Does the patient have high blood pressure?
You said that the patient does not have high blood pressure, so we need to consider whether the cerebral hemorrhage is due to cerebrovascular disease caused by diabetes.
The patient has two diseases, so he has to prioritize, including the diet. If he is in the bleeding period, he must follow the diet for cerebral hemorrhage. Of course, he must first control the cerebral hemorrhage. Then he must follow the diet for diabetes. For cerebral hemorrhage, the diet should be high. Protein, high vitamin, low fat, light and easy to digest nutritious foods, such as fish, soy products, grains, soybeans, etc. Avoid spicy and greasy foods (such as strong tea, coffee, fried foods), and eat more vegetables and fruits. Keep your bowel movements clear. For patients with facial paralysis, semi-liquid foods such as milk paste and porridge can be fed. When eating, the food must be delivered to the healthy side (the area without facial paralysis). The feeding speed should be slow to prevent the patient from choking and coughing, causing suffocation. If the condition is critical and swallowing is difficult, the doctor will insert a gastric tube and give nasal feeding fluids to ensure nutritional supply.
However, because all patients have diabetes, if cerebral hemorrhage cannot be controlled, if this is the case, Strictly follow the dietary method for diabetes. Dietary choices for diabetics outside of main meals:
In addition to planning the daily intake of calories and the three major nutrients, people with diabetes should also pay attention to outside of main meals. diet. Fruit Fruit is rich in vitamins, minerals and soluble fiber (pectin). Pectin can reduce the rate of glucose absorption and reduce fat absorption, so it has lipid-lowering and hypoglycemic effects. However, because the sugar content of fruits is higher than that of vegetables, for example, watermelon has a sugar content of 4.2%; peaches, pears, and bananas have a sugar content of about 8% to 10%; apples, sweet oranges, and tangerines have a sugar content of about 11% to 13%; bananas, persimmons, and lychees About 14% to 16%; dates, sugar cane, and red fruits about 20%. The main sugars in fruits are monosaccharides and disaccharides such as glucose, fructose, and sucrose. They are absorbed quickly and can easily increase blood sugar. Whether diabetics can eat fruits or not depends on their own circumstances. And achieve the following points: 1. I can seriously self-manage diabetes, insist on regular monitoring of blood sugar and urine sugar, and the blood sugar has been controlled at a relatively good and stable level; 2. Try to avoid dried fruits with high sugar content and choose sugary ones. Low-cost fresh fruits (such as watermelon, strawberry, etc.); 3. It is best to eat fruits on an empty stomach and between meals, starting with a small amount, such as half an orange or apple, no more than 10Og. To subtract the corresponding amount of staple food from the treatment plan, generally 200g of oranges or apples need to be subtracted from 25g of staple food. Sweeteners People with diabetes should not eat sugary sweets. Only sugar substitutes, that is, sweeteners, can be used to satisfy the taste. Currently used are xylitol, stevia, and saccharin. Xylonic acid can produce a certain amount of heat, and the promoting effect of insulin is only needed in the later stages of metabolism. After taking xylitol, for normal people and well-controlled diabetic patients, the amplitude and speed of blood sugar rise are lower than those of glucose and sucrose. However, the absorption rate of xylitol in the intestine is low, and eating too much can easily cause diarrhea and increase blood triglyceride concentration. Therefore, xylitol is only suitable for well-controlled diabetic patients, and the daily dosage should not exceed 50g. The sweetness of saccharin and stevia is about 300 to 50O times that of sucrose. They provide no calories and no nutrients. Some people have suggested that semen can induce bladder cancer, but recent studies have shown that it is safe if the daily dosage is less than SOO~1000mg. However, saccharin can cross the placenta and pregnant women should avoid taking it. Drinking alcohol has no nutritional value except providing calories. Each gram of ethanol produces 29.3kJ (7heal) of heat energy. Excessive drinking suppresses appetite and aggravates nutritional deficiencies. Long-term drinking may damage the liver, pancreas, reproductive system, and blood vessels, and increase blood triglycerides. In addition to the above adverse effects of drinking alcohol for diabetic patients, it also disrupts and interferes with the diet plan, inhibits gluconeogenesis, and induces hypoglycemia in patients who are injecting insulin or taking sulfonylurea hypoglycemic drugs such as Youjiang. Ketoacidosis. Therefore, in principle, people with diabetes should not drink alcohol. But a moderate amount of wine can increase appetite and eliminate fatigue. If you drink alcohol, you must pay attention to the following points: 1. Good blood sugar control, no chronic diseases of other important organs or complications of diabetes; 2. Do not inject insulin and take oral sulfonylurea hypoglycemic drugs; 3. Normal liver function; 4. Drink alcohol Eat at regular intervals to avoid hypoglycemia; 5. Drinking amount: wine should not exceed 100-150ml each time; beer should not exceed 350ml. If you do not drink liquor, the above-mentioned amount of alcohol is approximately equivalent to 25g of staple food. It should be subtracted from the diet plan. Drinking alcohol should not exceed 100ml per week. More than 2 times.
