Diets - The Patients Point of View

Both the American Diabetes Association and the British Diabetic Association now recommend that at least 50% of total calories should be taken as carbohydrate. This applies to both type one and type two diabetics, regardless of whether total energy restriction is also applicable. Diabetics are being asked, therefore, to eat substantially more carbohydrate than their non-diabetic peers. Neither of these Associations has provided clear 

Weight (g) Food Energy (kcal) Protein (g) Fat Cg) CHO (g) Fibre (g) Sugar (g) 

The literature on dietary management of diabetes contains many contradictions. There are, however, remarkable consistencies in several respects, and the following broad conclusions can be drawn  

There are several aspects of diabetic dietary management which have not been covered in this chapter salt intake and the effect of carbohydrate and fiber on blood coagulation, minerals, and trace elements are examples. It is important to remember that a benefit from change in diet can be offset by other unforeseen effects. There are, however, no known detrimental effects attributable to the consumption of mixed Western diets rich in complex carbohydrate and fiber. The optimum proportion of calories to be taken as carbohydrate remains open to question. The British Diabetic Association has suggested 50-55%, and some studies have shown benefit when even greater quantities of carbohydrate have been used. For practical purposes, a 50% proportion seems a sensible aim, but it must be remembered that while this figure represents a considerable increase for most diabetics, all the studies cited in this chapter have involved a higher proportion of calories from carbohydrate. 

Finally, we must not forget that in the Western World the majority of diabetics are of maturity onset type and that the majority of these are overweight. Preoccupation with proportions of calories derived from carbohydrate, fat, and protein must not overshadow the prime importance of total energy restriction in these patients. Achieving sustained weight reduction remains the biggest problem in the dietary management of diabetes. 

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