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There are different forms of diabetes: – from malnutrition; – gestational (in pregnancy): after pregnancy it may persist or “disappear”; – tasteless; – mellitus: you feel the need to drink continuously to dilute the sugars. We have studied diabetes mellitus in particular. Diabetes mellitus It can be:
1.Type I: DID or insulin-dependent (or juvenile) diabetes. We have an absolute insulin deficiency (caused by genetic factors – chromosome 6- and environmental – with the triggering of an autoimmune process against insulin-producing cells). Glycemia always remains high in the blood for this reason, therapy with the administration of insulin into the body is required. 2.Type II: NDID or non-insulin dependent (or senile) diabetes. In this case the insulin is produced but the receptors do not recognize it and therefore it is not used. For this reason, the therapy consists, in addition to weight reduction and regular physical activity, in the administration of a tablet that “awakens” the receptors so that they recognize insulin. This type of diabetes is typical of adulthood and is a consequence of other diseases such as obesity, hypercholesterolemia and hypertriglyceridemia. According to some statistics in Sardinia there is a high rate of diabetics, close to that of Finland. Several hypotheses have been made, one of these, although disproved, was the autoimmunity caused by cow’s milk. Italy: 6-8 people out of 100,000 Sardinia: 30 people out of 100,000 Finland: 43 people out of 100,000 Diabetes are mainly polydipsia and polyuria. Normal blood sugar is 100 mg / L; if the value exceeds 140 mg / L, the GP prescribes the glycemic or load curve which consists in the intake of 250ml of glucose solution. A withdrawal is made before taking, a second withdrawal after one hour, a third withdrawal after another hour and a fourth withdrawal after another two hours. Diet therapy Proper diet therapy should be introduced in both the DID patient and the NDID patient. The diet for diabetics is basically the same as that for non-diabetics. The diet program is developed on the basis of: 1. the subject’s caloric needs; 2. It is established in the content of the diet in proteins, glycides, lipids. Protides: (10-15%) both excessive protein restriction which decreases the deterioration of glomerular filtration, and excess protein, which increases the risk of nephropathy, must be avoided; Glycides: (50-55%) glycides stimulate the production of insulin: a diet low in glycides promotes ketogenesis and hyperlipidemia. The glycemic response varies according to both the quantity and the nature of the food, which is why a classification of food based on the glycemic index has been proposed. I Foods with low I.G. such as wholemeal pasta and rice and legumes are preferable to those with a high I.G. (bread, pasta and boiled potatoes). Simple glycides must be limited to avoid rapid changes in blood sugar and alcohol must be limited as much as possible. – Lipids: (30%) the preference goes to those of vegetable origin. It is necessary to limit the consumption of eggs due to the high cholesterol content concentrated on the yolk. Saturated fats must not exceed 10% and mono and polyunsaturated fats must be equal to 10%. – Fiber: the contribution of vegetable fiber is useful to reduce post-meal glycemic values. – Vitamins: especially in the elderly, it is necessary to supplement the diet with vitamins B and C. – Salt: limited use. – Sweeteners: fructose must be limited because it is converted into glycogen. Aspartame is an excellent sweetener (even if it is carcinogenic !!!). 3. Subdivision of meals: – Locate the meals in correspondence with the administration of drugs; – If you use intermediate or slow acting insulins it is advisable to have 5-6 meals a day; – The use of special dietary products is not recommended (because there is a risk of misuse;…) – Alcoholic beverages: they can promote hypertriglyceridemia; – Vary the foods. Diabetic Child: it is advisable to prepare dishes just for him to prevent him from feeling “different”.

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