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Type 1 Diabetes: Lifestyle & Nutritional Impacts




What is type 1 diabetes?


In Type 1 diabetes the pancreas can do longer release insulin. This is important because insulin is needed to move sugar (glucose) out of the blood and into muscle, brain, and other target cells where it is used for energy. The high blood sugar that results can lead to a number of complications such as kidney, nerve, and eye damage, as well as cardiovascular disease. Moreover, cells are not receiving the glucose they need for healthy functioning.


The loss of insulin secretion is typically caused by auto-immune destruction of the insulin-producing islet beta cells in the pancreas. Because people with type 1 diabetes can no longer produce their own insulin, they must inject insulin. Keeping blood sugar steady, by matching carbohydrate intake with the appropriate insulin dose, can prevent long-term complications of type 1 diabetes. Type 1 diabetes cannot be cured, but it may be managed.


Diet / nutrition / lifestyle choices the patient makes will certainly impact (good or bad) the progression of the known risks associated with diabetes (damage to the cardiovascular system, kidneys, eyes, nerves, blood vessels, skin, gums, and teeth).


Why are following the guidelines of a type 1 diabetes diet plan important?


While there are no absolute diet restrictions in type 1 diabetes, healthier food choices can make control a lot easier. For example, meal timing is very important for people with type 1 diabetes. Meals must match insulin doses.


Most people with type 1 diabetes use a long-acting insulin (also called basal insulin or NPH), which means it will continue to lower blood sugar over 24 hours. This means it will lower blood sugar even if there is no glucose from dietary carbohydrates to act upon. Because of this, skipping a meal or eating late puts a person at risk for low blood sugar (hypoglycemia).

On the other hand, eating a larger meal or a meal that contains more carbohydrates that normal will raise blood sugar more than the basal insulin can dispose of. In this situation, a short-acting insulin (also called regular insulin) must be given in the appropriate dose to match the carbohydrate content of the meal and the level of blood glucose before eating.


Eating meals with a low glycemic load (index) makes meal timing easier. Low glycemic load meals raise blood sugar slowly and steadily, leaving plenty of time for the body (or the injected insulin dose) to respond.


People who use continuous glucose monitoring and insulin pumps instead of finger sticks and injecting insulin have a little more flexibility in their meal timing because they have real-time feedback to help them match carbohydrate intake with insulin. However, everyone benefits from becoming more aware of their dietary intake, making diet restrictions to stay consistent with a low glycemic load diet, and matching their meals with appropriate insulin doses.


Paying attention to meal timing and glycemic load enables people with type 1 diabetes to keep their blood glucose levels relatively stable. Stable blood sugar prevents the complications of hypoglycemia and hyperglycemia, as well as minimizing / preventing the long-term complications of type 1 diabetes.




What are glycemic load and glycemic index?


Glycemic index and glycemic load are scientific terms used to measure the impact of a food on blood sugar. Foods with low glycemic load (index) raise blood sugar modestly and thus are better choices for people with diabetes. The main factors that determine a food's (or meal's) glycemic load is the amount of fiber, fat, and protein it contains.


The difference between glycemic index and glycemic load is that glycemic index is a standardized measurement per fixed amount of the food, and glycemic load accounts for a real-life portion size. For example, the glycemic index of a bowl of peas is 68 but its glycemic load is 16 (lower is better). If you just referred to the glycemic index, you'd think peas were a bad choice, but in reality, you wouldn't eat 100 grams of peas. With a normal portion size, peas have a healthy glycemic load as well as being an excellent source of protein.


One way to pay attention to glycemic load is similar to carb counting. For example, if you are about to eat a cup of whole wheat pasta with 35 grams of carbs and it also has 5 grams of fiber; you can subtract the 5 grams of fiber from the total carbohydrate because the fiber is reducing the glycemic load of the pasta. Thus, a rapid-acting insulin dose should be given to cover 30 grams of carbohydrate. You also can learn to follow a low glycemic load diet by looking at lists of dietary restrictions, or understanding how to add fat, fiber, or protein to a meal.


