Dietary strategies for the control of diabetes carbohydrates and lipids

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According to the American Diabetes Association, the goals of medical nutritional therapy for diabetes are to prevent and treat complications such as cardiovascular disease, hypertension, nephropathy, obesity and dislipidaemia, and include:

• achievement and maintenance of safe and near to normal or normal blood glucose levels;

• a normal lipoprotein profile'

• a change or improvement of health through food choices and physical activity'

• careful consideration of personal and cultural choices.

A healthy and balanced diet should provide enough calories for the daily energy requirement to maintain or achieve reasonable body weight, to provide for the needs of pregnant or lactating women, to allow for normal growth in children and adolescents and to satisfy the needs of ageing patients.

Attention should be paid to the daily energy requirement of children with type 1 diabetes, as they might lose weight at the onset of the disease. The weight-height charts used by paediatricians are useful to measure the adequacy of the energy intake. For adult type 1 diabetic patients, the daily energy requirement is not different from that of a normal individual. In this case it is also advisable to keep a desirable lean weight throughout life. However, for type 2 diabetes, since it usually occurs in overweight people, weight loss and behavioural changes are to be stressed.

In general, a healthy diet should provide 55 per cent of calories from carbohydrates, 10-20 per cent from protein and 30 per cent or less from fat.

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