By Mohamad Yulianto Kurniawan, M.Sc.
Faculty of FoodScience and Nutrition
Type-2 Diabetes Mellitus (T2DM) is a major, non-communicable disease with increasing prevalence at a global level. Based on the latest of RISKESDAS result, diabetes prevalence has increasing over the past five years from 6.9% in 2013 to 8.5% in 2018. The new trend mentioned that people from all ages can suffer T2DM, due to less concerned with healthy eating pattern. Thus, despite of taking drugs, the main treatment for T2DM is healthy diet with balanced food composition. However, making a well-balanced diet for people with diabetes is hard because it needs the deep assessment and knowledge from the nutritionists while the number of the nutritionists is limited. So, it needs program to make it easier and give alternative solution for the patient to obtain a healthy balanced diet.
Don’t worry!! Nowadays, in this millennial generation, people can easily search for the information through the internet. So, what do you think is the best diet for people with T2DM?
From existing evidence, it is also possible that omega-3 fatty acids, low glycemic index foods, fiber-rich food (fruits, vegetables, whole grains, nuts, beans, and legumes) intake (1) and exclusive breastfeeding may play a protective role, and that total fat intake and trans fatty acids may contribute to the risk (2). Moreover, it is recommended eat regularly in small amount (4-5 times) and avoiding sugar and simple carbohydrates were recommended to diabetes person (3). He divided the meal plan into 5 times a day: morning (06:00-07:00); morning snack (10:00); lunch (12:00-13:00); afternoon snack (16:00) and dinner (18:00-19:00) with the intention to maintain the blood glucose in normal level.
Everything mentioned above are all the past recommendations. This approach did little to control diabetes. In fact, some people have difficulties controlling their intake, especially white rice. In Indonesia, there is an idiom said that “ Individual not satisfied yet if they have not eaten rice”. This habit is more likely unchanged. Therefore, The National Institutes of Medicine and the American Dietetic Association (ADA) recommend the use of Medical Nutrition Therapy (MNT) for effectively managing, preventing and treating diabetes. MNT is defined as “nutritional diagnostic, therapy, and counseling services for the purpose of disease management, which are furnished by a registered dietitian or nutrition professional” (4).
Nowadays, research has shown that people with diabetes can enjoy modest amounts of sugar, in the context of a healthy meal plan and with respect paid to the total amount of carbohydrate eaten. Patients should no longer be handed pre-printed diet sheets, or simply advised to quit eating sugar as a method to treat diabetes. The understanding of dietary management, also called Medical Nutrition Therapy (MNT), has evolved, so that individuals with diabetes now have options, such as carbohydrate counting, to help manage their blood sugar levels (5).
(1) American Diabetes Association. Standards of medical care in diabetes-2013. Diabetes Care. 20113 Jan; 36 (Suppl 1): S11-S66
(2) Steyn, N. P., Mann, J., Bennett, P. H., Temple, N., Zimmet, P., Tuomilehto, J., … & Louheranta, A. (2004). Diet, nutrition and the prevention of type 2 diabetes. Public health nutrition, 7(1a), 147-165
(3) Perwira, R. I. (2012). Sistem untuk konsultasi menu diet bagi penderita diabetes mellitus berbasis aturan. Jurnal teknologi, 5(2), 104-113.
(4) U.S. Department of Health and Human Services: Final MNT regulations. CMS-1169-FC. Federal Register, 1 November 2001. 42 CFR Parts 405, 410, 411, 414, and 415
(5) Morris, S. F., & Wylie-Rosett, J. (2010). Medical nutrition therapy: a key to diabetes management and prevention. Clinical diabetes, 28(1), 12-18.