CHAPTER ONE

1.0       INTRODUCTION

1.1       Background of the Study

Diabetes mellitus is a chronic condition that arises when the pancreas fails to produce enough insulin or when the body cannot use the insulin produced effectively (Alva, 2000). There are currently an estimated 143 million people with diabetes worldwide and this figure is estimated to rise to 300 million by 2025 (Alva, 2000).

In the past, diabetes was considered a single condition. However, it is now clear that diabetes is a heterogeneous metabolic condition caused by many different mechanisms. Diabetes is now categorized based on differences in cause, natural history and clinical characteristics (Albert, 1998). There are two basic forms of diabetes: type 1 requiring insulin for survival and type 2 which may require insulin for metabolic control.  Type 1 is more common in children and adolescents and accounts for between 10 – 15% of all diabetes (Alva, 2000). More than 90% of all people with diabetes have type 2 diabetes mellitus (www.ext.colastate).

Diabetes mellitus can lead to long term complications many of which can be fatal, if not prevented and all of which have the potential to reduce quality of life for people with diabetes (JAMA, 2002). The underlying pathophysiology and management of both forms are different, a common feature is development of long-term micro and macro vascular complications such as retinopathy, nephropathy macro vascular disease peripheral and autonomic neuropathy. These complications are associated with increased morbidity and mortality (Diabetes Control and Complications Trial, DCCT, 1993). 

Diabetes management should consider nutrition, physical activity and pharmacologic therapies (www.ext.colastate).Globally, there is increasing use of complementary therapies by the general population and health professionals in management of diabetes mellitus (Dunning, 2002). Complementary therapies are known by varieties of terms such as “alternative”, “natural”, and “traditional”.   Most importantly, although complementary therapies have common philosophical basis, they are very heterogeneous in their approach and each therapy is different from others (Wood-Hart, 2002). Diet and exercise are the first line of treatment for allpeople with diabetes (International Diabetes Federation, IDF, 2002).  This research will place emphasis on dietary management of diabetics. Researchers have indicated that diet therapy is the corner stone of management in patients with diabetes, especially type 2 diabetes (Garg, 1996).

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