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1. Type 1 diabetes develops when the immune system mistakenly targets and destroys insulin producing cells in the pancreas, resulting in little or sometimes no insulin production. Without enough insulin, glucose cannot enter cells for energy, leading to increased blood sugar levels. DMII occurs when the body becomes insulin resistant or does not produce enough insulin to maintain normal blood sugar levels. This is caused by genetics, obesity, and a lack of activity. In DMII, the pancreas initially generates additional insulin to compensate for the resistance, but it eventually fails to keep up, resulting in high blood sugar levels (Clinic, 2024).
For someone with type 1 diabetes, it’s important to focus on a consistent carbohydrate intake to match insulin doses, along with monitoring blood sugar levels regularly. This means choosing complex carbohydrates like whole grains, fruits, and vegetables over simple sugars. Insulin therapy is typically necessary, with considerations for timing and dosage adjustments based on meal content and activity level. For DMII, managing carbohydrate intake is also important, along with portion control. Making sure to get enough exercise throughout the week is also essential for DMII. Medication options may include oral medications like Metformin, which works by decreasing glucose production in the liver and improving insulin sensitivity. Additionally, we need to know interactions between medications and food, as well as monitoring blood sugar levels to adjust treatment as needed. Some patients with DMII will require insulin therapy, which may involve a combination of long-acting and short-acting insulins to control blood sugar throughout the day (Diabetes Diet: Create Your Healthy-eating Plan, 2023).
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In diabetes, the body does not move glucose into the cells, leaving an excess of glucose in the blood. The difference between the two types of diabetes is the mechanism that causes blood glucose levels to rise. Type 1 diabetes is an autoimmune disorder where the body’s T-cells attack the pancreas (Silvestri, 2023). Beta cells in the pancreas are responsible for secreting insulin, but because of decreased beta cells, insulin is not produced as it should be. Insulin is a key for glucose to get into the cell, but because there is not enough insulin, glucose will not be able to get into the cell and stay in the blood, leading to hyperglycemia (Silvestri, 2023). In type 2 diabetes, the body produces average amounts of insulin, but cells are resistant to insulin, not allowing glucose to get into the cell like a “lock and key” dynamic. The key does not work for the lock, and glucose will not be able to get into the cell, leading to hyperglycemia.
There is no one perfect diet for someone with diabetes, regardless of type. There are popular diets like the Mediterranean-style diet, which has been observed to improve glycemic control and cardiovascular disease risk factors. There is a DASH eating plan that produces excellent results in reductions in glycemia, blood pressure, body weight, and -cholesterol concentrations (Reynolds, 2024). Regardless of what diet is chosen, the meal plan for a diabetic individual should be focused on keeping sugar levels at reasonable ranges.
A nutrition plan for a person with type 1 diabetes would include eating carbohydrates, protein foods, and non-starchy vegetables. A nursing consideration for this individual would be to avoid sugar-sweetened beverages so as not to raise blood sugar too much. A medication interaction for type 1 diabetics to be aware of would be those taking glucocorticoids, which increase sugar levels. Type 1 diabetics most of the time take rapid-acting insulin-like “insulin lispro,” which should be taken 30 minutes before meals (ATI. 2023).
A nutrition plan for a person with type 2 diabetes would include whole grains, fruits, vegetables, protein, beans, and dairy. A nursing consideration for this individual would be to eat fiber foods. These foods can help the person feel fuller for a more extended period. A medication interaction for type 2 diabetics is taking Metformin. Metformin is not insulin and instead allows the body to react to insulin efficiently. It is given to type 2 diabetics because they produce insulin, unlike type 1. Taking metformin together with insulin should give priority to sugar checks for a drop in sugar levels. Individuals with type 2 diabetes can be given long-acting insulin that is taken once per day (ATI. 2023). For example, “insulin glargine” works over 24 hours and is to be taken within one hour of the first meal.