Eating methods for diabetics:
It is advisable to eat small meals frequently, no less than three meals a day, and arrange meals in the morning and afternoon and before going to bed if possible, which not only ensures absorption, but also Reduce the burden on the pancreatic islets;
The amount of breakfast should be small, as liver glycogen decomposition is strong in the morning, and post-breakfast hyperglycemia is prone to occur. For example, the ratio of three meals a day can be 1/5, 2/5, 2/5; eat regularly and eat less snacks during meal times; implement it strictly and stick to it for a long time.
Patients with diabetes should not eat too much salt:
For understanding of diabetes, doctors usually regard dietary restriction, especially restricting the intake of foods with high sugar content, as an important prevention and treatment method. Instruct the patient. However, less attention has been paid to limiting salt intake. Modern medical research shows that too much salt can enhance amylase activity to promote starch digestion and promote the absorption of free glucose in the small intestine. It can cause an increase in blood sugar concentration and aggravate the condition. Therefore, diabetic patients should not eat more salt.
How to manage the diet of emaciated diabetic patients:
Most diabetic patients are obese, but some patients are not obese and are even emaciated. Do they not need to control their diet? Of course you need to control your diet! Diabetes does not distinguish whether you are fat or thin. If you do not control your diet, your blood sugar will be out of control. Of course, for patients with weight loss, the caloric intake can be appropriately relaxed, but the specific diet should still be arranged in accordance with the golden rules of nutritional therapy. You can use your body weight as a measure of whether your caloric intake is appropriate.
·It is necessary to distinguish whether the current weight remains stable or continues to decrease, because long-term poor blood sugar control or other wasting diseases such as tuberculosis, anemia, etc. will cause weight loss. After blood sugar is well controlled, the weight will remain stable. . ·Check with your doctor whether your treatment drugs are suitable and adjust them in time.
·Confirm that there are no other organic diseases.
Nutritional treatment plan:
·While increasing caloric intake, a certain amount of high-quality protein must also be added. The caloric energy can be 30 to 35 kcal/kg of body weight, and the protein can be Give it at a ratio of 1.2g to 1.5g/kg of body weight. Appropriately increase lean meat, chicken, eggs, dairy products, soy products and other foods. But at the same time, avoid eating too much fat.
·Supplement sufficient vitamins and iron, and choose animal foods and plant foods at the same time to promote the absorption and utilization of iron.
·Eat small and frequent meals to ensure that the designed meal amount can be fully consumed.
·Monitor your weight. Once your weight returns to normal, you should adjust your diet to a normal level. Do not overcorrect due to overweight.
Nutritional recipe examples:
Dietary treatment of diabetes:
(1) Controlling total heat energy is the first principle of dietary treatment of diabetes. It is advisable to consume enough calories to maintain normal body weight or slightly below ideal body weight. Obese people must reduce their caloric intake, while thin people can increase their caloric intake appropriately to gain weight. ?
(2) Supply an appropriate amount of carbohydrates. At present, it is recommended not to control carbohydrates too strictly. Carbohydrates should account for about 60% of the total energy. The daily intake can be 250g to 300g, and obesity should be 150g to 200g. Cereals are the main source of heat energy in daily life. Every 50 grams of rice or white flour provides about 38 grams of carbohydrates. Other foods, such as milk, beans, vegetables, fruits, etc. also contain a certain amount of carbohydrates. Oatmeal, oatmeal, buckwheat noodles, corn residue, mung beans, kelp, etc. all have the function of lowering blood sugar. ?Nowadays, you can often see "sugar-free foods", "low-sugar foods", etc. on the market. After eating these foods, some patients not only did not get better, but their blood sugar levels increased. This is due to people's misunderstanding of "low sugar" and "sugar-free". It is believed that these foods do not contain sugar, and the relaxation of dietary control has led some patients to consume these foods without restriction, causing blood sugar to rise. In fact, low-sugar foods refer to foods with low sucrose content, while sugar-free foods refer to foods that do not contain sucrose. However, these foods are composed of starch. When people eat starchy foods, they can be converted into glucose and be absorbed by the body. absorption, so this type of food should also be controlled. ?
