Diabetes mellitus enteral nutrition

Diabetes is a group of metabolic diseases characterized by hyperglycemia. Hyperglycemia is caused by impaired insulin secretion or its biological effects, or both. The long-term hyperglycemia in diabetes leads to chronic damage and dysfunction of various tissues, especially in the eyes, kidneys, heart, blood vessels and nerves.

1. diabetes mellitus enteral nutrition

Intestinal nutrition in patients with diabetes is to supply the amount of calories, blood glucose control in the basic close to normal level, reduce the occurrence of cardiovascular risk factors, acute and chronic complications of diabetes prevention, improve overall health, improve the quality of life of patients;

The principle of enteral nutrition support varies from person to person, choosing a nutritional formula, input method, and dosage that can control blood sugar and blood lipids in a better state. The input or intake of enteral nutrition is closely related to blood glucose control and complications.

Blood glucose monitoring in enteral nutrition support: it is critical to monitor blood sugar strictly. All patients with EN support need regular and regular blood glucose monitoring, early detection of hyperglycemia or hypoglycemia, guiding the adjustment of EN prescriptions and hypoglycemic agents. The fluid and electrolyte state of the patient should also be evaluated regularly.

Total nutrition of diabetes

From the three major production nutrients (protein, fat and carbohydrate), the feeding of diabetic patients is not balanced. In addition to the three large capacity nutrients balanced, we should also pay attention to vitamin and trace elements.

Diabetic patients should meet the following technical requirements with all nutritive formula:

1)use formula with low glycemic index(GI), GI≤55.

2)Energy from saturated fatty acid should no more than 10%

3)Ratio of energy from CHO should be 30-60%, DF content should not less than 0.3g/100kJ (1.4g/100kcal)

4) Sodium content should be not less than 7mg/100kJ(30mg/100kcal) and not more than 42mg/100kJ(175 mg/100kcal)

3.Diabetic nutritional therapy

Control weight reasonably

strict control of calorie intake

Proportion of food distribution

Food intake and selection

Ø Carbohydrate(CHO): normally energy from CHO should be 55-65%. should control quality of CHO, and choose high content of complicate CHO

Ø FAT: Diabetes diet should appropriately reduce the fat supply. Energy from fat should be 20-30%, or intake based on 0.7-1.0 g/kg every day. Animal fat and saturated fatty acid should be limited intake, vegetable oil should be more than 1/3 of total fat, cholesterol intake should be less than 300mg everyday, When hypercholesterolemia is associated with hypercholesterolemia, it should be 200mg per day.

Ø Protein: improve the protein intake properly. (1)The plant and animal protein in proportion to the 2 to 1. (2)The main source of vegetable protein in a variety of beans and nuts. (3)The animal protein intake is also essential, is the main source to provide the necessary amino acids.

Ø Food fiber: cellulose rich foods can reduce fasting blood glucose, postprandial blood glucose and improve glucose tolerance, but also reduce the level of blood lipids in patients, and prevent arteriosclerosis.

Ø Vitamins , minerals and trace elements: major diabetic patients with lower vitamin B6 levels, vitamin B6 supplements to neurological complications could alleviate pain, numbness reduction, and adequate vitamin C supplementation could inhibit protein glycation, refined protein plays an important role in the chronic complications of diabetes. Beneficial to reduce diabetic retinopathy, nephropathy; appropriate sodium restriction, to prevent and reduce coronary heart disease, hypertension, hyperlipidemia and renal dysfunction and other complications; selenium could significantly promote the ability of cell uptake of sugar, which regulates glucose metabolism and insulin the same physiological activity.

Ø Sweetener: diabetes patients should not eat more sucrose, but the sweetener, such as Newt sugar, has the characteristics of small heat production and less consumption.