Energy Requirements

A diabetic diet should be related to the patient’s needs, after considering such factors such as age, sex, actual weight, occupation and other physical activities.

Approximate ranges for various groups are:

1. An obese, middle aged or elderly patient with mild diabetes requires 1000-1600 kcal daily.
2. An elderly diabetic, but not overweight requires 1400-1800 kcal daily.
3. A young and active diabetic, including juvenile diabetics, require 1800-3000 kcal daily.
4. Pregnant diabetics also require 1800-3000 kcal energy daily.
5. Overweight young diabetics should have an energy intake of only 1800 kcal daily.

The proportion of energy derived from the carbohydrates should be 46%, protein 12% and fat 42%. But in most diabetic diets, the proportion of energy from carbohydrates should be 50-55%, from proteins between 10-15% and from fat less than 35%.

Carbohydrates

If the daily intake of carbohydrates has to be as high as 240 g to meet energy needs, about 50g is usually provided in each of the three main meals, 20 g in three snacks and 30g in 600 ml of mi&. Fruits containing fructose rather than those with sucrose and glucose bou1d be included because fructose may not raise the blood sugar level as much as sucrose or glucose, it may raise plasma triglyceride more.

Proteins

Proteins should be included at each meal, because amino acids stimulate insulin secretion in both normal and in maturity-onset diabetes. A smaller rise in blood glucose occurs when carbohydrates is consumed along with proteins. 50g of proteins or more should be a must for all diabetics unless the patient is obese.

Fat

Because diabetic patients have increased risk of death from coronary heart disease, and because this may be related to the amount of saturated fat in the diet, the total amount of fat should be restricted even in those who are not obese.