The Role Of Nutrition In The Management Of Diabetes Mellitus
2013 Folorunso and Oguntibeju, licensee InTech. This is an open access chapter distributed under the terms of the Creative Commons Attribution License (which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is Olabiyi Folorunso and Oluwafemi Oguntibeju Additional information is available at the end of the chapter Scientific evidence abound to show that the prevalence of diabetes mellitus(DM) is increasing around the world at a rate that appears dramatic as to have been characterized as an epidemic[1]. Among several factors that have been postulated to contribute to DM epidemic, environmental factors have drawn particular attention because of the rapidity of the increase in type 2 or the so called maturity on- set diabetes mellitus. Nobuko Seike, Mitsuhiko Noda and Takashi Kadowaki [2] evaluated the association between alcohol consumption and the risk of type 2 DM, it was pointed out that type 2 diabetes mellitus is closely related to life style factors including diet, physical activities, alcohol and smoking as well as obesity and a family history of diabetes. According to the researchers, in Japan the prevalence of diabetes mellitus both for men over age 50 and women over 60 well exceeds 10% and most have type 2 DM which is associated with excessive energy intake, lack of physical exercise and obesity. In addition, Mayes and Botham[3] revealed that obesity particularly, abdominal obesity(a diet related disorder) is a risk factor for increased mortality, hypertension, type 2 DM, hyperlipidaemia and various endocrine dysfunctions. On the other hand, type 1 DM, or Juvenile DM or insulin-dependent diabetes is less common than type 2. Only 10% of all diabetics have type 1. Type 1 diabetes occurs when the pancreas produces n Continue reading >>
Nutrition In Patients With Diabetes
Background Diabetes is a chronic illness that requires a holistic approach in terms of care to prevent both acute and long-term complications. Nutritional management for diabetic patients has been evolving for 100 years as the pathophysiological basis of the complications incurred from diabetes becomes more explicit. Medical nutrition therapy is extremely important for diabetic patients and prediabetic patients so that adequate glycemic control can be achieved. One-on-one consultations with a registered dietician well-versed in diabetic nutrition are most preferable, as has been shown in studies performed in Pakistan [1] and Hungary, [2] which proved the utility of a dietician in improving dietary adherence. Nutrition counseling should be sensitive to the personal needs of the patient and how much effort the patient is willing to put in to making the change to eating appropriately. Medical nutrition therapy for diabetics can be divided into (1) dietary interventions and (2) physical activity. Lifestyle and dietary modifications form the cornerstone of therapy in type 2 diabetic patients (insulin resistance). In type 1 diabetic patients, who have an insulin deficiency, a balance between insulin and nutrition needs to be obtained for optimal glycemic control. [3] Continue reading >>
Nutrition In Patients With Diabetes
Author: Fazia Mir, MD; Chief Editor: George T Griffing, MD more... Diabetes is a chronic illness that requires a holistic approach in terms of care to prevent both acute and long-term complications. Nutritional management for diabetic patients has been evolving for 100 years as the pathophysiological basis of the complications incurred from diabetes becomes more explicit. Medical nutrition therapy is extremely important for diabetic patients and prediabetic patients so that adequate glycemic control can be achieved. One-on-one consultations with a registered dietician well-versed in diabetic nutrition are most preferable, as has been shown in studies performed in Pakistan [ 1 ] and Hungary, [ 2 ] which proved the utility of a dietician in improving dietary adherence. Nutrition counseling should be sensitive to the personal needs of the patient and how much effort the patient is willing to put in to making the change to eating appropriately. Medical nutrition therapy for diabetics can be divided into (1) dietary interventions and (2) physical activity. Lifestyle and dietary modifications form the cornerstone of therapy in type 2 diabetic patients (insulin resistance). In type 1 diabetic patients , who have an insulin deficiency, a balance between insulin and nutrition needs to be obtained for optimal glycemic control. [ 3 ] Nutrition for diabetic patients can be further divided into prevention and continual management of glycemic control. Prevention is more for individuals at risk for developing diabetes and for type 2 diabetic patients than for patients who have already developed complications, in order to prevent further progression. The goals of nutrition in prevention are as follows: Primary prevention Identification of the population at high risk (body mass index [ Continue reading >>
Diabetes Mellitus - The Role Of Nutrition In Maintaining Health In The Nation's Elderly - Ncbi Bookshelf
