**9. Sodium**

Only in poorly controlled diabetes or in a period of recovering from ketoacidosis, the amount of protein should be greater than 2g/kg. The most important sources of protein are meat, fish and egg whites, but proteins are also represented in foods rich in carbohydrates

Excessive protein intake has also been implicated in the pathogenesis of diabetic renal disease and restricting its intake may retard the progression of nephropathy (Brenner BM., et al 1982)

The caloric mixture should comprise approximately 55% carbohydrate, 30% fat and 15% protein. A daily intake should be divided in 6-7 meals; breakfast and lunch should be repre‐ sented with 20% of total caloric needs, dinner with 30% and each snack should contain 10% of daily calorie inputs. Each meal should be taken at certain time during the day with no major or frequent deviations. A bed time snack is considered an essential part of the regi‐ men. This is necessary to prevent nocturnal hypoglycemia. The bed time snack includesat least 7-8g of protein, the amount equivalent to that in a meat or a milk exchange (7 to 8g).

Dietary fibers may be divided into soluble (found in fruits, oats, barley, legumes and root vegetables) and insoluble (found in wheat, wheat bran, grains and some vegetables). Soluble fibers are mainly hemi-cellulose compounds that bind water, bile acids and build seques‐ tered forms with monosaccharides and disaccharides; thus, they partially inhibit the action of digestive enzymes and slow down the process of absorption of food by increasing the time of intestinal passage. This action lowers postprandial glycemia and total cholesterol levels. These fibers also reduce the levels of lipids, cholesterol, LDL cholesterol and body mass. Soluble fiber supplements such as pectin, fiber from carob can improve metabolic reg‐ ulation. Insoluble dietary fibers have little effect on blood glucose and no effects on lipids, but may increase satiety and inhibit hunger, and thus induce positive effects in obese pa‐

By complying with a proper and balanced diet, people with diabetes daily take adequate amount of vitamins and minerals, so there is usually no need for pharmacological supple‐

Individuals on weight –reducing diet, strict vegetarians patients with poor metabolic control and patients in critical care environments require special attention and assessment. A sup‐ plementation therapy containing vitamins and minerals is most often needed in these cases. In animal models it was shown that chromium deficiency was often associated with elevat‐ ed blood glucose, cholesterol and triglyceride levels (Schrroeder HA, 1966;Wolscroft J et al,

ments. The exceptions are some trace elements-copper, selenium and magnesium.

(legumes, bread and cereals)

(Rudolph AM et al 1996)

tients with diabetes (Dimitrijevic-Srećković V., 2002).

**8. Micronutrients: Vitamins and minerals**

**7. Fiber**

476 Type 1 Diabetes

The American Heart Association recommends that sodium intake should not exceed 3000 mg/day, while other authors (National High Blood Pressure Education Program, 1993) rec‐ ommend not more than 2400mg/day. Individuals with mild to moderate hypertension should ingest no more than 2400mg of sodium daily (or less than 6 g/day of sodium chlor‐ ide). A study performed in mildly hypertensive subjects with diabetes on moderate dietary sodium restriction showed a reduction of approximately 20 mmHg in systolic blood pres‐ sure. A difference in diastolic blood pressure was not achieved (Dodson PM., et al 1989).

Routine supplementation with antioxidants, such as vitamins E and C and carotene, is not advised because of lack of evidence of efficacy and concern related to long-term safety.
