Anyone with a fasting blood glucose higher than 14 mmol/liter or more is considered to have severe diabetes. The condition of these patients is extremely unstable, with a wide range of blood glucose fluctuations, also known as brittle diabetes, accounting for about 5% of the total number of diabetes. Generally have a rapid onset of symptoms, symptoms, "three more and one less" obvious symptoms, more likely to occur ketoacidosis, most patients are sensitive to insulin injection. This kind of patients in the implementation of diet therapy at the same time, at the same time to use insulin treatment to control the condition.

(1) The diet of severe diabetic patients should be based on the patient's standard weight to calculate their calorie requirements. Due to insufficient glycogen reserves in diabetics, protein catabolism is enhanced and negative nitrogen balance is more likely to occur, the supply of protein can be increased appropriately. Generally, the amount of protein is 1 to 1.5 grams per kilogram of body weight. Children, pregnant women, lactating mothers, as well as those who are malnourished and suffering from wasting disease can be increased as appropriate. When diabetes mellitus is combined with nephropathy or has renal insufficiency, protein intake should be strictly limited. Patients with more severe disease, fat intake should not be too high, 0.6 to 1 gram per kilogram of body weight is appropriate, generally about 40 to 60 grams per day.

(2) severe diabetic patients with disorders of glucose metabolism, fat oxidation is incomplete, easy to produce ketone bodies, ketoacidosis, so it is not appropriate to supply a high-fat diet. When the patient is severely emaciated and needs to increase calories, and carbohydrates are strictly controlled, the amount of fat in the diet can be appropriately increased under the guidance of the physician, but the ratio of fatty acids to glucose should not be more than 1.5, otherwise the meal itself can lead to the production of ketone bodies, which induces ketoacidosis.

(3) In general, the amount of total carbohydrates should not exceed 250 grams per day for critically ill patients, depending on the patient's age, height and other factors.

(4) Seriously ill patients should also be supplied with adequate and comprehensive vitamins and trace elements. The lack of any one vitamin or trace element will affect the normal metabolism of the patient and cause various complications. Especially vitamin C, vitamin B1, as well as potassium, phosphorus and other elements of the supplement, to prevent a variety of peripheral neuropathy, microvascular lesions, as well as reduce blood potassium and blood phosphorus has positive significance.

When using insulin therapy, the patient's daily meals should be timed and quantitative, generally using 1/5, 2/5, 2/5 distribution of three meals calories. The calculation of total calories and the design of recipes should follow the principles of diet, refer to diabetic recipes, or follow the guidance of physicians or dietitians, scientific arrangements.