Nutritional therapy 
The most important objectives in the diatory and nutritional management of diabetes are control of total caloric intake to attain or maintain a reasonable body weight, control of blood glucose levels and normalization of lipid and blood pressure to prevent heart disease.

Nutritional management of diabetes include the following goals.

To achieve and maintain :
1.blood glucose levels in the normal range.
2.a lipid and lipoprotein profile that reduces the risk of vascular disease.
3.blood pressure level in the normal range. address individual nutritional needs ,taking into account personal and cultural preference and willingness to change. prevent development of chronic complications of diabetes by modifying nutrient intake and lifestyle.

According to research study  Some are key nutrients which reduced the blood glucose at home:

1.Bitter gourd(karela):

Nutrition and nursing management of diabetes mellitus

Karela tends to influence the glucose metabolism all over the body And not just of a particular organ. It increases pancreatic insulin secretion to prevent insulin resistance. Thus Karela is beneficial for both type 1 and typa2 DM.
You can drink bitter gourd juice on an empty stomach each morning or one dish prepared with karela daily in your diet.


Fenugreek slow down our digestion , allowing blood sugar to be absobed properly and also stimulate the secretion of glucose dependant insulin.

It can work as effective to lower blood sugar levels in case of uncontrolled type 2 diabetes.
4.Indian goosberry (amla) :
It’s rich in vitamin c which has antioxidants properties. Amla juice prompts proper functioning of your pancreas which initiate  production of insulin to lower blood sugar. plum or Indian blackberry:
Seeds of this plant have hypoglycemic effects, which means that reduces blood sugar and urine sugar.
Make a powder of dried seeds of jamun fruit and eat this powder with water twice a day.

 5. Mango leaves:

Are powerful antioxidants , contain vitamin c, a, also other compound called 3-beta taraxerol, ethyl acetate extract synergise with insulin to activate GLUT4 and  stimulates synthesis of glycogen.
Soak 10 to 15 mango leaves in glass Of
water overnight.

Curry leaves,  aloe Vera,  guava,  basil (Tulsi leaves), flax seeds (alsi), neem etc… Are very important nutrients which helpful to reduced blood sugar.

Meal planning and related teaching :
The meal plan must be considered the client food preference, lifestyle, usual eating times, ethnic and cultural background.
For clients who require insulin to help control blood glucose levels, maintaining as much as possible in the amount of calories and carbohydrates injected at each meal is essential.

Caloric requirements :
Caloric requirements based on age, gender, height, and weight and activities.
To promote 1 to 2 pound weight loss per week, 500 to 1000 calories are subtracted from daily total.
The calories are distributed in to carbohydrates, proteins and fats.

Carbohydrates :

Carbohydrates are the starches, sugar, and fiber in foods such as grains, fruits, vegetable, milk products and sweets. They raised blood glucose faster and higher than other nutrients food. 
Proteins :
Proteins are a necessary part of balance diet and can keep you feeling hungry. Proteins are not directly raise your glucose like carbs. However, to prevent weight gain, use portion control with protein. 
Healthy fats from fatty fish, nuts and seeds. They do not raise blood glucose but are high in calories and can cause weight gain. 

Glycemic index:

The term glycemic index is used to describe how much a given food increases the blood glucose levels compared with an equivalent amount of glucose. 
Following guidelines may be helpful when making dietary recommendation:

1.combining starchy food with protein containing and fat containing foods tends to slow their absorption and lower the glycemic response. general ,eating foods that are raw and whole results in a lower glycemic response than eating chopped, pureed,  or cooked Food.

3.adding foods with sugars to the diet may result in a lower glycemic response if these food are eaten with foods that are more slowly absobed.

4.eating whole fruit instead of drinking juice decreases the glycemic response, because fiber in the fruits slow absorption.

Client can create their own glycemic index by monitoring their blood glucose levels after ingestion of particular food. This can help improve blood glucose control through indivialized manipulation of the diet.

Nursing management :

Nursing management of diabetes can involve a wide variety of physiologic disorder, depending on the client heath status, whether clients newly diagnosed or seeking care for a unrelated hyperglycemia, DKA etc..
In nursing management master the concept and skills necessary for long term management and avoidance potential complication of diabetes.
Assessment :
Assessment is very important for assessing the client for
-Awareness of DM.
-knowledge regarding DM like
Exercise, nutrition,medical treatment, complications ,self administrator insulin, self monitoring blood glucose  etc…
So. After assessing the client plan for take acting in which way.
Planning :
In this step organize short term goal and long term goal.
For example if you plan for giving education to clients for foot care then short term goal is.  To aware the client for foot care. While long term goal is :client who educate about foot care have never foot ulcers.
Then implement our goal on the client then evaluate after some times whether our goal is achieved successfully or not.

Providing client education :
some key points are important to educate diabetic clients .
=)Exercise :

Exercise is lower blood glucose levels by increasing the uptake of glucose by body muscle and by improving insulin utilization, and reducing cardiovascular risk factors.
Exercise recommendation :
.Should exercise at same time and same amount each day.
.regular daily exercise rather than sporadic exercise.
.client who have complication such as ratinopathy, neuropathy, or nephropathy, they are take phycian advice for doing exercise .
Exercise precaution :
.Use proper footwear and if appropriate other protective equipment.
.Avoid exercise in extreme heat or cold.
.inspect feet daily after exercise.
.avoid exercise during period of poor metabolic control.
.client who have blood glucose levels exceeding 250 mg/dl and who have ketone in their urine should not begin exercise until result is negative.
.client who required insulin should be taught to eat a 15g carbohydrates with a protein before exercise to prevent unexpected hypoglycemia.
.To avoid post exercise hypoglycemia, specially after prolonged exercise client may need to eat a snakes at the end of exercise.
.for elderly  people with diabetes  exercise may lead to improve glycemic control and improve quality of life. But because there is an increased incidence of cardiovascular problem in the elderly, a physical examination and exercise stress test done before initiating exercise program.
=)Also educate about self monitoring of blood glucose.

=)how to self administer insulin injections
=)avoid alcohol consumption and tobacco chewing.
Consumed alcohol in empty stomach ,there is increased hypoglycemia. Also alcohol consumption may lead to excessive weight gain, hyperlipidemia and elevated glucose level.
=)foot care, eye care etc.. ,
=)avoiding misleading food labels :
Foods lebeled “sugarless” or “sugar  free” may still provide calorie equal to those of the equivalent sugar containing products.

 =)take food having minerals and vitamins And antioxidants which is helping diabetic clients to improve immune system and decrease chances of infection also live healthier.