Type 1 diabetes mellitus (T1DM) is an autoimmune disease that results in destruction of the beta cells in the islet of Langerhans, leading to severe insulin deficiency. Diabetic control depend on both pharmacological treatment and lifestyle: behavioural science research in diabetes promotes lifestyle changes related to physical activity and nutrition. Medical nutrition therapy is very important in the primary prevention of diabetes, in the secondary prevention of diabetes complications, and in the tertiary prevention of associated morbidity and mortality. Persons with T1DM are subjected to widely varying dietary advice based in part on the putative effects of different foods on glycemic control. The American Diabetes Association (ADA) nutrition recommendations suggest that people with T1DM adjust insulin doses to meal content, meal size, and activity levels to achieve near-normal glycemic control. Day-to-day carbohydrate consistency has been suggested to be especially important for individuals using fixed daily insulin doses. Healthy dietary behaviour in T1DM is essential to have good nutritional status, which makes it possible to get good metabolic control (glycosylated haemoglobin [HbAlc] < 6%). It is important to recognize that there is no single measurement method to estimate body composition, however clinical, humoral and instrumental evaluations can show nutritional status pretty well. Clinical evaluations include Body Mass Index (BMI, kg/m2), skinfold thickness measuring at the subscapular (SSF), biceps (BCF), triceps (TCF), suprailiac (SIF) areas, circumference measuring at waist, hip, midarm (MAC), upper thigh (UTC). The ratios waist/hip (WHR), waist/thigh (WTR), and trunk/total skinfolds are calculated. The traditional total upper arm area, TUA = MAC2/4Π, upper arm muscle area, UMA = [MAC - (TCF×Π)]2/4Π, and upper arm fat area, UFA = TUA - UFA, as well as the new upper arm fat area estimate, UFE = MAC × (TCF/2), and upper arm muscle area estimate, UME = TUA - UFE, are also calculated. The plasma concentrations of some proteins, like albumin, retinol-binding protein, insulin-like growth factor I, etc, are used as visceral proteins metabolism expression. Bioelectrical Impedance Analyzer (BIA) doesn’t measure body composition directly, but it gives two bioelectric parameters: resistance (R, Ω) and reactance (Xc, Ω) offered by the body to the flow of 50 kHz alternating electrical current. People with diabetes have the same nutritional needs as anyone else: considerable evidence supports the importance of maintaining a 20 < BMI < 25 kg/m2, eating a nutritionally balanced diet. The recommended daily caloric intake (National Institute of Nutrition, LARN) is 25-30 kcal/kg/die, the caloric division between macronutrients is: 25-30% fat (satured < 7%, polyunsatured ≈10%), 55-60% carbohydrate, rich in fiber (25–30 g/day), and 15-20% protein. Cholesterol from the food may increase the blood cholesterol, so it is better to eat less than 200 mg per day (ADA). American Heart Association (AHA) dietary guidelines advice limiting salt (< 6g/day) and alcohol intake, and engaging in a regular physical activity (30–60 min on most if not all days of the week).
Body Composition and Type 1 Diabetes
MATTEUCCI, ELENA
2010-01-01
Abstract
Type 1 diabetes mellitus (T1DM) is an autoimmune disease that results in destruction of the beta cells in the islet of Langerhans, leading to severe insulin deficiency. Diabetic control depend on both pharmacological treatment and lifestyle: behavioural science research in diabetes promotes lifestyle changes related to physical activity and nutrition. Medical nutrition therapy is very important in the primary prevention of diabetes, in the secondary prevention of diabetes complications, and in the tertiary prevention of associated morbidity and mortality. Persons with T1DM are subjected to widely varying dietary advice based in part on the putative effects of different foods on glycemic control. The American Diabetes Association (ADA) nutrition recommendations suggest that people with T1DM adjust insulin doses to meal content, meal size, and activity levels to achieve near-normal glycemic control. Day-to-day carbohydrate consistency has been suggested to be especially important for individuals using fixed daily insulin doses. Healthy dietary behaviour in T1DM is essential to have good nutritional status, which makes it possible to get good metabolic control (glycosylated haemoglobin [HbAlc] < 6%). It is important to recognize that there is no single measurement method to estimate body composition, however clinical, humoral and instrumental evaluations can show nutritional status pretty well. Clinical evaluations include Body Mass Index (BMI, kg/m2), skinfold thickness measuring at the subscapular (SSF), biceps (BCF), triceps (TCF), suprailiac (SIF) areas, circumference measuring at waist, hip, midarm (MAC), upper thigh (UTC). The ratios waist/hip (WHR), waist/thigh (WTR), and trunk/total skinfolds are calculated. The traditional total upper arm area, TUA = MAC2/4Π, upper arm muscle area, UMA = [MAC - (TCF×Π)]2/4Π, and upper arm fat area, UFA = TUA - UFA, as well as the new upper arm fat area estimate, UFE = MAC × (TCF/2), and upper arm muscle area estimate, UME = TUA - UFE, are also calculated. The plasma concentrations of some proteins, like albumin, retinol-binding protein, insulin-like growth factor I, etc, are used as visceral proteins metabolism expression. Bioelectrical Impedance Analyzer (BIA) doesn’t measure body composition directly, but it gives two bioelectric parameters: resistance (R, Ω) and reactance (Xc, Ω) offered by the body to the flow of 50 kHz alternating electrical current. People with diabetes have the same nutritional needs as anyone else: considerable evidence supports the importance of maintaining a 20 < BMI < 25 kg/m2, eating a nutritionally balanced diet. The recommended daily caloric intake (National Institute of Nutrition, LARN) is 25-30 kcal/kg/die, the caloric division between macronutrients is: 25-30% fat (satured < 7%, polyunsatured ≈10%), 55-60% carbohydrate, rich in fiber (25–30 g/day), and 15-20% protein. Cholesterol from the food may increase the blood cholesterol, so it is better to eat less than 200 mg per day (ADA). American Heart Association (AHA) dietary guidelines advice limiting salt (< 6g/day) and alcohol intake, and engaging in a regular physical activity (30–60 min on most if not all days of the week).I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
