**5. Diet-planning strategies**

Dietitians offer several diet planning stratagems to help diabetic people for maintaining glycemic control. These stratagems emphasize control of saccharide intake and portion sizes. People using intensive insulin therapy must learn to match insulin injections with meals and to match insulin dosages to saccharide intake.

The first step is to determine an appropriate saccharide intake and suitable distribution pattern; an example is shown in **Table 9**. With the help of nutrition assessment, a person's usual energy and saccharide intake are estimated. Frequent monitoring of blood glucose levels can help determine whether additional saccharide restriction would be helpful [12]. We cannot consider a food's glycemic index without taking the glycemic load into account (**Table 10**).

The sample given in **Table 9** illustrates a meal pattern for a person consuming 8373.6 KJ (2000 Kcal) daily with a saccharide allowance of 50% of KJ.


**Table 10.**

*Sample saccharide distribution for 8373.6 KJ.*

Calculation : 50% � 2000 Kcal ¼ 250g saccharide per day 1000Kcal of saccharide÷4kcal*=*g saccharide ¼ 250g saccharide per day 250g saccharide÷15g 1 saccharide portion <sup>¼</sup> <sup>16</sup>*:*7 saccharide portions per day

Secondly, in type 1 diabetes, the insulin regimen must manage with the individual's dietary and lifestyle choices. People using conventional insulin treatment must maintain a consistent saccharide intake from day to day to tally their particular insulin prescription, whereas those using intensive therapy can adjust insulin dosages when carbohydrate intakes change.

Saccharide counting can be done either by counting the grams of saccharide provided by foods or by counting saccharide portions, expressed in terms of servings that contain approximately 15gm each. **Appendix 1** shows the serving size of different foods group containing 15gm saccharide, which is one saccharide count. One person


