DIET AND EXERCISE FOR DIABETIC PATIENTS
Although no cure, people with diabetes could have a normal life. How to make blood sugar control with diet and regular aerobic exercise.
Diabetes is not a new disease. Since 1552 BC disease characterized by frequent urination in large quantities as well as a drastic weight loss, it's been known and referred to Polyuria. 400 BC, an Indian writer Sushratha named him "honey urine disease". Name diabetes mellitus (diabetes = flowed steadily, mellitus = sweet) finally given by Aretaeus about 200 years before Christ.
Managing the disease is actually easily from person to discipline yourself and do exercise regularly, follow your doctor's advice, and not easily discouraged.
Someone said to suffer from diabetes when blood glucose levels above 120 mg / dl in fasting conditions, and above 200 mg / dl two hours after eating. Another more obvious signs are positive if the urine contains sugar.
Diabetes appeared because of the hormone insulin is released by beta cells of Langerhans islands (the structure in charge of the pancreas that regulate blood sugar levels) no longer work normally. As a result, blood sugar levels to rise. If this situation continues and passes the threshold of the kidney, the sugars are excreted in the urine.
So far there are two groups of patients: those affected by diabetes since childhood or adolescence, and those affected when fully grown (mostly ages 50 and over). Young people with diabetes since most require insulin injections, while starting in adulthood does not.
Since the discovery of the hormone insulin by Banting and Best of Canada in 1921, people with diabetes who require insulin can be overcome so that the infant mortality rate and miscarriage in pregnant women who suffer from diabetes decreases. In addition to the hormone insulin, Franke and Fuchs (1954) tested and proven antidiabetic drugs help many patients.
Diabetes is an incurable disease, but with good care, each patient can live a normal life.
Diet and exercise
In addition to controlling blood sugar levels regularly, have a diet and regular exercise is the key to success pengelolaaan diabetes. In terms of food, for example, people with diabetes should pay attention to the dose of carbohydrates. For more than half the energy needs derived from these substances. According to dr. Elvina Karyadi, M.Sc., nutritionist from SEAMEO-TROPMED UI, there are two classes of the types of complex carbohydrates and simple types. The first has more than one chemical bond of glucose chains while others only one. In the body of complex carbohydrates such as bread or rice in, must be parsed into a single chain before being absorbed into the bloodstream. Conversely, simple carbohydrates such as ice cream, jelly, jam, syrup, soft drinks and candy, straight into the bloodstream so that blood sugar levels instantly soared.
Of the diabetic diet is recommended to consume more fibrous carbohydrates such as beans, vegetables, fresh fruits such as papaya, kedondong, apples, tomatoes, barking, watermelon etc.. While the fruits are too sweet like brown, orange, pineapple, rambutan, durian, jackfruit, grapes, not recommended.
Nutrition researchers from the University of Airlangga, Surabaya, Prof. Dr. Dr. H. Askandar Tjokroprawiro, classify the diet of two parts, A and B. Diet B with a composition of 68% carbohydrate, 20% fat, and 12% protein, more suitable for people of Indonesia as compared with a diet consisting of 40-50% carbohydrates, 30-35% fat and 20-25% protein. Diet B contained carbohydrate rather than high, also rich in fiber and low in cholesterol. Based on research, high-complex carbohydrate diet in divided doses, can improve the sensitivity of pancreatic beta cells.
Meanwhile, high in vegetable fiber type A (spinach, green beans, long beans, baby corn, squash, carrots, melon, young jackfruit) type B plus vegetables (cauliflower, fresh mushrooms, celery, bean sprouts, cucumber, squash, green peppers , water gourd, eggplant, tomatoes, mustard greens) will suppress the rise in blood glucose and cholesterol.
Red and white onions (shallots efficacious 10 times) as well as excellent beans if added in a diabetic diet because taken together can lower blood lipid levels and blood glucose.
3J pattern
Another nutritionist, dr. Andry Hartono D.A. Nutr., From Panti Rapih, Yogyakarta suggest 3J pattern: the number of calories, eating schedule, and type of food.
For patients who do not have a problem with weight is easier to count the number of daily calories. The trick, body weight multiplied by 30. For example, people with weight 50 kg, then the requirement is 1,500 calories a day (50 x 30). If you are running the sport in question, on the day to exercise calorie needs about a 300-plus calories.
Recommended feeding schedule with diabetes are more frequent portions. It means that the number of calories evenly throughout the day. The end goal for the workload of the body is not too heavy and abdominal salivary gland production is not too abrupt.
In addition to main meals morning, noon and night, light meals are also recommended on the sidelines of the time (an interval of about three hours).
That need to be limited is a high-calorie foods such as rice, lean meats, organ meats, egg yolks. Also high fat foods like ice cream, ham, sausage, cake, chocolate, beef jerky, fried food. Dark green vegetables and orange like carrots, green beans, spinach, caisim can be consumed in greater amounts, as well as fresh fruit. However, keep in mind if the person is suffering from kidney disorders, consumption of green vegetables and high protein foods should be limited so as not to overload the kidneys.