Diabetes mellitus type 1 is an autoimmune disease that destroys the beta cells of the pancreas, leading to insulin deficiency. The resulting hyperglycemia can lead to microvascular and macrovascular disease. The microvascular complications include retinopathy, nephropathy, and neuropathy. The macrovascular complications include coronary artery disease, peripheral vascular disease with amputation, stroke, and renal disease. The disease usually manifests early in life, although it can also occur in adulthood. Diabetes mellitus type 2 is a familial hyperglycemia that occurs primarily in adults but can also occur in children and adolescents. It is caused by an insulin resistance whose etiology is multiple and not totally understood. The net result of the insulin resistance is to initially cause a compensatory hyperinsulinemia. Subsequently, the beta cells of the pancreas fail to meet the compensatory need, less insulin secretion occurs than is required for the adequate elimination and utilization of glucose, and hyperglycemia results. Dyslipidemia and hypertension are common in patients with type 2 diabetes, and about 80 percent of patients with type 2 diabetes are obese (LaPorte et al., 1995). The complications arising from this condition are the same as those described for type 1 diabetes mellitus. Because of the later age of onset in persons with type 2 compared to type 1 diabetes, evidence of clinically significant microvascular complications is less. Estimates of prevalence have increased over the years in part due to more stringent diagnostic criteria as well as the continued rise in obesity. In 1997, the diagnostic criterion for a diagnosis of diabetes was lowered from a fasting glucose tolerance test result of 140 mg/dL to 126 mg/dL (American Diabetes Association, Continue reading >>
The Role Of Carbohydrate In Diabetes Management
The role of carbohydrate in the diet of people living with diabetes is an area of much debate. This relates to both type and quantity of carbohydrate consumed, with low carbohydrate diets increasing in popularity. However, it is important to take a whole diet approach and not just in terms of single nutrients. This review considers what carbohydrates are and how recommendations for people with diabetes might differ from those for the general population. There are no obligate requirements for dietary carbohydrate. UK recommendations suggest 50% of total energy should come from carbohydrate for the general population; however, evidence does not support an optimal carbohydrate intake for people living with diabetes. Equally, there is no evidence to support a change in other macronutrient intakes including fat; thereby challenging the perspective of low carbohydrate diet advocates, which may encourage higher saturated fat intakes. Carbohydrate quality is important in terms of glycaemic index and fibre, and may have other health benefits; however, the quantity of carbohydrate is a more important predictor of glycaemic response. People with type 1 diabetes can improve the accuracy of insulin dosing with carbohydrate counting and technology may also have a role to play in this, with the introduction of bolus advisor meters. There is no universal recommendation for the amount of carbohydrate for people living with diabetes. Recommendations should therefore be based on personal preference, individual glycaemic response and other health targets, ideally with the support of a registered dietitian specialising in diabetes. Introduction The role of dietary carbohydrate in diabetes is the subject of much debate – especially with respect to ideal amounts and types of carbohydrate.1 Continue reading >>
The Role Of Nutrition In The Management Of Diabetes Mellitus
The Role of Nutrition in the Management of Diabetes Mellitus 1. Introduction Scientificevidence abound to show that the prevalence of diabetes mellitus(DM) is increasing around the world at a rate that appears dramatic as to have been characterized as an epidemic[1]. Among severalfactors thathave been postulated to contribute to DM epidemic, environmentalfactors have drawn particular attention because of the rapidity of the increase in type 2 or the so called ‘maturity on- set’ diabetes mellitus. Nobuko Seike, Mitsuhiko Noda and Takashi Kadowaki [2] evaluated the association between alcohol consumption and the risk of type 2 DM,it was pointed out that type 2 diabetes mellitus is closely related to life style factors including diet, physical activities, alcohol and smoking as well as obesity and a family history of diabetes. According to the researchers, in Japan the prevalence of diabetes mellitus both for men over age 50 and women over 60 well exceeds 10% and most have type 2 DM which is associated with excessive energy intake, lack of physical exercise and obesity. In addition, Mayes and Botham[3]revealed that obesity – particularly, abdominal obesity(a diet related disorder) is a risk factor for increased mortality, hypertension, type 2 DM, hyperlipidaemia and various endocrine dysfunctions. On the other hand,type 1 DM, or ’Juvenile DM’ or ‘insulin-dependent’ diabetes is less common than type 2. Only 10% of all diabetics have type 1. Type 1 diabetes occurs when the pancreas produces no insulin at all. It tends to emerge in childhood or early adulthood (before the age of 40) and must be regulated by regularly injecting insulin. Although the exact cause of type 1 diabetes is currently unknown, it is widely believed that majority of type 1 diabetes is of t Continue reading >>
