Nutrition in Type 1
Diabetes
Most people with type 1 diabetes are of normal body weight, and
they usually do not need to be on a calorie-restricted diet. They also do not tend to have the cholesterol
abnormalities that are commonly seen in patients with type 2 diabetes.
The American Diabetes Association recommends that an adult should
obtain
• 45 to 65 percent of the total daily kilocalories in the form of
carbohydrates
• 25 to 35 percent of the total daily kilocalories in the form of
fat (of which less than 7 percent are from saturated fat)
• 10 to 35 percent of the total daily kilocalories in the form of
protein
These recommendations also apply to lean individuals without
diabetes. In other words, this is a normal, healthy diet.
You should have a good idea of how much carbohydrate you are going
to eat at a meal, because it will affect how much insulin you should take before the meal. Estimating the
carbohydrate content of a meal is called carbohydrate counting or carbohydrate exchange. You need two pieces
of information to count carbohydrates:
• You need to know the carbohydrate content of the food per unit
measure.
• You need to estimate the size of the food portion (for example,
by weighing it or using a measuring cup or counting slices).
You can think of food in 15-gram carbohydrate units: this is
equivalent to 1 carbohydrate exchange or 1 carbohydrate unit.
For each meal, count the total number of carbohydrates in all the
foods (typically anywhere from 30 to 105 grams), and then inject a dose of a fast-acting insulin analog
based on the amount of carbohydrates. For example, if your insulin to carbohydrate ratio is 1 unit for 15
grams carbohydrate, for a bagel containing 60 grams carbohydrate you would give 60 15 4 units
fast-acting insulin analog.
The insulin to carbohydrate ratio can vary according
to
• The time of day
• Your age
• The duration of diabetes
Although using ratios of insulin to carbohydrate allows you to eat
variable amounts of carbohydrates, some restrictions are still necessary. You should limit carbohydrates in
liquid form, such as juice and regular sodas, which are rapidly absorbed. You should also bear in mind that
the insulin injected can’t deal very well with large amounts of carbohydrates (over 105 grams at one time).
An exception to this rule is athletes, who can manage higher amounts of carbohydrates at one time (up to 150
grams).
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