Nutrition in Diabetes

Diabetes is a disease that occurs when your blood glucose, also called
blood sugar, is too high. Blood glucose is the main source of energy and
comes from the food we eat. Insulin, a hormone made by the pancreas,
helps glucose from food get into our cells to be used for energy. It is a
metabolic disorder characterized by high blood glucose level due to a
decreased ability or complete inability of the tissues to utilize
carbohydrates, accompanied by changes in the metabolism of fat, protein,
water and electrolytes. The disorder is due to a deficiency or diminished
effectiveness of the hormone insulin, produced by the beta-cells of islets of
Langerhans of pancreas. The metabolic derangement in long standing
cases is frequently associated with permanent and irreversible, functional
and structural changes in the vascular system of the body characteristically
affecting the eye, kidney and nervous system.

Causes of diabetes

Diabetes is the result of lack of effective insulin action. Insulin is a hormone

secreted by the beta cells of islets of Langerhans which are an endocrine
portion of the pancreas. Some minute quantities of insulin are also known
to be secreted by the muscle tissue for its own use. For this reason
moderate amount of muscular exercise (long walks, swimming, etc.) is
always advocated for diabetic patients. This hormones is necessary for
release of energy from glucose, which is a simple sugar obtained from
carbohydrate sources.

Lack of insulin may be either absolute or relative. Absolute insulin

deficiency does not occur normally. It occurs only in patients whose
pancreas has been operated upon for the removal of a malignant tumour.
In a majority of patients, however, the disease develops apparently
unprovoked probably as a result of a hereditary predisposition, i.e.an
inherent weakness of beta cells.
PRIMARY CAUSE OF DIABETES

·​ ​Heredity:​ There is a familial tendency to develop diabetes

but the specific biochemical defect and the mode of
inheritance has not been identified. If both parents are
diabetic, all their children would be diabetic if they live long
enough and if one parent is a diabetic and the other a
diabetic carrier, half of their children would be potential
diabetics. If one parent is a diabetic and the other a
non-diabetic and also a non-carrier, none of their children
would be diabetic, but they would all be carriers.

·​ ​Age:​ The disease may occur at any age but about 80

percent of the cases occur after the age of 50 years.
Diabetes is thus mainly a disease of the middle aged and
elderly.

·​ ​Gender:​ In the younger age groups, diabetes is more

commonly seen in males than in females. In middle age,
women are more affected and the chances increase with
pregnancy and increasing parity.

·​ ​Obesity:​ There is a strong association between diabetes

and obesity but it is uncertain whether obesity is the result or
the cause of diabetes. The majority of middle-aged diabetic
are obese, while only a minority of obese people develop
diabetes. Whether an obese individual develops diabetes or
not is probably dependent on genetic factors. Obese people
are also less physically active than normal weight individuals
which increases the risk of diabetes.

·​ ​Dietary factors:​ A high intake of sugar has been related to

obesity and may predispose to diabetes as seen in Indians
in South Africa. A low intake of fibre due to consumption of
 refined foods is associated with high prevalence of diabetes
prosperous communities.

·​ ​Stress:​ Physical injury or emotional stress may be caused

by unmasking latent diabetes by eliciting adrenocortical
response. Surgical operations and severe infections may,
therefore, be contributing factors in precipitating the disorder.

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