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Diet in Type 2 Diabetes

A significant proportion of persons with type 2 diabetes are obese. Obesity increases the risk of developing type 2 diabetes and enhances the chances of developing coronary artery disease. Rapid weight gain in adult life especially predisposes to type 2 diabetes.

Many overweight diabetics can be treated by a reducing diet and in fact do not need insulin or tablets. With passage of time, most diabetics who were previously controlled by diet alone require drugs. A 1000 kcal diet is prescribed if an obese person leads a sedentary life, and a diet of 1200 kcal is advised if the obese diabetic leads a very active life. Or 250-500 kcals/day should be cut down from his/her usual diet. The total food allowance is divided into three meals, breakfast, lunch and supper and two small snacks, midmorning and afternoon. Breakfast should not be skipped. There is no "fattening food" or "slimming food". All foods provide energy to a greater or lesser extent. What matters is the total energy consumed. The secret is to avoid foodstuffs in which a lot of calories are concentrated in a small bulk, for example, cheese and have foodstuffs of low calorie value for example, leafy vegetables, vegetables with carbohydrate content of less than 10 per cent, high fibre foodstuffs etc. Noting down all the foodstuffs consumed every day and marking the energy rich foods consumed is a good exercise. In general, fats and concentrated carbohydrates should be cut down. Protein is not restricted.

Exercise should be taken within the limits of physical capacity. Initial weight loss is rapid and is due to loss of glycogen and water from the body. Subsequently the rate of weight loss slows down. Weight reduction is a slow process and weight loss should not be more than 2 kg/week. A lot of patience, self-discipline and motivation are essential for successful treatment. The diet should be reviewed if the expected weight loss docs not occur.

Even a moderate weight reduction improves glucose tolerance, reduces blood pressure, blood glucose and blood lipid levels.

Maintenance of the weight at the reduced level is important. Unless the person is very vigilant, relapse of obesity is very common.

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Diet in Type 2 Diabetes