Overview & Description

Diabetes mellitus, often called diabetes, makes it hard for the body to control the level of glucose in the blood. Glucose is the main form of sugar in the body.

There are three main types of diabetes:

• Type 1 Diabetes. This type used to be known as insulin-dependent diabetes mellitus, IDDM, or juvenile-onset diabetes mellitus. A person who has this type of diabetes makes little or no insulin. Most will need to take insulin shots one or more times a day.
• Type 2 diabetes. This type used to be known as noninsulin-dependent diabetes mellitus, NIDDM, or adult-onset diabetes. This is by far the most common type of diabetes. The person who has type 2 diabetes might make healthy or even high levels of insulin. But obesity often makes his or her body resistant to its effect.
• Gestational diabetes. This type is brought on by pregnancy. In most cases, this type of diabetes goes away after the child is born.

There are other types of diabetes that are less common. This group includes diabetes caused by:

• a genetic defect or pancreatic diseases
• hormonal problems
• being exposed to certain drugs or chemicals

What is the information for this topic?

A healthy diet for a person with diabetes is based on a nutritional assessment. This information is then used to prescribe the diet. This diet:

• is based on treatment goals
• takes into account what the person is able and willing to do
• is sensitive to cultural, ethnic, and financial factors

A proper diet for a person who has diabetes focuses on these overall goals:

1. It helps to maintain blood glucose levels as near to a healthy range as possible.

2. It helps keep blood lipids such as cholesterol at healthy levels to help reduce the risk of complications. This includes:

• HDL or so-called good cholesterol
• LDL or so-called bad cholesterol
• triglycerides
• VLDL, also called very-low-density lipoproteins

3. It provides enough calories to help keep a person healthy.

• For adults, it means the diet will help them maintain or reach a healthy weight.
• For children and adolescents, it means the diet provides enough energy to promote normal growth and development.
• For both groups, the diet should also allow for special events such as breast-feeding or getting over an illness.

4. It helps to prevent and treat complications of diabetes, such as high blood pressure and heart disease.

People who have any type of diabetes should follow these general guidelines:

• Protein: Depending on the person’s kidney function, the ADA recommends that 15% to 20% of his or her daily calories come from protein. The protein can be from both animal and plant sources.
• Fat: Less than 10% of the person’s daily calories should come from saturated fats. About 10% should come from unsaturated fats. Monounsaturated fats and carbohydrates should make up the other 60% to 70% of the total calories. The breakdown between fats and carbohydrates varies for each person. It is based on his or her goals for blood glucose and blood lipid levels, as well as weight.
• Cholesterol: The person’s intake of cholesterol should be less than 300 mg daily.
• Fiber: The person should choose a variety of fiber-containing foods, such as whole grains, fruits, and vegetables. Some studies have shown a positive effect on blood glucose levels from fiber. But a person would have to eat very large amounts of fiber to have this effect. So experts recommend a person stick with 5 to 9 servings a day of fruits and vegetables.
• Sodium: Sodium, or salt, intake should be no more than 2,400 mg/day for people with mild to moderate high blood pressure.
• Alcohol: Men should have no more than two drinks a day and women no more than one drink a day. One drink is 12 ounces of beer, 5 ounces of wine, or 1-1/2 ounces of distilled spirits. People who have a history of alcohol abuse or women who are pregnant should avoid alcohol. Those who have diabetes along with other medical conditions, such as pancreatitis, high triglycerides, liver disease, or neuropathy, should restrict or avoid alcohol.
• Vitamins and Minerals: When people who have diabetes eat a balanced diet with enough nutrients, there is often no need for extra vitamins or minerals. For some people, the doctor may recommend supplements.

A diet plan for a person with type 1 diabetes is designed to match insulin therapy with the person’s eating and exercise patterns. Mealtimes are planned around the effects of the insulin shots. The person measures blood glucose levels one or more times a day. Then he or she adjusts the dose and type of insulin as needed.

A diet plan for a person who has type 2 diabetes aims to keep the person’s blood glucose, blood lipids, and blood pressure at or near healthy ranges. Since obesity is the major cause of type 2 diabetes, weight loss is often a goal. The American Diabetes Association suggests taking the following steps to lose weight.

• Slightly decrease the number of calories eaten each day. Most often, this means 250 to 500 calories less than the average daily intake total that the person is used to eating.
• Follow a meal plan that contains healthy foods and less total fat.
• Become more physically active. Follow the exercise guidelines for a person with diabetes.
• Space meals throughout the day. This is especially true of carbohydrates.

A diet plan for a pregnant woman who has diabetes should be based on a nutritional assessment. This is true whether her diabetes is preexisting or whether she has gestational diabetes. A dietitian can help to create and adjust a meal plan based on:

• the needs of both mother and baby
• blood glucose levels
• ketones in the urine
• appetite
• weight gain