The patient with diabetes mellitus has insufficient insulin secretion for his needs in metabolizing carbohydrates. As a result, the diabetic suffers from high blood sugar, glycosuria, thirst, loss of weight, and ketosis due to the production of keto-acids from improper fat metabolism. If the situation degenerates to uncontrolled diabetes, a severe case will prove fatal from acidosis as ketoses accumulate in the blood. Not all cases however are severe, in some; insulin supply is adequate if the diet is moderate in calories and in carbohydrates.

In others, the diabetic patients must be given insulin in quantities sufficient to deal with the carbohydrate in their diet. The management of these cases requires skill from the doctor and dieticians, and insight from the nurse who is looking after the patient during the time when the insulin and dietic requirements are being balanced.

Mild or Moderate Case
Diabetes occurs in a mild form in middle aged patients, and is often only discovered in the course of investigation of some other condition. Such people are usually overweight and frequently women. Insulin is often not needed, provided the weight can be reduced and a low carbohydrate diet adhered to. All sugar must be omitted and starch reduced as in all obesity diets. As the weight falls, the sugar in the urine decreases and may eventually disappear.

Moderate or Severe Cases
These people, who are usually children and young adults, have insufficient insulin for their metabolic needs and it must be given to them by injection. All that is given here are some of the principles used in constructing diabetic diets for patients needing insulin. If he is receiving insulin, he must have a diet matched to it; if he is given insufficient insulin, ketones will appear in the blood stream and diabetic coma will ensue. While if his insulin is excessive, in relation to his carbohydrate intake, it will lower his blood sugar until hypoglycemia and its attendant symptoms occur.

Some physicians advocates the free-diet treatment in which the patient eats what he likes, and his insulin dosage is stabilized according to the severity of his disease. This relies on the fact that most people's calorie consumption is fairly constant. It is attractive to patients because they are not troubled with diabetic calculations, but in practice control of the blood sugar is not very good, and some of the long-term complications of diabetes, such as nephritis, seems to occur more commonly in people treated in this way.

The patient's carbohydrate needs are estimated, according to his age, weight and type of work. As a rule, only the carbohydrate need be weighed. A new diabetic is best stabilized in hospital and usually begins with a diet with a carbohydrate intake of 150 G and a calorie value of 1,500. His insulin is then adjusted until the urine is sugar-free, and then the diet and the insulin are raised together until the diet is sufficient for the patients need in the outside world.

Apart from dietary management of diabetes, other factors that can help a diabetic patient put the condition to an absolute check and live a healthy live are;

• Exercise: Doing light exercises can also help put diabetes conditions to a minimum level. Exercise like climbing a staircase is advisable.

• Insulin injection, if need be. Drugs are strongly not advised because of their possible adverse effects on some organs of the body. If drugs must be involved, it should be upon the recommendations of a experienced medical practitioner.