United Nations Diabetes Day | Diabetic patients should be alert to malnutrition

November 14th is United Nations Diabetes Day, and this year's theme is "Know the Risk, Know the Response."

In the past, many people said that diabetes is a "rich man's disease" because eating too much and too well, and "overnutrition" will cause diabetes. Influenced by this saying, many diabetic patients dare not eat meat, staple food, or fruit in order to control their blood sugar... However, they often ignore a more dangerous factor - unbalanced nutrition, which is often called malnutrition.

Talking about diabetes and malnutrition together always sounds like a challenge to our common sense. Most diabetic patients, especially those with type 2 diabetes, are overweight or at least not thin, so how can they be malnourished?

In fact, domestic and foreign studies have shown that malnutrition is a common problem among diabetic patients. Among hospitalized patients with diabetes, more than 60% suffer from malnutrition or related risks, and the incidence of malnutrition among non-hospitalized patients is as high as 30%. Therefore, diabetic patients should be careful to prevent malnutrition.

Why does malnutrition occur?

Overly restrictive diet

Due to concerns about the impact of diet on blood sugar and body weight, many diabetic patients will deliberately diet, and some extreme cases will even stop eating staple foods. If the diet is overly restricted, the body can only supply energy by breaking down protein and fat when it lacks energy. The decomposition of fat will produce ketone bodies, causing ketosis. Excessive control of diet (insufficient intake of protein, calcium and vitamin D) will also accelerate the loss of skeletal muscle, leading to insufficient muscle strength, combined with osteoporosis, decreased balance and physical weakness, and even disability and death in severe cases. Long-term insufficient intake will cause protein to be broken down, leading to weight loss and malnutrition, and even more dangerous is the occurrence of sarcopenia.

Gastrointestinal lesions affect absorption

Diabetic gastroparesis is one of the more common complications of diabetes. Patients experience symptoms such as swallowing discomfort and abdominal distension. In severe cases, gastric retention, intractable vomiting, and difficulty eating may occur, leading to digestive disorders. Intestinal dysfunction can also cause chronic diarrhea and lead to malabsorption. In addition, the adverse reactions of some hypoglycemic drugs can cause digestive tract symptoms or affect the absorption and utilization of nutrients.

Incorrect exercise method

Over-emphasizing aerobic exercises such as jogging and fast walking, while ignoring resistance exercises, which we call "muscle-building exercises", can lead to rapid weight loss and muscle loss.

How can you reduce the risk of malnutrition?

First, diabetics should learn to “control their mouth” instead of “shut their mouth”.

Diabetic patients should implement an individualized energy balance plan to achieve or maintain their ideal weight while meeting nutritional needs in different situations, rather than controlling their diet in a "one-size-fits-all" manner.

Patients can first calculate their daily energy needs, and then arrange the intake of the three major nutrients through reasonable distribution: carbohydrates account for 45% to 65% of total calories, fat accounts for 20% to 35% of total calories, and protein accounts for 15% to 20%.

Then make slight adjustments based on blood sugar conditions: replacing some refined grains with whole grain carbohydrates (a combination of coarse and fine grains) is beneficial to blood sugar control; a low glycemic index/glycemic load diet is more effective in controlling blood sugar without increasing the incidence of hypoglycemia events.

Eating at regular times and in regular amounts, and following the order of soup - vegetables - meat - staple food, can help control blood sugar more smoothly.

When cooking, you can choose steaming, boiling, stewing, blanching, and mixing, and avoid frying, deep-frying, and braising. This can reduce fat intake and better control weight and blood sugar.

Eat more vegetables (daily vegetable intake is about 500 grams, with dark vegetables accounting for more than 1/2), and an appropriate amount of fruit with various types and colors.

Eat fish, poultry, eggs and livestock meat in moderation, and limit the intake of processed meat.

Drink 300 ml of liquid milk or equivalent amount of dairy products every day, and eat beans every day.

Limit oil and salt, control daily cooking oil to less than 30 grams (about 3 teaspoons), and less than 5 grams of salt per day (about one beer bottle cap).

Second, you need to master the correct exercise methods.

Appropriate exercise helps control blood sugar, control weight, promote appetite and increase muscle mass.

opportunity:

It is suitable for diabetic patients to exercise about 1 hour after a meal. Usually, blood sugar levels reach a peak about 1 hour after a meal. At this time, exercise is beneficial for lowering blood sugar and reducing the risk of hypoglycemia.

form:

The combination of aerobic exercise and resistance training is more effective in controlling blood sugar in patients with type 2 diabetes. Aerobic exercise is very helpful in improving metabolism, reducing weight, and improving cardiopulmonary function; resistance training can exercise muscles well, and muscles are conducive to storing glycogen and better utilizing blood sugar, which is very helpful for long-term blood sugar control.

strength:

When doing moderate-intensity exercise, the target heart rate should generally reach "150-age" but not exceed "170-age". This intensity of exercise has a significant effect on lowering blood sugar. Type 2 diabetes patients should do 150-300 minutes of moderate-intensity aerobic exercise, or 75-150 minutes of high-intensity aerobic exercise, or a combination of moderate-intensity and high-intensity aerobic exercise per week.

time:

When patients with type 2 diabetes start doing aerobic exercise, the exercise time should be controlled at 10 to 15 minutes each time; after the body adapts, it is recommended to increase the exercise time to at least 30 minutes each time, but does not include warm-up and cool-down exercises after the end. It is recommended to do 5 to 10 minutes of warm-up and cool-down exercises before and after each exercise.

frequency:

Aerobic exercise 3 to 7 times a week. Resistance training should be performed at least 2 times a week, and ideally gradually increased to 3 times a week.

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