Diabetes Mellitus is one of the major chronic diseases which can be prevented. The study was conducted to assess the carbohydrate intake of type 2 diabetic female patients of age from 45 to 50 years at diabetic clinic of Services Hospital, Lahore. The tools used for data collection were anthropometric measurements, biochemical analysis, clinical signs and dietary data. The findings of the study are; BMI of selected diabetic patients reflects that the majority patients (54 per cent) are overweight. HbA1C value of selected diabetic population is 9.0 per cent which indicated a high blood sugar level and poor management and control of diabetes. Multiple clinical signs and symptoms are present among diabetic patients. Hypertension is found to be the most common health problem in patients with type 2 diabetes. A strong family history and gestational diabetes history relates to the onset of type 2 diabetes. Majority patients have less than basal energy expenditure k-calorie intake. Majority patients have more than 3 meals with snacks in a day. An important finding is that carbohydrate intake of diabetic patients is 156g/day while requirement is for 200g/day. Fibre consumption is unsatisfactory in diabetic patients.
The combination of blood sugar controlling strategies (diet, medications and exercise) is followed by only a small percentage of patients. Majority patients are complying with a prescribed diet plan. Reasons for non compliance are also observed. The diet plan provided to diabetic patients is unsatisfactory and based on improper distribution of k-calorie between carbohydrate, protein and fat. It is recommended that balanced diet with adequate kilo calories and proper distribution of carbohydrates should be provided to the diabetic patients to prevent many health problems.
AWARENESS is needed on the management of diabetes.
ENCOURAGE patients to lead a normal healthy life and assure them that it is a manageable problem.
WEIGHT MAINTENANCE should be achieved for a good glycemic control.
OBESITY is the major risk factor and weight maintenance should be part of school education.
FAMILY HISTORY is also a major contributing factor and people should be screened and encouraged to adopt a lifestyle to delay the onset of diabetes.
EDUCATION LEVEL is an important factor for the better management and treatment of diabetes.
INDIVIDUAL NUTRITIONAL COUNSELING and nutrition education with special reference to patient’s carbohydrate intake is needed for much better control of glycemic levels; individualizing patient’s own variables, i.e. sex, age, body weight parameters, cooking methods, eating patterns and their lifestyles.
PROPER MEAL SPACING should be introduced to the patients for the best glycemic goals to achieve.
FLEXIBILITY in eating patterns should be encouraged to the patients, by providing them more food choices of selection with the same (amount) grams of carbohydrates.
PROPER DISTRIBUTION OF CARBOHYDRATE regarding quantity and quality be encouraged. Such low-calorie recipes should be developed that focus on complex carbohydrates, high fiber and low to moderate fat, and modified diets that help to produce a low-glycemic load after a meal and ultimately beneficial for improving blood sugar levels.
Much attention is needed in the control of portion sizes by the use of measuring cups, and with the visual aids, rather than written documentations for majority of illiterate patients so that the focus on amount is achieved for all diabetic patients.
Household chores; a part of physical activity was also ignored by diabetic patients. Such types of physical activity should be encouraged for diabetic patients.
Diabetes is a lifelong problem and must be managed and controlled to avoid complications. Every diabetic clinic must have a qualified dietitian in the health care team.
This is an excerpt from the Ghazala Pervez Zaman-supervised thesis of the writer, a Punjab University MSc Food and Nutrition student.