(3) Supply sufficient dietary fiber. Epidemiological surveys suggest that dietary fiber can reduce fasting blood sugar, postprandial blood sugar and improve glucose tolerance. The mechanism may be that dietary fiber is water-absorbent and can change the transit time of food in the gastrointestinal tract. Therefore, it is recommended to increase the amount of dietary fiber in the diabetic diet. Some vegetables, wheat bran, beans and whole grains should be included in the meal. Dietary fiber has the function of degrading bacteria. After eating crude fiber foods, it can decompose polysaccharides in the large intestine to produce short-chain fatty acids and bacterial metabolites, and can increase the volume of stool. This type of dietary fiber belongs to polysaccharides. Pectin and mucilage can retain water, expand intestinal contents, increase viscosity, speed up gastric emptying and absorption of nutrients, increase the excretion of bile acids, and slow down digestion and absorption in the small intestine. Such foods are wheat germ and beans. The previous theory was that cellulose is not absorbed because the basic structure of most dietary fiber is glucose, but the way glucose is connected is so different from starch that the body's digestive enzymes cannot break it down. However, it has recently been discovered that dietary fiber can be decomposed and utilized by intestinal microorganisms, and part of the decomposed short-chain fatty acids can be absorbed by the human body, and can be absorbed quickly. The soluble fiber of oats can increase insulin sensitivity, which can reduce the sharp rise in blood sugar after a meal, so the body only needs to secrete less insulin to maintain metabolism. Over time, soluble fiber can reduce circulating insulin levels and reduce the need for insulin in diabetics.
At the same time, it can also lower cholesterol and prevent diabetes from being complicated by hyperlipidemia and coronary heart disease. (4) Supply sufficient protein. Diabetic patients should have adequate protein supply in their diet. Some patients are afraid that eating more protein will increase the burden on the kidneys. When kidney function is normal, dietary protein for diabetics should be similar to that for normal people. When combined with kidney disease, the protein amount of daily meals should be reasonably arranged under the guidance of a nutritionist. Milk, eggs, lean meat, fish, shrimp, and soy products are rich in protein. High-quality protein should be consumed appropriately. It is currently advocated that protein should account for 10% to 20% of total energy. Cereals contain plant protein. If you eat 300 grams of cereals a day, you can consume 20 to 30 grams of protein, which accounts for about 1/3 to 1/2 of the whole day's protein. The physiological value of plant protein is lower than that of animal protein, so plant protein should also be appropriately controlled in the diet. Especially when combined with kidney disease, the consumption of plant protein should be controlled. ?
(5) Control fat intake. Some diabetic patients mistakenly believe that dietary treatment for diabetes is only about controlling the amount of staple food. In fact, it is not the case. It is now advocated not to control carbohydrates too much, but to strictly control fat. Controlling fat can delay and prevent the occurrence and development of diabetes complications. It is currently advocated that dietary fat should be reduced to 25% to 30% of total energy, or even lower. Saturated fatty acid fats such as beef tallow, mutton fat, lard, butter and other animal fats should be limited. Vegetable oils such as soybean oil, peanut oil, sesame oil, rapeseed oil and other polyunsaturated fatty acid-containing fats can be used, with the exception of coconut oil. The fat content of peanuts, walnuts, hazelnuts, pine nuts, etc. is also not low and must be appropriately controlled. Cholesterol should also be properly controlled to prevent complications. Foods with high cholesterol should be properly controlled, such as animal livers, kidneys, brains and other internal organs. Eggs are also rich in cholesterol, so you should eat one a day or one every other day. ?
(6) Supply sufficient vitamins and inorganic salts. Patients whose disease is not well controlled are prone to concurrent infections or ketoacidosis. They should pay attention to supplementing vitamins and inorganic salts, especially as the consumption of vitamin B family increases. Vitamin B preparations should be given to improve neurological symptoms. Whole grains, dry beans, eggs, animal offal and green leafy vegetables contain more B vitamins. Fresh vegetables contain more vitamin C and should be supplemented. ?In elderly patients with diabetes, the chromium content should be increased. Chromium can improve glucose tolerance and reduce serum cholesterol and blood lipids. Foods containing chromium include yeast, beef, liver, mushrooms, beer, etc. At the same time, pay attention to eating more foods containing zinc and calcium to prevent tooth loss and osteoporosis. Diabetic patients should not eat too salty food to prevent the occurrence of high blood pressure. The daily salt intake should be less than 6 grams. ?
(7) Diabetic patients should not drink alcohol. Alcohol produces heat energy, but insulin is not required for alcohol metabolism, so small amounts of alcohol are allowed. It is generally believed that it is better not to drink alcohol, because besides providing heat energy, alcohol does not contain other nutrients. Long-term drinking is not good for the liver and can easily cause hyperlipidemia and fatty liver. In addition, some patients who drink alcohol after taking hypoglycemic drugs are prone to palpitation, shortness of breath, and even hypoglycemia. ?
(8) Diabetic patients should reasonably arrange three meals a day, and each meal should contain carbohydrates, fats and proteins to help slow down the absorption of glucose. ?
(9) Fried foods, vermicelli, potato foods and fruits should be controlled.
But this does not mean that you should not eat potatoes and fruits. You should learn to master various food exchange methods on your own, so as to achieve balanced nutrition