Diet and insulin in Type 1 diabetes
The key rule for the diet in insulin dependent diabetes is the food intake 5-6 times a day in small portions. This schedule of food intake presupposes to adapt the food intake to the action of insulin.
The greatest difficulty is associated with the preparations of long action insulin as in this case it is more difficult to adapt to them. If the food intake is missed, the level of sugar may fall abruptly and hypoglycemia develops. If too much carbohydrate is consumed, the hyperglycemia may arise; the case is that the long acting insulin produces smooth and gradual effect and cannot eliminate this phenomenon. The insulin absorption from the subcutaneous fat is oscillatory; the carbohydrate absorption in the intestines is also changeable, though in some cases it is possible to achieve synchronous action of food and insulin.
When, however, the insulin of short action is used in the therapy after each basic food intake in a combination with prolonged action insulin, which dose is reduced, the number of food intakes can be reduced. This treatment regimen allows reducing the risk of hyperglycemia occurrence after food intake as well as the risk of hypoglycemia. As a rule, these treatment regimens of basis-bolus therapy are effective enough; the daily dose of insulin is reduced and the tendencies to gaining body weight are not observed.
Main principles of diet in Type 1 diabetes
1. The caloric content of a daily diet is approached to the normal conditions, the contents of carbohydrates and vegetative fibers in food should be high and amount to 50-55 % of all calories;
2. Carbohydrates should be distributed according to food intakes depending on the number of insulin injections;
3. The amount of the carbohydrates influencing upon the level of blood sugar should be taken into account by means of using the system of CU and partition of carbohydrates into groups depending on glycemic index;
4. In excessive body weight and increased level of blood cholesterol it is necessary to limit the consumption of fats.
Such a diet is called a liberalized diet because it is quite free and flexible. It is possible to choose independently the dose of short acting insulin before the food intake depending on the amount of carbohydrates, which it is needed to consume. The modern estimation of carbohydrate value of products is exact enough, which allows reducing or increasing the dose of short acting insulin in reasonable limits. Such a treatment regimen for insulin therapy allows achieving a lasting effect without the development of diabetes complications.
To achieve this success, it is necessary to make a habit the carrying out of the curative actions connected both with the food intake and with introduction of insulin in due time. Such an experience is gained with practice, and practice can be got only taking an active part in one’s own treatment. Taking responsibility for one’s own health and the process of treatment, it is necessary first of all to start a diary and notice daily all due facts and the data. In experts’ opinion, keeping a diary is a mandatory condition of diabetes compensation. Gathered together, all collected data will allow estimating objectively the condition and progress of treatment. On the basis of these data, it is possible to make an individual diet, a diet with the greatest rationality, to adjust the style of work and rest. It is necessary to learn thoroughly the carbohydrate value of the products included in the diet, to check on a regular basis the working life of insulin. During catarrhal and infectious diseases as well as in weight gain of the body the requirement for insulin increases. The causes of development of labile, difficult-to-compensate diabetes are, as a rule, patient’s disorganization and laziness.