NASIHAT UMUM KEPADA PESAKIT DIABETES

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NASIHAT UMUM KEPADA PESAKIT DIABETES

• Tingkatkan pengambilan fiber pada setiap
• waktu makan.

Buah-buahan boleh diambil bersama makanan utama.
Susu tepung/UHT tanpa perasa boleh diminum 2
gelas sehari.
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NASIHAT UMUM KEPADA PESAKIT DIABETES
Kurangkan makanan tinggi kandungan lemak
kolesterol kerana pesakit diabetes lebih
berisiko mendapat penyakit kronik yang lain
seperti sakit jantung, darah tinggi, buah
pinggang dan sebagainya.
Turunkan berat badan jika pesakit mengalami
masalah berlebihan berat badan.
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NASIHAT UMUM KEPADA PESAKIT DIABETES

• Lakukan senaman secara berkala sekurang-
• kurangnya 3 kali seminggu 20 minit setiap sesi.

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MAKANAN YANG PERLU DIELAKKAN

• Glukosa
• Gula putih dan merah
• Madu
• Semua jenis sirap
• Jem
• Kaya

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• Kordial
• Biskut manis
• Semua minuman ringan
• Gula-gula
• Coklat
• Buah-buahan dalam tin
• Susu pekat manis
• Semua makanan yang ditambah gula

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MAKANAN YANG PERLU DIKAWAL

• Nasi, mee, bihun, keow teow, spageti, makaroni,
  oat
• Roti putih/mil penuh, roti bun, biskut krim
  kraker.
• Capati, tosai, idli, putu mayam
• Ubi kentang, ubi kayu, labu merah, sengkuang,
  kacang dal, kacang kuda, jagung.
• Buah

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MAKANAN YANG BEBAS DIMAKAN

• Sayur-sayuran
• Semua jenis sayuran hijau, berdaun, timun,
  ulam-ulam dan tomato

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• Perasa dan rempah.
• Lada hitam/bunga cengkih
• Esen vanila
• Pemanis tiruan
• Contoh Aspartam
• Cecair tanpa gula
• Kopi, teh, air mineral, air limau nipis dan air
  kosong, sup jernih.

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SPECIAL TOPICS
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FASTING DURING RAMADAN

• Safe for most people except
• Brittle (uncontrolled) type 1 DM
• Poorly controlled type 1 or 2 DM
• Those known to be non-compliant to drug regimen,
  dietary daily activity advice
• Those with serious complications.
• Those with recent history of / prone to DKA
• Pregnant
• Those with intercurrent infections
• Elderly individuals with any altered conscious
  state or living alone
• Those with gt episodes of hypoglycemia during
  previous Ramadan

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FASTING DURING RAMADAN

• Start practising fasting in the month of Rejab /
  Shaban. This will help in the adjustment of
• Diet
• Drug regimen
• Physical activity
• Recognition of warning symptoms of dehydration,
  hypoglycemia, and other possible complications
• The need for monitoring of blood glucose body
  weight

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FASTING DURING RAMADAN

• Dietary adjustment
• Never skip sahur, taken as late as possible
• Do not delay berbuka, 1 2 dates at start may
  be taken as part of CHO allowance
• Supper after Tarawikh may be taken as replacement
  of pre-bed snack
• High fibre CHO is encouraged at all meals,
  include fruits vegetable at both sahur
  berbuka
• Limit fried / fatty foods
• Limit highly salted foods to reduce risk of
  dehydration
• Sufficient fluid to replenish fluid loss during
  the day

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GLYCAEMIC INDEX (GI)

• GI is a classification of how high and how fast
  particular CHO foods raise blood sugar. It
  compares the way CHO foods raise blood sugar with
  the way white bread (index 100) raises it.
• For a person with Diabetis, a low GI is
  preferable but the primary nutrition intervention
  which focuses on educational approaches i.e.
  reduced energy intake, modest weight loss and
  basic CHO counting has been shown to be more
  effective in glycaemic control than the low GI
  approach on its own.
• Brand Miller, 2003

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GLYCAEMIC INDEX

• If the concept of GI in dietary advice is chosen,
  it must incorporate with other nutrients
  especially fat, fibre salt content.
• I.e Ice cream ? ? GI but ? fat , Carrots ? ? GI
  but ? nutrients
• Substituting low GI for high GI foods (Brand
  Miller et al, 1996)

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GLYCAEMIC INDEX REFERENCE
120
- Honey
110
- Watermelon
- French fries
100
HIGH
REFERENCE
- Bread
90
- Ice cream
- White Rice
80
70
MEDIUM
- Parboiled Rice
60
- All bran
50
- Apple
- Milk skim
40
- Grapefruit
LOW
30
- Fructose
20
- Yogurt
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HIPOGLISEMIA

• Hipoglisemia ialah keadaan di mana paras gula
  darah terlalu rendah dari tahap normal (lt
  3.9mmol/L).

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GEJALA HIPOGLISEMIA

• Terasa lapar
• Loya
• Berpeluh-peluh
• Menggigil/sejuk
• Kabur penglihatan
• Letih
• Peningkatan degupan jantung

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Ia berlaku disebabkan oleh

• Tidak mengikut jadual makan yang betul, makan
  terlalu sikit atau menukar masa makan.
• Terlalu banyak senaman yang tidak dirancang tanpa
  makanan sampingan sebelum melakukan senaman.

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• Makan ubat berlebihan atau menukar masa makan
  ubat
• Tekanan
• Kesan sampingan ubatan lain
• Pengambilan alkohol

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LANGKAH MENGATASI

• Ambil makanan seperti -
• 1 biji gula-gula
• atau
• ½ cawan jus buah
• atau
• 1 gelas minuman bergula

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• Diikuti dengan
• 1 keping roti
• atau
• 2 keping biskut
• atau
• sedikit buah-buahan
• !!!Jika pesakit tidak sedarkan diri, jangan beri
  apa-apa makanan dan bawa berjumpa doktor.

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CONTOH MENU (1500 Kcal)

• Sarapan pagi (7.30 pagi)
• 2 keping roti mil penuh
• 1 ekor ikan sardin
• 1 cawan salad/timun/tomato
• 1 gelas susu rendah lemak
• 1 sudu teh minyak/marjerin dibenarkan

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• Minum pagi (10.00 pagi)
• 1 keping popiah basah
• Teh o tanpa gula
• Makan t/hari (1.00 t/hari)
• 1 ½ cawan nasi
• 1 ketul ayam goreng
• ½ cawan sup sayur campur
• 1 potong tembikai
• 1 sudu teh minyak
• Air kosong

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• Minum petang (5.00 petang)
• 1 biji pau ayam
• Kopi o tanpa gula
• Makan malam (7.00 malam)
• 1 ½ cawan nasi
• 1 ekor ikan stim
• ½ cawan sayur goreng
• 1 potong betik
• 1 sudu teh minyak
• Air kosong

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• Minum malam (10.00 malam)
• 1 gelas susu rendah lemak
• 1 keping roti mil penuh

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CONCLUSION
The ideal diet

• Limit carbohydrate
• Low Fat
• Low Glycemic Index
• High Fiber
• 3 meals 3 snacks

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THANK YOU