What is the best “diet” for Type 1 Diabetes?


In general, the Mediterranean Diet Plan is the dietary pattern that can be most easily incorporated. This refers to the true Mediterranean pattern traditionally followed in the south of Italy and Greece; not "Americanized Italian," which is heavy in pasta and bread.


The Mediterranean pattern includes lots of

  • fresh vegetables

  • some fruit

  • plant-fats such as olive oil and nuts

  • fish such as sardines

  • occasional meat and dairy

This type 1 diabetes diet plan is full of very nutrient-dense foods, meaning you get a lot of vitamins, minerals, phyto-nutrients and other healthful properties for every calorie consumed.


Nutritional Support Considerations




Dynamic Cardio-Metabolic is a delicious drink formula containing a comprehensive mix of macro- and micronutrients. Dynamic Cardio-Metabolic promotes overall health and well-being by supporting healthy blood glucose and blood lipid profiles.

It is an easily digested, low-carbohydrate source of pea protein isolate and organic brown rice protein with concentrated levels of vitamins, minerals, plant sterols, BCAAs, and prebiotic fiber. Dynamic Cardio-Metabolic contains no artificial sweeteners, gluten, GMOs, or added sugars, only stevia and natural flavors.









Gluco IR is a high quality vitamin and mineral supplement formulated with a proprietary blend of natural extracts and powders which may assist with helping to supportR balancing healthy blood glucose levels already in the normal range.




According to James W Russell, MBChB, professor of neurology, anatomy, and neurobiology at the University of Maryland, Baltimore, "There are now convincing data that low vitamin D levels predispose to developing diabetes. Even though we may not have the definitive evidence for diabetic neuropathy or prediabetic neuropathy, it's highly likely that it's predisposing you to developing diabetes, and there's an association with worsening diabetes early in the disease, and it probably is affecting neuropathy as well,”"The key problem is, nobody is going to make money from vitamin D [research and development], so nobody's pushing it. It's extremely cheap."


Source: American Diabetes Association 2015 Scientific Sessions; June 6, 2015: Boston, Massachusetts.




The evidence available from experimental studies and clinical trials supports our suggestion that the modulation of the intestinal microbiota by probiotics may be effective towards prevention and management of T1D and T2D. The findings discussed here provide an insight into the investigation of further hypotheses aiming to elucidate molecular mechanisms involved in the modulation of intestinal microbiota by probiotic administration, their roles on the development of T1D and T2D and potential effectiveness for clinical practice.



Reference: Nutrition Journal 201413:60, DOI: 10.1186/1475-2891-13-60 - "Gut microbiota, probiotics and diabetes”.



References


  1. Chronic Disease Overview | Publications | Chronic Disease Prevention and Health Promotion | CDC. Cdcgov. 2017. Available at: https://www.cdc.gov/chronicdisease/overview/. Accessed March 15, 2017.

  2. A Fletcher J. The Second Meal Effect and Its Influence on Glycemia. Journal of Nutritional Disorders & Therapy. 2012;02(01). doi:10.4172/2161-0509.1000108.

  3. Higgins J. Whole Grains, Legumes, and the Subsequent Meal Effect: Implications for Blood Glucose Control and the Role of Fermentation. Journal of Nutrition and Metabolism. 2012;2012:1-7. doi:10.1155/2012/829238.

  4. St-Onge M, Ard J, Baskin M et al. Meal Timing and Frequency: Implications for Cardiovascular Disease Prevention: A Scientific Statement From the American Heart Association. 2017.

  5. Glycemic index and glycemic load for 100+ foods – Harvard Health. Harvard Health. 2017. Available at: http://www.health.harvard.edu/diseases-and-conditions/glycemic_index_and_glycemic_load_for_100_foods. Accessed March 15, 2017.


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