metabolic disorders- diabetes mellitus (dietary management (the need to…
metabolic disorders- diabetes mellitus
definition- diabetes mellitus is a group of metabolic disorders characterized by elevated blood glucose levels resulting from inadequate insulin action.
diabetes mellitus occurs as result of insulin deficiency or ineffective insulin action.
in insulin deficiency, the pancreas produces little or no insulin whereas in ineffective insulin action means that pancreas produces normal or excessive amount of insulin but the sensitivity of the target cells to insulin is decreased.
the organs that require insulin are the liver, skeletal muscles and adipose tissue.
glucose and amino acid uptake in the bloodstream fails. levels of free fatty acid in the blood circulation are elevated. ingestion of carbohydrates worsen the situation because they are metabolized into glucose in which the targets cells can not utilize thus increasing blood glucose level.
the aim of the treatment of diabetes mellitus are as follows:
the normalisation of insulin activity and blood glucose levels.
the prevention of vascular and neuropathic complications of diabetes mellitus.
obesity- the bigger body surface predisposes the ptient to increased uptake of glucose in the body which may result in alteration in glucose use.
diet and life style- a diet high i carbohydrates and sugar may predispose the individual to the development if diabetes mellitus.
genetic factors- the occurence of diabetes millitus is strong correlated with a positive family history.
the need to reduce weight in type ii DM may require carbohydrates restriction in the treatment is based on diet alone.
fat and protein should be present in meals to slow down the elevation of postprandial blood glucose.
the diet should consist of 55-65% carbohydrates, 12-20% protein and 20-30% fats.
dor all type of diabetes mellitus refined and simple sugars should be reduces.
the patient should have at least three meals per day and have some snacks in between them.
complex carbohydrates such as bread cereals, pasta and beans should be added in the diet to slow digestion of monosaccharides and disaccharides.
signs and symptoms
sores that do not heal
increasd thirsty and urination
unexplained weight loss
random plasma glucose level of more than 11.1 mmol/l of more than one occasion is diagnostic of diabetes mellitus
oral tolerance test- following of taking fasting blood glucose , a patient is asked to drink a concentrated glucose solution. blood levels are then taken half-hourly to determine how quickly is the glucose removed from the circulation.
fasting blood glucose of more than>8 mmol/l found on at least two occasions indicates glucose intolerance.
the diagnostic features of DM is abnormal high levels of blood glucose. the normal blood glucose level is 4-6 mmols/l