**10. Recommended foods**

A dietary intake of dark bread, rye, whole-meal bread, oats and barley flakes, porridge of maize flour, rice, spaghetti, potatoes, beans and lentils as a substitute for bread is recom‐ mended. Also, use of all kinds of vegetables (legumes, root and leafy vegetables) in the amount of 400-500 g/d (250g boiled, 250g fresh). All kinds of fruits are allowed, except for grapes, figs, prunes. The amount of fruit should be 500 g per day, divided into several in‐ stallments. In addition, fresh fruit has an advantage over the pressed juice, since it is rich in dietary fibers.


the aim to provide knowledge of flexible insulin meal–by-meal adjustments in order to match the carbohydrate content in a free diet.The groups consist of adult participants with type 1 diabetes of>2 years duration, without advanced complication, with HBA1c levels of 7.5-12%. DAFNE involves attending a 5-day training course plus a follow-up session around 8 weeks after the course and yearly half-day top-up sessions. The structured teaching pro‐ gram is delivered to groups of 6-8 participants and covers topics including carbohydrate es‐ timation, blood glucose monitoring, insulin regimens, hypoglycemia, illness and exercise. A significant reductions in HbA1-c were found after 6 ( -1.0%) and 12 months ( -0.5%) of inter‐ vention, respectively. Also, a significant improvement in quality of life and well-being and satisfaction with treatment scores was registered (Nutrition Sub-Committee of the Diabetes

**Carbohydrate**

**Meat**

Bread/starch 80 15 3 Trace Fruit 60 15 - -

Lean 55 7 3 - Medium fat 75 - 7 3 High fat 100 - 7 8

Skim 90 12 8 Trace Low fat 120 12 8 5 Whole 150 12 8 8 Fat 45 - - 5 Vegetable 25 5 2 -

**11. Nutrition recommendations for controlling diabetes complications**

If there was a family history of hypercholesterolemia (total cholesterol >240 mg/dl) or a fam‐ ily cardiovascular event before age of 55 years, or if family history was unknown, a fasting lipid profile should be performed on children >2 years of age soon after diagnosis (after glu‐ cose control has been established). If family history is not of concern, then the first lipid screening should be considered at puberty (≥10 years). All children diagnosed with diabetes at or after puberty should have a fasting lipid profile performed soon after diagnosis (after

**Grams of Protein Grams of Fat**

Nutritional Management in Type 1 Diabetes Mellitus

http://dx.doi.org/10.5772/52465

479

Care Advisory Committee of Diabetes UK, 2003).

**Exchange Calories Grams of**

**Table 3.** Nutrient composition of the exchanges

glucose control has been established

**Milk**

**Table 2.** (Connor H. et al. 2003)

The diet may contain dairy products - a skim milk, buttermilk, yogurt with 3.2% milk fat, cream, sour cream, butter, fatty cheeses and cheese. Lean meat (chicken, turkey, veal, beef, lamb, horse, deer, fish-river and sea), and cured meats from chicken, horse sausages, and sardines drained of oil are also recommended. Pork, duck, goose, sheep meat, fatty fish (cat‐ fish, perch, carp) should be avoided. The recommended intake is two poached eggs a week (in people with high cholesterol and triglyceride levels intake of yolk is not allowed). The use of vegetable fats is preferable (olive and sunflower oil) (Srećković V. Dimitrijevic, 2002).

The intake of starch should be provided by eating bread, grains, cereal, pasta, and starchy vegetables like corn and potatoes. They provide carbohydrate, vitamins, minerals, and fiber. Whole grain starches are healthier because they have more vitamins, minerals, and fiber.

The UK DAFNE Project (Dose Adjustment For Normal Eating) includes adults with type 1 diabetes participating in a group program. It is a kind of a group skills-based training with the aim to provide knowledge of flexible insulin meal–by-meal adjustments in order to match the carbohydrate content in a free diet.The groups consist of adult participants with type 1 diabetes of>2 years duration, without advanced complication, with HBA1c levels of 7.5-12%. DAFNE involves attending a 5-day training course plus a follow-up session around 8 weeks after the course and yearly half-day top-up sessions. The structured teaching pro‐ gram is delivered to groups of 6-8 participants and covers topics including carbohydrate es‐ timation, blood glucose monitoring, insulin regimens, hypoglycemia, illness and exercise. A significant reductions in HbA1-c were found after 6 ( -1.0%) and 12 months ( -0.5%) of inter‐ vention, respectively. Also, a significant improvement in quality of life and well-being and satisfaction with treatment scores was registered (Nutrition Sub-Committee of the Diabetes Care Advisory Committee of Diabetes UK, 2003).


**Table 3.** Nutrient composition of the exchanges

**Component Comment**

Total fat

478 Type 1 Diabetes

Sucrose

Total carbohydrate

Saturated+trans-unsaturated fat n-6 Polyunsaturated fat n-3 Polyunsaturated fat cis-Monounsatureted fat

**Table 2.** (Connor H. et al. 2003)

**Protein** Not"/> 1g per body weight

**Fiber** No quantitative recommendation

**Salt** Approx 6 g sodium chloride per day

**Vitamins and anti-oxidants** Encourage foods naturally rich in vitamins and anti-

harmful

The diet may contain dairy products - a skim milk, buttermilk, yogurt with 3.2% milk fat, cream, sour cream, butter, fatty cheeses and cheese. Lean meat (chicken, turkey, veal, beef, lamb, horse, deer, fish-river and sea), and cured meats from chicken, horse sausages, and sardines drained of oil are also recommended. Pork, duck, goose, sheep meat, fatty fish (cat‐ fish, perch, carp) should be avoided. The recommended intake is two poached eggs a week (in people with high cholesterol and triglyceride levels intake of yolk is not allowed). The use of vegetable fats is preferable (olive and sunflower oil) (Srećković V. Dimitrijevic, 2002).

The intake of starch should be provided by eating bread, grains, cereal, pasta, and starchy vegetables like corn and potatoes. They provide carbohydrate, vitamins, minerals, and fiber. Whole grain starches are healthier because they have more vitamins, minerals, and fiber.

The UK DAFNE Project (Dose Adjustment For Normal Eating) includes adults with type 1 diabetes participating in a group program. It is a kind of a group skills-based training with

< 35% of energy intake <10% of energy intake <10% of energy intake

45-60%

lipid metabolism

gastrointestinal health

supplements-not recommended 10-20% ( 60-70%) energy intake

Eat fish, especially oily fish, once or twice weekly. Fish oil

Up to 10% of daily energy requirements, provided it is eaten within the healthy diet. Those who are overweight or who have hypertriglyceridemia should consider using

Soluble fiber"/> has beneficial effect on glycaemic and

Insoluble fiber"/> no direct effect on glycaemic and lipid metabolism but its high satiety content may benefit those

malnourishment, cancer etc. there is no evidence for the use supplements and some evidence that some are

not-nutritive sweeteners where appropriate

trying to lose weight and its advantageous to

oxidants. With exception of some patients e.g.
