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| Sugar Blood Control |
Macronutrient has a significant relationship with blood sugar control in patients with Diabetes Mellitus. Diet in diabetics can help patients improve their eating habits to obtain a better metabolic control. A diet that is used as part of the management of Diabetes Mellitus is controlled based on energy content, protein, fat and carbohydrates. As a guideline used eight types of Diabetes Mellitus blood money.
There is a relationship between the intake of carbohydrates, fat and energy by controlling blood sugar levels outpatient Diabetes Mellitus. While macronutrient associated with diabetes in the regulation of blood sugar levels for type 2 diabetes mellitus patients:
Carbohydrate : Carbohydrates play an important role in nature because it is the main energy source for humans and animals are relatively cheap. Through the process of photosynthesis, chlorophyll plants with the help of sunlight is able to form carbohydrates from carbon dioxide (C) derived from air and water from the soil (Al matsier, 2004).
Glucose is the carbohydrate most important, were mostly carbohydrate in food is absorbed into the bloodstream as glucose and other sugars are converted into glucose in the liver. Glucose is the major metabolic fuel in mammals (except ruminants) and is a precursor for the synthesis of all the other carbohydrates in the body (Murray, 2009).
The principle of eating arrangements in persons with diabetes is almost the same with the recommendation for the general public that eating a balanced diet and in accordance with the calorie and nutrient needs of each individual. In people with diabetes need to eat emphasized the importance of regularity in terms of feeding schedule, type and amount of food, especially in those taking blood glucose lowering drugs or insulin (Perkeni, 2006).
Low carbohydrate diet is recommended because the effect on fasting blood sugar levels and 2 JPP. Carbohydrate intake is important to generate energy, national food and nutrition Academy recommended intake of Carbohydrates 45-65% of the total energy. In addition to the amount, it should be noted also the type of carbohydrates consumed, because the type of carbohydrate will affect blood sugar levels (Sheard, et al, 2004)
Carbohydrate composition that's recommended for diabetics according Perkeni (2006).
- Carbohydrates are recommended for 45-65% of total energy intake. - Restriction of carbohydrates total <130 g / day are not recommended
- Food should contain mainly high-fiber carbohydrates.
- The sugar in the seasoning is allowed so that people with diabetes can eat family meals together with the other
- Sucrose should not be more than 5% of total energy intake.
- Alternative sweeteners can be used as a sugar substitute, as long as does not exceed the safe daily intake (Accepted Daily Intake)
- Eat three meals a day to distribute the intake of carbohydrates a day. If required can be given a snack of fruit or other foods as part of daily caloric needs.
Protein : Protein is a source of amino acids that contain the elements C, H, O and N are not owned by fat or carbohydrates. Proteins can also be used as fuel when the body's energy needs are not met by carbohydrates and fats. Proteins involved also regulate various body processes, either directly or indirectly by forming substances in the body's regulatory processes.
The body does not have a backup as much protein as carbohydrates or fats. In the liver is only available pool of amino acids which are generally exhausted within a few hours. Therefore, especially the essential amino acid is always necessary to repair or replace (repair or replace) certain body parts (cells, enzymes, hormones, etc.) then the protein should be consumed every day. If not, an amino acid needed to be taken from the network. In people with diabetes are not well controlled, structural proteins are used to meet energy needs through the process of gluconeogenesis, so a lot of nitrogen excreted in the urine (Rahardja, 1999).
WHO recommended protein intake for adults 0.8 g / kg / day but some populations in Europe consume more than that. Epidemiology of high protein intake daily is one of the ingredients nepropathy in patients with DM.
Low protein intake can be beneficial for patients with DM who experienced changes in renal function. The recommended protein intake for patients with diabetes is between 10 and 20% of the total energy. (McGough, 2003). Protein intake is recommended for patients with DM is as follows - Needed for 15-20% of total energy intake
- Good protein sources are fish, seafood, lean meat, skinless chicken, low fat dairy products, nuts and beans (legumes), tofu, tempeh
- In patients with nephropathy have decreased protein intake to 0.8 g / kg body weight per day or 10% of energy needs and 65% should be of high biological value (Perkeni, 2006).
Fat : Lipids or fats are one of the elements contained in food. Fat is not soluble in blood plasma, except when bound to specific proteins. Our bodies need fat, especially for the production of various hormones and maintenance of nerve tissue in the body. But if excessive levels of fat, the fat will give very serious side effects, which is damaging the coronary vessels (Baraas, 1996).
Things to note on food intake Diabetes Mellitus is one of them fat intake should be regulated. As research conducted by Harding et al (2001) showed that there is a relationship between the number and type of fat intake with higher levels of HbA1c.
There is a positive relationship between intake of saturated fat with higher levels of HbA1c but not with monounsaturated and polyunsaturated fatty acids. Epidemiological and clinical evidence of animal experiments have confirmed that elevated levels of fat is a risk factor for atherosclerosis. Recommended either by the ADA (American Diabetes Association) and the EASD (European Association for the Study of Diabetes) that fat intake not more than 30% and less than 300mg cholesterol / day (Waspadji, 2006).
Fat intake recommended badi Type 2 Diabetes Mellitus:
- Recommended fat intake of about 20-25% of caloric needs. Not allowed to exceed 30% of total energy intake
- Saturated fat <7% of calories
- Polyunsaturated fat <10%, the rest from monounsaturated fat
- Raw foods should be limited is a lot of saturated fat and trans fat include: fatty meats and full milk
- Prompts the consumption of cholesterol <300 mg / day. Cultivated fats from sources of monounsaturated fatty acids (MUFA), limiting polyunsaturated fatty acids (PUFAs) and saturated fatty acids (Perkeni, 2006)
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