Nutritional Challenges In The Elderly With Diabetes - Sciencedirect
Volume 1, Issue 1 , April 2009, Pages 26-31 Nutritional challenges in the elderly with diabetes Author links open overlay panel Ali A.Rizvi Adults age 60 and older will comprise two-thirds of the diabetic population by the year 2025. Older patients with diabetes are more likely to have coexistent chronic conditions like hypertension, dyslipidemia, and cardiovascular disease that may impact their nutritional requirements. The issue of attainment and maintenance of an optimal body weight in elderly diabetic persons may not be as straightforward as in other age groups, and the risk-benefit ratio may be different as well. Although increased prevalence of overweight and obesity in the elderly contributes to insulin resistance and hyperglycemia, older inhabitants of long-term care facilities who suffer from diabetes tend to be underweight. Both may signify inadequate nutritional status and lead to increased morbidity and mortality. The attendant problems of appetite changes, palatability of food, dietary restrictions, loneliness, and depression may affect the type and quantity of food consumed by elderly persons. Structured screening tools may identify nutrition-related issues that warrant evidence-based interventions. Although glucose control and health concerns are important factors in diet modification in the older population, other considerations include quality of life and individual preferences. Customizing of nutritional guidelines to the needs of the older diabetic patient makes sense. Continue reading >>
Role Of Nutritional Factors At The Early Life Stages In The Pathogenesis And Clinical Course Of Type 1 Diabetes
Role of Nutritional Factors at the Early Life Stages in the Pathogenesis and Clinical Course of Type 1 Diabetes 1Department of Health and Nutrition, The University of Shimane, Matsue, Shimane 690-0044, Japan 2Department of Developmental Biology, Faculty of Medicine, Shimane University, Izumo, Shimane 693-8501, Japan Received 26 June 2014; Revised 2 November 2014; Accepted 3 November 2014 Copyright 2015 Yukiko Kagohashi and Hiroki Otani. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Nutrition has been suggested as an important environmental factor other than viruses and chemicals in the pathogenesis of type 1 diabetes (T1D). Whereas various maternal dietary nutritional elements have been suggested and examined in T1D of both humans and experimental animals, the results largely remain controversial. In a series of studies using T1D model nonobese diabetic (NOD) mice, maternal dietary n-6/n-3 essential fatty acid ratio during pregnancy and lactation period, that is, early life stages of the offspring, has been shown to affect pathogenesis of insulitis and strongly prevent overt T1D of the offspring, which is consistent with its preventive effects on other allergic diseases. Type 1 diabetes (T1D) results from insulin deficiency mostly due to the autoimmune-mediated destruction of the insulin-producing pancreatic islet cells (insulitis) and arises from incompletely understood interactions between cells, the immune system, and the environment in genetically susceptible individuals [ 1 4 ] (Figure 1 ). Concordance of T1D between the monozygotic twin pairs has been reported as approximately 30%, and therefore Continue reading >>
Diabetes And Nutrition
People who have diabetes have too much sugar in their blood. Managing diabetes means managing your blood sugar level. What you eat is closely connected to the amount of sugar in your blood. The right food choices will help you control your blood sugar level. Path to improved health Eating well is one of the primary things you can do to help control diabetes. Do I have to follow a special diet? There isn’t one specific “diabetes diet.” Your doctor can work with you to design a meal plan. A meal plan is a guide that tells you what kinds of food to eat at meals and for snacks. The plan also tells you how much food to have. For most people who have diabetes (and those without, too), a healthy diet consists of: 40% to 60% of calories from carbohydrates. 20% calories from protein. 30% or fewer calories from fat. Your diet should also be low in cholesterol, low in salt, and low in added sugar. Can I eat any sugar? Yes. In recent years, doctors have learned that eating some sugar doesn’t usually cause problems for most people who have diabetes — as long as it is part of a balanced diet. Just be careful about how much sugar you eat and try not to add sugar to foods. What kinds of foods can I eat? In general, at each meal you may have: 2 to 5 choices (or up to 60 grams) of carbohydrates. 1 choice of protein. A certain amount of fat. Talk to your doctor or dietitian for specific advice. Carbohydrates. Carbohydrates are found in fruits, vegetables, beans, dairy foods, and starchy foods such as breads. Try to have fresh fruits rather than canned fruits, fruit juices, or dried fruit. You may eat fresh vegetables and frozen or canned vegetables. Condiments such as nonfat mayonnaise, ketchup, and mustard are also carbohydrates. Protein. Protein is found in meat, poultry, fish Continue reading >>
How Can Nutrition Aid Diabetes Management?
