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Starlix (Nateglinide)

The problem is that our bodies are not machines. A car owner can calculate the number of miles his car goes per gallon and knows how much the fuel tank holds – so he knows how much fuel he needs and how often. But there are so many variables in the working of the human body that a simplistic view of food as a fuel may lead to a false sense of security.
For example, if John needs 50 grams of carbohydrate to work all afternoon, he could eat his 50 g of carbohydrate in various ways – 20 g as new potatoes, 20 g as bread and 10 g as an apple. But if he eats the potato as crisps and the apple as apple juice, the same 50 g of carbohydrate will produce a different rise in his blood glucose after the meal because these foods will be digested differently. It is possible to calculate the amount each carbohydrate containing food will elevate the blood glucose concentration as compared with an equivalent amount of carbohydrate as glucose itself. This produces the glycaemic index. For example, the glycaemic index of new potatoes is 70 but the glycaemic index of potato crisps is 51.
What are the practical implications? If there is such a variable blood glucose response to carbohydrate foods there seems little point in weighing out precise carbohydrate portions for every meal. However, for people taking insulin, it is helpful to have some idea of how much carbohydrate a meal contains as this is one factor which determines how much insulin you inject. It is also helpful for all of us to know approximately what is on our plates in terms of total energy (calories), carbohydrate, fat and protein. Start looking at the back of food packets and the labels on tins – most now provide this information. One piece of useful information is that 1 g of fat provides twice the number of calories (9 cals/g) as 1 g of carbohydrate (3.8 cals/g) or 1 g of protein (4.0 cals/g). Most foods contain water which adds to the weight but not the energy content.
John has a plateful of food containing about 500 calories. Of this 55 per cent (275 cals) should be starchy carbohydrate, 30 per cent (150 cals) should be fat and 15 per cent (75 cals) should be protein. John could eat this as 75 g carbohydrate, 17 g fat and 16 g protein. This is approximately equivalent to 290 g boiled potato (it contains a lot of water) with 100 g lean ham (it contains some water). Lettuce, tomatoes and onion rings, all of which can be regarded as calorie-free could be added, with 20 g salad cream and two apples for dessert.
There is absolutely no need to do such complex dietary calculations yourself – as discussed above this is not appropriate – but this example shows you how tiny your helpings of fatty foods should be in comparison with carbohydrate foods. Essentially your plate should contain four helpings (by weight) of dry carbohydrate food, one helping of fat and one helping of protein.
If your foods have water in them (like vegetables or meat) you can eat more of them than of drier foods. Because protein foods often contain fat you will find there is very little of your fat allowance left over for dressings or spreading on your bread. Some carbohydrate foods also contain fat (potato crisps). This can make them very high in calories (potato crisps contain 559 cals per 100 g, boiled old potatoes 80 cals per 100 g) but may also use up most of your fat allowance (100 g crisps contain 37 g fat).
Special diabetic foods have no place in your diet. They contain fructose or sorbitol and neither has been shown to be of definite benefit in the management of diabetes. You are better eating small amounts of natural foods as part of your diet.

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