Weight control for Diabetics : Weight control for Diabetics By Rajni Kaul
Objectives : Objectives you will be able to understand the
importance of weight control for diabetics
assess the nutritional status
calculate ideal body weight & Body mass index
Slide 3 : Diabetes is a disease of metabolic disorder where pancreas produces less insulin, ineffective insulin or no insulin which leads to increase in blood glucose level.
Some of the clinical symptoms are
i) Polyurea- excessive urination
ii) Polydipsea - excessive thirst
iii) Polyphagia- Increased appetite
iv) Blurring of vision-
v) Delay in wound healing
vi) Lassitude & lack of energy.
Slide 4 : Diabetes is of two types-
Insulin dependent &
non-insulin dependent
For practical purposes we call it Type I & Type II Diabetes.
It has been researched that 80% of NIDDM cases are either overweight or obese. So it is very important for these patients to know about weight control.
Slide 5 : Patients which are insulin dependent may be underweight if they do not consume enough carbohydrate for the units of insulin consumed.
During periods of unusually intense exercise the person with Type I diabetes will need more food, since exercise has insulin like effect
So it is equally important for IDDM patients also to understand weight control.
Complications : Complications The complications arising due to uncontrolled diabetes are acute or chronic.
Acute complications are Hypoglycemia or hyperglycemia.
Hypoglycemia could be because of an overdose of insulin, decrease in the available glucose because of delay in eating, omission of food, loss of food by vomiting and diarrhea, increase in exercise without the modification of the insulin dosage.
Hyperglycemia is a state of severe insulin deficiency characterized with acidosis and elevated blood ketones, which may progress to coma.
Chronic complications : Chronic complications Chronic complications in uncontrolled diabetes may lead to:
Atherosclerosis-degeneration of walls of arteries.
Retinopathy -(cataract, blindness)
Nephropathy-changes occur in nephrons
Neuropathy-numbness in the upper or lower limbs
Infections –more prone to bacterial, viral & fungal infections. Wounds heal slowly. Foot ulcers very common.
Nutritional status of the patient : : Nutritional status of the patient : Assess the nutritional status of the patient :
To achieve weight control, it is important to assess the nutritional status of the patient.
Nutritional status can be assessed by anthropometric measures, biochemical tests, clinical observations& dietary regimens.
1.Anthropometric Data : 1.Anthropometric Data 1.Anthropometric Data means the height & the weight of the person.
One needs to periodically check height & weight for children & weight for adults& pregnant women to ensure that the meal plan provides appropriate energy .
Biochemical tests : Biochemical tests 2. Biochemical tests monitor the success of diabetes therapy .
Tests which indicate the nutritional status are GTT (glucose tolerance test), blood lipid concentration, blood or urinary ketones, urinary protein & Glycosylated hemoglobin
Clinical signs : Clinical signs Clinical signs are observed with the patients general appearance.
Nutrition oriented aspects of physical examination focus on skin, hair, eyes mouth, extremities & fat stores,
Signs of foot ulcers, foot infections, nerve damage dehydration, especially in older adults are observed.
Foot Ulcer : Foot Ulcer
Diet : Diet 4. Finally the dietary intake-it is important to have an accurate & thorough record of food intake& meal patterns.
Common methods used include the 24 hour recall method, food frequency method ,diet history etc.
One can maintain appropriate carbohydrate intake &energy intake. The quality of CHO is equally important. Carbohydrates which have more fibre should be preferred.
Physical Activity : Physical Activity Physical activities also play equally important role in planning & calculating the energy requirement.
Weight control is easy when the person has incorporated some exercise regime in daily routine.
Regular exercise programme leads to increased work capacity, cardiovascular efficiency, reduction in total fat stores & improved muscle tone
Calculations : Calculations Based on the assessment one can calculate
A) the ideal body weight &
B) body mass index (BMI)
which will clearly indicate the nutritional status of the patient.
Calculation for Ideal body weight : Calculation for Ideal body weight Ideal weight is calculated based on the age, sex, activity & the body frame of the patient .
Three types of frames are there Large, Medium& small. Allow 10% extra weight for large frame & subtract 10% for small frame.
Calculate Body Mass Index : Calculate Body Mass Index Assess nutritional status by calculating BMI
Another tool which is commonly used is the Body mass Index which provides the most useful method of measuring obesity.
It is a ratio between the weight &height of a person. Various grades of obesity can be calculated by body mass index (BMI)
BMI = Weight (Kg)
Height (m)2
Weight status according to BMI range : Weight status according to BMI range
Slide 21 : After assessing the nutritional status one can work on the energy requirement & plan a diet accordingly.
Thank you