Changes in nutrition and diet, in addition to exercise, are an important part of diabetes management. Yet according to the American Diabetes Association (ADA), many misconceptions still exist concerning nutrition and diabetes. In a 2004 position statement published in Diabetes Care, the ADA said that “nutrition recommendations that have little or no supporting evidence have been and are still being given to persons with diabetes.” Good nutrition? The nutritional goals for diabetes are generally aimed at attaining or maintaining optimal metabolic functions; these include maintaining normal – or close to normal – blood glucose levels, improving blood lipid and lipoprotein profiles, and reducing blood pressure. All of these goals relate to the prevention or reversal of underlying conditions associated with diabetes, including obesity, dyslipidemia, cardiovascular disease, hypertension and kidney damage (nephropathy). Fatty deposits and energy balance The effects of obesity on insulin resistance mean that weight loss is an important objective for people with type-2 diabetes. Studies have shown that weight loss in people with type-2 diabetes is associated with decreased insulin resistance, improved measures of glycaemia and dyslipidemia, and reduced blood pressure. Research has also suggested that fatty deposits can also play a major role in the development of type-2 diabetes by disturbing vital functions of key organs such as the liver, kidneys and pancreas. In doing so, it is believed that the fatty deposits interfere with important metabolic functions including the production of insulin and the storage of glucose. A recent study published in the journal Diabetologia reported that an extreme low calorie diet could reverse the condition in just Continue reading >>
The Role Of Diet In The Prevention Of Type 2 Diabetes
Abstract Type 2 diabetes mellitus is an important preventable disease and a growing public health problem. Epidemiologic and interventional studies suggest that weight loss is the main driving force to reduce diabetes risk. Landmark clinical trials of lifestyle changes in subjects with prediabetes have shown that diet and exercise leading to weight loss consistently reduce the incidence of diabetes. However, from these studies it cannot be established whether dietary changes alone play a significant role in preventing diabetes. Here we review epidemiologic and clinical trial evidence relating nutrients, foods and dietary patterns to diabetes risk and the possible mechanisms involved. The differential effects of carbohydrate and fat quantity and quality, and those of specific foods and whole diets are discussed. Importantly, most dietary components influencing diabetes risk have similar effects on biomarkers of cardiovascular risk and inflammation. The conclusion is that there is no universal dietary strategy to prevent diabetes or delay its onset. Together with the maintenance of ideal body weight, the promotion of the so-called prudent diet (characterized by a higher intake of food groups that are generally recommended for health promotion, particularly plant-based foods, and a lower intake of red meat, meat products, sweets, high-fat dairy and refined grains) or a Mediterranean dietary pattern rich in olive oil, fruits and vegetables, including whole grains, pulses and nuts, low-fat dairy, and moderate alcohol consumption (mainly red wine) appears as the best strategy to decrease diabetes risk, especially if dietary recommendations take into account individual preferences, thus enabling long-time adherence. Continue reading >>
The Role Of Nutrition In Diabetes Prevention And Management
Stanford University School of Medicine blog Can certain diets help patients prevent or manage their diabetes? Which foods are best for diabetics and which ones should they avoid? If you increase your coffee consumption, will it reduce your risk of diabetes? Kathleen Kenny , MD, a clinical associate professor at Stanford, and Jessica Shipley , a clinical dietitian at Stanford Hospital & Clinics, answered these questions and others about diabetes and nutrition in a recent Stanford Health Library talk. In the above video , Kenny and Shipley also discuss the glycemic index and how it should be used to tailor dietary choices; examine how Mediterranean, low-carb and low-calorie diets affect diabetes; and explain how eating healthy can prevent or reverse the disease. The lecture is a must-watch for anyone wanting to make healthier food choices to benefit their health. This video is the final lecture in a three-part series addressing important questions related to diabetes and lifestyle choices. Continue reading >>
- Role of Medical Nutrition Therapy in the Management of Gestational Diabetes Mellitus
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- Olive oil in the prevention and management of type 2 diabetes mellitus: a systematic review and meta-analysis of cohort studies and intervention trials
Diet And Diabetes
