What kind of childhood diabetes diet is it? You know that children diabetes diet ate it? The following describes zgtnw "Children diabetic diet":
As social and economic development and changing lifestyles, the incidence of childhood diabetes, there have been a growing trend. Diet therapy is the most comprehensive treatment of diabetes emphasizes effective, the most basic treatment. In this paper, the principles of diabetes in children's diet, dietary precautions and implementing diet and exercise, medication, relationships are described.
Diabetes (diabetes mellitus) is a group of relative or absolute insulin secretion due, or the role of defects caused by lack of carbohydrates, fats, proteins and other metabolic disorders, and long-term high blood sugar as the main manifestation of the syndrome. Ⅰ type diabetes in children is mainly based insulin-dependent, but with the improvement of living standards and lifestyle changes, more and more obese children, Ⅱ incidence of diabetes increasing trend. Comprehensive treatment of diabetes stressed that diet therapy, exercise therapy, drug therapy, diabetes education and self-monitoring. Diet therapy is effective for any type of diabetes, the most basic treatment.
1, the etiology and clinical features:
Children with diabetes may be related to genetic, environmental factors and immune abnormalities, that is, on the basis of genetic stimulated by exogenous (eg viral infection) caused by changes in their immune function, so that destruction of islet β cells, leading to insulin-dependent diabetes mellitus; popular Disease studies have shown [1]: Ⅱ diabetes has obvious genetic predisposition, childhood obesity is an important factor in inducing diabetes, because obesity is caused by insulin resistance and not sensitive to common causes; too much too soon can increase the intake of milk Type Ⅱ diabetes risk [2]; In addition, frequent use of certain drugs (such as hormones) also allows blood sugar to induce diabetes.
Childhood diabetes in childhood has two peak age groups were 5 to 6 years old and 11 to 13 years old; most rapid onset diabetes in children together, a little more than three symptoms, about half of the symptoms of ketoacidosis, susceptible to infection. Chronic complications of kidney disease caused by microvascular disease and retinopathy more common, the occurrence of rare large vessel disease than adults.
2, diet therapy principles:
Growth and development of children with diabetes are at times, should not be restricted calorie intake, should meet their needs. Children should be slightly higher in calories, with age should be increased food intake; requirements of eating time, and quantity, to avoid overeating; proper control of heat in order to reduce the burden of pancreatic β cells, and to avoid ketoacidosis; with children age, height, weight, blood glucose, the amount of insulin injections, nutritional status, growth conditions, activity, complications, and normal eating habits, etc., to develop individualized diet plan.
2.1 Thermal
Children's individual situation should be combined with supply for each day. The total daily calories (kcal) = 1000 +100 × (Age -1) [3]; or press 0 to 4 years old 0.21MJ (50kcal) / kg.d, 4 ~ 10 years old 0.19MJ (45 ~ 50kcal) / kg.d, 10 ~ 15 years old 0.18MJ (40 ~ 35kcal) / kg.d [4]; Where malnutrition and wasting disease who weighed less than the standard weight, the total heat can increase, as appropriate; obese children should be controlled heat, and gradually lose weight.
2.2 Carbohydrates
Adequate intake of dietary carbohydrates can improve glucose tolerance and improve insulin sensitivity. But the high blood sugar can increase the burden of increased islet; too easily lead to excessive breakdown of fat, leading to ketoacidosis, usually 55% carbohydrate of the total energy to 65%. Should strictly control the quality of carbohydrates, choose complex carbohydrates (high glycemic index low) of food, such as: buckwheat, naked oats surface, the second joint surface (corn and soybean flour), triple surface (corn, soybeans surface and flour) and so on.
2.3 fat
To prevent and delay complications of diabetes should be appropriately reduced dietary fat supply. Fat, 20% of the total energy to 30%, or 0.7 ~ 1.0g/kg body weight per day. Should limit intake of animal fat and saturated fat, total fat, vegetable oil, at least 1 / 3; daily cholesterol intake should be less than 300mg, combined with high cholesterol should be a daily 200mg.
2.4 protein
According to the growth and development characteristics of children to fully ensure the demand for protein. General requirements 2.0 ~ 3.0g/kg body weight per day, 20% of the total energy, total protein animal protein not less than 33% to 50%, adding a certain amount of soy protein. Renal insufficiency, according to the degree of renal dysfunction, every day supply by 0.5 ~ 0.8g/kg body weight.
