh Wafer biscuits
Vegetables Table sugar Rice cakes
Sweet potato Cake Corn chips
Pasta Raisins Watermelon
Noodles Potato, boiled Chips, potato
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Type 1 Diabetes Mellitus
Type 1
Diabetes Melllitus (absoluteinsulin deficiency)
Circulating
Auto-antibodies
Immune-mediated
(Autoimmunity)
(viral infection,toxicchemicals, ect.)
Idiopathic
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Type 2 Diabetes Mellitus
Genetic
Factors
Type 2
Diabetes
Mellitus(insulin
resitance;insulindeficiency)
Environmental
factors
Intake ofExcessive calories
Risk Factors(physicalinactivity,
olderage, obesity)