For most people who don’t feel well, a visit to the doctor can diagnose and fix the problem. Simple, right? But some diseases can be silent predators, offering few or no warning signs to alert you early on that help is needed. One such disease is diabetes. Not only does diabetes affect almost 24 million people in the United States, but 25 percent don’t even know they have it. What Is Diabetes? As food is digested, it is broken down into glucose (also known as sugar), which provides energy and powers our cells. Insulin, a hormone made in the pancreas, moves the glucose from the blood to the cells. However, if there is not enough insulin or the insulin isn’t working properly, then the glucose stays in the blood and causes blood sugar levels to rise. There are three main types of diabetes: type 1, type 2, and gestational diabetes. Type 1 results from the pancreas no longer being able to make insulin and is usually found in children, teens, and young adults. Gestational diabetes can occur near the end of a woman’s pregnancy and usually disappears after the baby’s birth. The most common form of diabetes is type 2. Risk factors include being overweight; not getting enough physical activity; having a parent or sibling with diabetes; being African-American, Asian-American, Latino, Native American, or Pacific Islander; being a woman who had gestational diabetes or gave birth to a baby who weighed more than nine pounds; having high blood pressure, having low HDL (good cholesterol) or high triglycerides; and having pre-diabetes. Diabetes: Why Is It Dangerous? “When poorly controlled diabetes causes blood glucose levels that are too high or too low, you may not feel well,” explains Claudia L. Morrison, RD, outpatient diabetes program coordinator at Washington Hospital Continue reading >>
Diabetes Nutrition
Tweet Nutrition is a critical part of diabetes care. Balancing the right amount of carbohydrates, fat, protein along with fibre, vitamins and minerals helps us to maintain a healthy diet and a healthy lifestyle. Getting the balance right can help the body to stay in prime condition, but what is the right balance of nutrients? People have been arguing over the ideal mix for generations and the discussion still rages today. For people with diabetes, there is at least one extra consideration for our nutritional needs and that is the question of how our blood sugar levels will respond to different diets. Macronutrients The macronutrients referred to in human diets are the three food groups that provide us with energy, namely: carbohydrates, fat and protein. The three major nutrients are more than simply providers of fuel for our bodies. Fats and protein are both vital for building cells and helping the cells carry out their duties. Each of the macronutrients are versatile allowing the body to break them down into a number of uses. Carbohydrate can be stored as fat and fat and protein can both be converted into glucose for example. Read more on macronutrients and their relevance to diabetes: In addition, we have guides on the differences between carbohydrate types and sugar and fat. Simple carbs vs complex carbs Read more about trans fats and their relation to fats as well as guides to vitamins and supplements: Micronutrients Micro may mean small, but micronutrients are far from insignificant. Without a regular supply of micronutrients, our bodies would literally starve. Micronutrients include all vitamins and minerals we take it in, often without realising, and are an essential part of a diabetic diet. As an example, celery contains well over a dozen different micronutrient Continue reading >>
The Role Of Nutrition In Children And Adolescents Withtype 1 Diabetes
In nutrition and diet of children and adolescents with Type Idiabetes, it should be noted that: Different countries and regions have different cultures andsocioeconomic status which is effective on their dietaryhabits and diet. Therefore, nutritional recommendations should be proportionate to culture, ethnicity, familytraditions, as well as cognitive and psychological needs ofpatients with Type I diabetes [13]. Training diet should be done individually proportionate tothe age of patients with Type I diabetes to help the interactionand active learning of patients [13]. There should be a dietitian with experience of working onfield of Type I diabetes in the treatment team which to beavailable and has the supervision and support on nutritionof adolescents with Type I diabetes [13]. The AmericanDiabetes Association recommends that diabetic patients should annually refer to a dietitian or attend in a diabetesself-management training program that also includesnutritional therapy training. In Jaacks et al. research, lessthan half of patients with Type I diabetes always referredto a dietitian and only 18 percent of patients participated intraining sessions over the past year [17]. Research has shown that children and adolescents with TypeI diabetes consume fats, especially saturated fats more thanthe recommended dose [13]. In study of Patton [1], percentof calories from fat in Type I diabetes patients is in the rangeof 31 to 47 percent which is more than the recommendeddose for healthy people (less than 30%). In research of Theet al., percent of calories from fat in Type I diabetes patientsis significantly higher than the amount recommended forhealthy individuals [15]. Eating some healthy fats such asolive oil, reducing the use of saturated fats, decrease, or nouse of Trans fa Continue reading >>