Calorie-restricted diet
The patient can follow the example of the arrangement menu for 2100 calorie diet B (Simbardjo and Indrawati, B.Sc. of the Hospital Dr nutritional science. Sutomo Surabaya) as shown in Table 1. High-fiber diet B was included general diabetes diet, which does not suffer from complications, not to fast or are pregnant.
B diet menu consists of:
Protein
Fat
Carbohydrate
Cholesterol
65.49 g
45.89 g
377.45 g
112.5 mg
Breakfast (6:30 pk.)
Rice
Meat
Tempe
Vegetables A
Vegetables B
Oil
110 g
25 g
25 g
100 g
25 g
5 g
Interlude (09:30)
Banana
200 g
Lunch (12:30)
Rice
Meat
Tempe
Vegetables A
Vegetables B
Oil
150 g
40 g
25 g
100 g
50 g
10 g
Interlude (15:30)
Banana / potatoes
Papaya
200 g
100 g
Dinner (18:30)
Rice
Meat
Tempe
Vegetables A
Vegetables B
Oil
150 g
25 g
25 g
100 g
50 g
10 g
Interlude (21:30)
Banana / potatoes
Papaya
200 g
100 g
While the guide book "Eating People with Diabetes by Planning Unit System" published by Clinical Nutrition and Diabetes Education Clinic Hospital Tebet, write about the basic principles of a diabetic diet, calories in accordance with the provision of basic needs. For women, the basic requirement is (Ideal Body Weight x 25 calories) plus 20% for the activity. As for the men, (Ideal Body Weight x 30 calories) plus 20% for the activity. To determine the ideal weight (BBI) can be taken benchmark: BBI = Height (cm) - 100 cm - 10%.
Example, a man plays the body 164 cm, weight 70 kg, the BBI = 64 kg - 10% = 58 kg. Basic caloric needs = 58 x 30 calories = 1740 calories. Activity calories plus 20% = 2088 calories. So, this man needs about 2,000 calories a day diet.
However, this formulation is not absolute. If the patient is sick, the activity changed, or is far from ideal body weight, the caloric needs will change. When the excess weight, reduced number of calories from basic needs. Conversely, if the patient has less weight, the amount of calories exaggeration of basic needs. Once reached normal body weight, total calories adjusted to basic needs.
The next principle is to avoid eating the consumption of sugar and foods containing sugar. Also avoid refined carbohydrate consumption of carbohydrate that is the result of a flour mill with all its products. Plus it reduces the consumption of fat in daily diet (animal fats, coconut milk, margarine, etc..), For patients with excess body fat in the blood.
That need to be reproduced exactly in the food consumption of fiber, particularly soluble fiber such as pectin (in apples), nuts, and seeds (not fried).
If the patient also has kidney problems, which need to be considered is the amount of protein intake. Generally, the formula used 0.8 g of protein per kilogram of body weight. If levels of cholesterol / high triglycerides, low-fat diet is recommended. When high blood pressure, reducing salt intake is recommended.
Failure patients on a diet could be due to lack of discipline in choosing the food or not able to reduce the amount of food calories. Patients can also ignored doctor's advice.
For ease of implementation, made the system unit 80 calories. Table 2 presents the food contains 80 calories per unit. For example, a patient who requires 1,600 calories per day, will receive 20 units of food a day worth 80 calories per unit. The number of 20 units divided into four units breakfast, snacks (pk. 10.00) two-unit, six-unit lunch, snacks (pk. 16.00) two units, and dinner six units.
The table below shows examples of the five food groups: staple foods, side dishes, vegetables, snack foods / ready to eat, fruit, and beverages.
Type of food
A
B
C
Staple food
Side dishes
Vegetable
Ready to eat
Fruit Snacks
Beverages
rice
Pepes fish
vegetable nodes
ketoprak
apple
lemper
tea / coffee
bread
satay
lodeh
hamburger
banana
croquette
mixed ice
French fries
rendang
knapsack
pizza
wine
lapis legit
soft drink
A group of food in berkomposisi arguably the best, because they contain fiber and low carbohydrate or low-fat and processed. While the class C is not good because of the high sugar content, low or no fiber, and too much fat. Thus, it is recommended to choose A or B, not C. Better than rice porridge, because the fiber content the better, so more time to survive in the intestine. Sugar sweeteners can be replaced with artificial sweetener.
Given here are examples of menus that can be followed (20 units or 1,600 calories):
Breakfast
Setangkap bread
Chicken egg
1 teaspoon butter
Skim milk 1 GLS
1.50 unit
1.25 unit
0.25 unit
0.75 unit
Interlude (in office):
Arem-arem
Tea without sugar
2.75 unit
Lunch:
White rice
Meat cah cauliflower
Spinach vegetable nodes
Papaya
1.25 unit
3.00 unit
0.25 unit
0.50 unit
Interludes pm
Pandan pancake (wet cake)
1 GLS melon juice
1.75 unit
0.50 unit
Dinner
Rice, vegetables, meat, fried fish, gado-gado
Tomato juice 1 GLS
3.75 unit
0.25 unit
Interludes night
1 banana
1.25 unit
By doing a regular diet and discipline definitely sugar levels under control.