2.5 Vitamins, minerals
Vitamin and diabetes are closely related, especially vitamin B1, vitamin C, vitamin B12 and vitamin A, etc., should pay attention to add. Appropriate restrictions on salt, to prevent and reduce high blood pressure, coronary heart disease, hyperlipidemia and renal insufficiency and other complications; appropriate increase in potassium, magnesium, calcium, chromium, zinc and other elements added.
2.6 dietary fiber
Fiber diet reduces blood sugar and improve the effectiveness of glucose tolerance, and blood fat, blood pressure, reduce cholesterol, can reduce the patient's hunger and prevent constipation and promote excretion of toxic substances. But too much can affect the absorption of minerals and trace elements, the general energy per 1000kcal 12 ~ 28g dietary fiber supplement can.
3, diabetic diet in the implementation of children's Note:
3.1 The arrangements for food distribution and meal times
Usually combined with dietary habits, blood glucose increased urine time, taking hypoglycemic agents, especially insulin injection time and the stability condition and other factors, to determine the ratio. Eat small meals often as possible, regular quantitative, to prevent an excessive increase food intake islet burden, or one too little food intake, hypoglycemia or ketoacidosis. Distribution of food throughout the day according to 1 / 5 2 / 5, 2 / 5, 1 / 3, 1 / 3, 1 / 3 and 1 / 7, 2 / 7, 2 / 7, 2 / 7 ratio.
Cooking is 3.2
Dietary treatment of diabetes diet is weighing on the necessary food, should be in the skin before cooking, root, bone and other inedible parts removed and weighed, processed, and then cooking. No sugar added during the cooking process, with little or no fried cooking as much as possible, to use more fry, steaming, boiling, stewing, simmering, and other methods, onions, ginger, soy sauce, vinegar, spices without restriction. Children with diabetes require lifelong dietary treatment, usually both nutrient intake of dietary requirements according to the treatment, but also take into account the eating habits of age characteristics, as do varieties rich, delicious, texture soft, easy to digest.
3.3 food taboos
Strictly limit the honey, sucrose, maltose, fructose and other pure sugar products, such as the must eat sweets, can be used stevia, xylitol, aspartame and other sweeteners instead of sugar and sugar; high in sugar or fruit sugar content higher than 10% 15% of the fruit, such as persimmon, lychee, red fruits, sugar cane, do not eat as much as possible, the choice of low sugar watermelon, peach, apple, loquat to also be used tomatoes, cucumber, radish instead. Consumption of fruits, they should lose part of the staple food of the appropriate time to make proper arrangements, preferably in two between meals.
4, diabetic diet and exercise, drug relationship:
Children are characterized by lively, exercise on diabetes treatment is also very important. Proper exercise can reduce insulin resistance, improve blood glucose and lipid levels. However, properly handle the relationship between exercise and diet, exercise time, or after a meal usually selected 1h postprandial increase is appropriate, it is best not fasting for vigorous exercise to prevent hypoglycemia. Conditions by monitoring of blood glucose before exercise, too low, do not exercise or snacks after exercise, before exercise to the water, and bring food and candy bars for emergencies.
Drug treatment, especially life-long replacement therapy in children with insulin-dependent, diabetes diet plan need based on the reasonable application. Insulin injection and meal with insulin therapy is an important part of the general choice of fasting insulin 0.5h. Latest reports: Select 1h before a meal does not change the dose of insulin in the case, can effectively control the fasting blood glucose and postprandial blood glucose, but avoid eating the food shortage and delay caused by low blood sugar reactions [5]. This can be implemented with diabetes blood glucose monitoring provides a flexible insulin treatment. ◇
References:
[1] American Diabetes Association.Type 2 diabetes in children and adolescents. Diabetes care, 2000,23 (3) :381-389.
[2] Ma Xueyi. Finnish children's diet, milk protein antibodies and insulin-dependent diabetes mellitus risk. Chinese Journal of Diabetes, 1994,2 (4): 200.
[3] Ge Yu. Dietitian training materials in China. Beijing: People Health Press, 2005:529.
[4] Dong-Lian Cai. Modern diet therapy. Beijing: People's Medical Publishing House, 1996:338.
[5] Zhou Jin. Ⅰ type diabetes treated with insulin. Chinese Journal of Health Care, 2004,2 (2): 121.
Author: Xia Meilian (1965), female, Shandong, Qingdao, charge nurse, nursing, mainly in clinical nutrition.
