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Do Diabetes Patients Need Nutritional Milk?

“Milk is essential, it is a must in our diet.”

You may probably have heard of this, but is it so? As infants, indeed it is essential. That is why mothers produce milk after giving birth. However, once the infant started solid food in six months old, or some even earlier, milk is no longer essential.

We've all heard the benefits of milk, such as it is a healthy beverage to consume, it builds strong bones as a calcium-rich food. And many people who heard these slogans while growing up were urged to drink a few glasses of milk a day because of these health benefits.

Even though milk is no longer a necessity in the diet as we grew up. Milk does provide nutrients that our body needed. According to Malaysia Food Pyramid 2020, it is recommended that we take 1 to 2 servings of milk and dairy products daily. In other words, you would be able to achieve it by having 1 to 2 glasses of milk daily.

Is it the same for diabetes patients?

There are 2 types of diabetes patients, both are related to insulin. Type I diabetes is caused by insufficient insulin produced by the body, while type II diabetes is caused by insulin resistance in association with a relative insulin deficiency.

One of the risk factors for type II diabetes is overweight and obesity. Even so, there a subgroup of individuals who is malnourished or at risk of malnutrition due to dietary restrictions in diabetes. Whereas some may be suffering from uncontrol glucose management. In contrast to the available standard oral nutrition supplement (ONS) in which readily available carbohydrates such as maltodextrin provide 55–60% of total calories, diabetes specific formulas (DSF) have replaced parts of these carbohydrates with monounsaturated fatty acids (MUFA), medium-chain triglycerides (MCT) and dietary fibre.

Diabetes specific formulas is a better choice

When we talk about nutritional milk, perhaps some people linked it with cow’s or goat’s milk. However, we are going to discuss a more suitable “milk” for diabetes people. Yes, it is diabetes specific formulas (DSF). This formula can be dairy or soy-based, commonly known as low GI formula.

Diabetes specific formulas (DSF) is a specialized form of therapy that consists of macro and micronutrient ingredients to manage malnutrition, dysglycemia, and other cardiometabolic risk factors. These formulas have a low glycaemic index (GI) and complement dietary recommendations for diabetes patients.

Diabetes specific formulas (DSF) have some of the following features compared to standard ONS:

  • Lower carbohydrate content

  • A higher proportion of carbohydrates that have a low GI and/or are slowly digestible, e.g. by replacement of high glycaemic-index maltodextrin, starch, and sucrose with low GI carbohydrates such as isomaltulose

  • Fat content enriched in unsaturated fatty acids, particularly monounsaturated fatty acids

  • Higher fibre content

Therefore, Diabetes specific formulas (DSF) are recommended for people with diabetes, either type I or type II diabetes people.

Diabetes specific formula improves glycaemic control in type 2 diabetes patients.

A double-blind randomized controlled trial clearly demonstrates that consumption of diabetes specific formulas (DSF) with low carbohydrate for 12 weeks significantly improved postprandial hyperglycaemia in terms of iAUC0-240 in type 2 diabetes patients with normal body weight. In other words, it reduced blood glucose fluctuations after having the meal. Therefore, it leads to better glycaemic control.

Many studies have reported that diabetes specific formulas (DSF) can improve glucose control and metabolic risk factors among patients with diabetes or stress-induced hyperglycaemia compared with a standard ONS. Despite the lower carbohydrate and higher fat content of the DSF, there were no significant changes in plasma triglycerides and cholesterol as compared to standard ONS in the study. This showed that DSF that contains MUFA and MCT as major fat components do not adversely affect lipid metabolism.

Furthermore, MCT is rapidly and more efficiently oxidized for energy production than LCT. As a readily available source of energy, MCTs are particularly suitable for patients with high energy needs. On the other hand, MCTs may support control of fat accumulation and lipid metabolism, both key features in the management of obese and patients with metabolic syndrome.

Effect of diabetes specific formulas (DSF) as meal replacements on blood glucose

A systemic review revealed that, for patients with uncontrolled diabetes, Diabetes specific formulas (DSF) should be incorporated 1-2 times per day into a meal plan, either as a calorie replacement for a meal, as a partial meal or as a snack.

When diabetes specific formulas (DSF) is used to replace one meal, a lower GI has been linked with the consumption with extended-release carbohydrates, if compared with the same amount of carbohydrates from a reference food, such as bread or glucose. This means that a lower glycemia was observed in subjects consuming DSF.

In contrast, a liquid, fiber-containing standard ONS was found to increase fasting glucose levels and insulin resistance when use to replace breakfast and one snack, but this didn’t happen in diabetes specific formulas (DSF). One of the reasons is the low GI in diabetes specific formulas (DSF), not to forget the high fiber content as well. No doubts that low GI foods have consistently shown beneficial effects on blood glucose control in both the short-term and the long-term.

In conclusion, diabetes specific formulas (DSF) is a safe and cost-effective strategy to support the management blood glucose control. Evidence shows that use of DSF helps manage blood glucose levels, aiding recovery from illness or injury, and reducing health care costs. > Learn more about the no 1 lowest GI diabetes specific formula in Malaysia

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