Do not forget to exercise
In addition to considering the daily diet, the patient should do physical exercises. In principle exercise for people with diabetes are no different from that for healthy people. Also among the new or old patients. Exercise was mainly to burn calories the body, so that blood glucose can be used for energy. Thus the concentration of sugar can go down.
"I have many patients with diabetes. Only with exercise training they are able to live as healthy people without drugs," said dr. Hario Tilarso. Better to heal naturally, it's the principle. If the exercise, blood sugar can go down, why should the drug. The new drug is given that the decline alot so feared all sorts of complications arise.
"My experience shows, the people who do not depend on insulin, sugar can go down with just exercise. In fact, while attending a party, people with diabetes can eat a lot. But, the next he had to run to burn calories you have entered," he said.
People with diabetes who have long feared may have atherosclerosis (narrowing of blood vessels). However, with the exercise of cholesterol deposits in blood vessels will be reduced, so that the risk of heart disease also declined.
According to the sports physician at the Sports Center of Public Health (BKOM) DKI Jaya, the best type of exercise for people with diabetes who have chosen a high aerobic value, kind of brisk walking, running (jogging), aerobics, swimming, and cycling. Kinds of other sports, tennis, table tennis and even football, too don'ts home with extra attention.
FID (frequency, intensity, and duration) of exercise for people with diabetes in principle no different from those applied to healthy people. Exercise frequency is 3-5 times a week. "Instead, choose the appropriate time in the sun can burn more calories. This is dangerous because it can cause hypoglycemia, blood sugar shortage," said dr. Hario.
Only, patients who use insulin injections have to be careful. It should be noted that the peak time of insulin injected. "Do not let the peak of insulin to work, exercise patient. It will be a lot of blood sugar levels drop. If plus exercise, could be added down again, could get hypoglycemia," he said.
Thus, the insulin that is used must be known work, a short-acting or long acting. Typically, based on the condition of the patient, the doctor determine the type of insulin given. Well, exercise schedules tailored to the insulin it.
Intensity ranges from 60-75% DSM (maximum pulse rate, the calculation is 220 - age in years). Duration is approximately 60 minutes each time exercising at a training zone. For people with diabetes are obesity, duration can be added, eg 90 minutes. "With the addition of prolonged exercise, not only reduced blood sugar, body fat burned, too," said dr. Hario.
When the head of the drift
Weight training is also recommended for diabetics. "In addition to maintaining blood sugar levels, patients also maintain their muscle mass to keep muscles strong, so it could remain like any other production," he said.
Lodging is very severe, such as leg nerve is disrupted, the selected light exercise and not too much and loud The impact. For example cycling. That, too, have to be careful, especially when it happens to diabetic retinopathy (retinal disorders), because of the possibility of very large hemorrhage. When the disease is more severe, such as the sugar content above 400 are not allowed to move on, its handling is more left to the physician in internal medicine. "The choice is somewhat difficult. We have to be interdisciplinary. So, who can exercise only those who actually still active, there are no limitations on musculuskeletal, no arthritis, and other limitations."
While obese people with diabetes, the type of exercise combined with exercise for obesity. "Typically, the length is one hour, but two hours for example. That is, so that combustion more, her blood sugar dropped, and less body fat. If he really follow the rules, it does not matter," he said.
In the exercise, there are several things to note. The patient's blood sugar levels during exercise should be in the range 100-300 mg / dl. "More than 300 mg / dl occurred feared ketosis (excess ketones in the network), for example. Patients with very low sugar content are also prohibited from engaging in exercise. Meanwhile, if the concentration of sugar was normal and then do the exercise, fear of hypoglycemia even happened." To be safe, he said, people should be exercising with other people. If there's anything anyone can help.
People with diabetes should also be armed with little food or drink sweet things. Perhaps sweet rolls, candy, sweet tea. "If the head has begun to drift, just eat lunch or drink it in moderation. Also when cold sweat started out. Head floating in a cold sweat and it showed his blood sugar has dropped too much," said Hario.
In people with diabetes, when most of the sugar can lead to hyperglycemia and this could make the poisoning. But this effect is long. Rapid effect and can cause death even hypoglycemia.
Those who choose the type of sport that takes a long time, kind of tennis or football field, preferably every 30 minutes to consume glucose (food or sugary drinks). That way the blood sugar levels can be maintained so as not too down. Noteworthy also is the weather during exercise. At the very hot weather, a lot of insulin absorption. Means more blood sugar is absorbed again.
Maintain cleanliness and foot health is also important in the exercise. When jogging or walking, the foot will rub against the shoe. Therefore, the socks are worn must be clean. Shoes also have a soft interior to prevent blisters. Wear shoes appropriate use.
With the diligent exercise plus diet regulate and control blood sugar levels regularly, complications from diabetes can be avoided
Hopefully blogger Salam Help Posted By Febri Irawanto
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