Diabetes Mellitus Type 1
Type 1 diabetes mellitus is an endocrine-metabolic disease that negatively affects the pancreatic insulin secretion. In subjects affected by this disease the quantity of insulin produced by the pancreas is insufficient to ensure the proper functioning of the organism; consequently, it is necessary to resort to daily injections of synthetic insulin.
The pancreas, which has a promiscuous function (endocrine and exocrine), may suffer a reduction in its general or specific function due to causes: genetic, autoimmune, infectious, inflammatory, etc.
Insulin is an essential hormone for the body, because it regulates blood sugar by feeding massive glucose into certain specific tissues (muscle, heart and fat).
In case of type 1 diabetes mellitus, there is NO solution cure, but maintenance drug therapy. As mentioned, the reference drug is based on synthetic insulin, which can be injected intravenously.
The dosage and duration of action of the injected insulin vary according to the subjective characteristics and the type of food consumed in the meal. To learn more: Drugs to Treat Type 1 Diabetes Mellitus
Diet, Insulin and Diabetes 1
The type 1 diabetes mellitus diet is a very important aspect for the prevention of chronic complications due to hyperglycemia.
In healthy subjects, the glycemic surge is only postprandial. However, if the insulin is absent or insufficient, this condition of hyperglycemia lasts over time, causing various damages to: eyes, kidneys, nervous system, cardiovascular system and neurovegetative system.
Insulin injection is intended to prevent this circumstance by reducing postprandial blood glucose. Nevertheless, the quantity of drug must be chosen carefully, without deficit (for the reasons mentioned above) or exceeded. In fact, too much insulin is able to reduce blood sugar levels (hypoglycemia), causing serious reactions such as ketoacidosis and hypoglycemic shock (loss of consciousness, coma and death).
It is therefore understandable that the eating habits of the type 1 diabetic should be more or less standardized, in order to avoid complications in the short and long term.
On the other hand, if properly instructed, the subject is able to effectively manage his / her diet by modifying foods, portions and the level of physical activity.
When the parameters of glycaemia and glycated hemoglobin fall within the norm, the diet, physical activity and pharmacological doses can be defined as satisfactory.
Dietary principles
The nutritional organization of a diabetic must take into account above all the glycemic impact of food. The greater the knowledge of this variable, the easier the choice of food and portions will become.
Let's go into more detail:
Is it better to take proteins, fats or carbohydrates?
The body is able to maintain blood sugar from the energy macronutrients in food. Among these, the most effective are certainly carbohydrates; however, glycaemia can be maintained by using certain alternative molecules: protein amino acids, triglyceride glycerol, lactic acid and pyruvic acid (intermediate products of cellular respiration).
The higher the blood sugar level, the higher the patient's dose of insulin must be.
Meals that require higher pharmacological doses are those rich in carbohydrates. Of these, easily digestible carbohydrates and sugars that do NOT require any metabolic transformation (eg the conversion of fructose or galactose into glucose) are responsible for a more rapid glycemic spike.
With the same portion, there are factors that make it possible to limit the increase in blood sugar and the rate at which it rises (glycemic index); for example the concomitant taking of:
- proteins and lipids
- fibers
- plenty of water.
How should nutrients be broken down?
The simplest criterion to respect is that of the Mediterranean diet: 10-15% from proteins (never more than 20%), 25-30% of fats and 55-65% of carbohydrates (10-16% simple). To learn more: Diet allocation.
Many choose to adopt intermediate solutions, in which total glucides are decreased up to 50 or 40%, to the advantage of fats (30-35%) and proteins (15-20%)
A practical example is the following:
LUNCH
Pasta and Beans: Whole Wheat Pasta 40g, Dry Beans 40g, Total Water 500ml (hydration and cooking), Parmesan 10g, Extra Virgin Olive Oil 5g
Fennel Salad: Fennel 150g, Extra Virgin Olive Oil 5g
Wholemeal Bread: 25g
Apple: 150g
Drinking water: 2 glasses
Where are the carbohydrates found? Which? How many?
Food carbohydrates can be simple and complex.
Simple sugars are in fruit, vegetables, milk, honey, table sugar (fructose and sucrose), in desserts that contain them (drinks included) and in some cooked foods (toasted cereals, bread crust, etc.).
The complex ones (starch) are found instead in cereals, legumes and some tubers.
As anticipated, the amount of carbohydrates must be balanced with the right dose of insulin. Obviously, this requires a real count of total carbohydrates in the meal.
Many help tools are available to carry out this daily operation correctly, starting from actual training courses, up to the use of automatic calculators.
NB . Food labels are always an excellent expedient.
Other useful tips
After establishing the insulin dose related to the glycemic load and learning how to manage food, all that remains is to follow a balanced diet.
In fact, the nutritional recommendations for the type 1 diabetes mellitus diet are the same as for a common nutritional regime.
It is recommended to:
- Prefer fresh food, to the detriment of processed food and above all junk food
- Treating fiber, vitamins and minerals intake
- Emphasize the intake of natural antioxidants, both vitaminic and saline, and of other kinds (eg phenolic ones). These are contained above all in vegetables and fruit
- Reduce the amount and percentage of saturated or hydrogenated fats contained in junk foods, dairy products and fatty meats
- Reduce the amount of total cholesterol, contained above all in dairy products and fatty meats
- Favor the intake of essential fatty acids (AGE), especially omega 3 (more difficult to introduce with the diet). AGEs are found mainly in cold-pressed oils, oil seeds, blue fish and algae.
- Reduce the amount of sodium and increase that of iodine. Sodium may already be present in preserved foods (canned food, preserved meat, etc.) or added (called discretionary). Iodine is introduced mainly with fortified foods and food supplements.
- Reduce the amount of toxic molecules and foods that contain them. Among these we could mention all the carbonization residues, nitrates and nitrites, foods with pharmacological residues or pollutants, products with many food additives, etc.
