Diabetes dietary recommendations of american association of clinical endocrinologists: Difference between revisions

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Carbohydrate absorption may be altered by other foods in a mixed meal. For example, fat and fiber delay the absorption of carbohydrates and blunt the glycemic response. Terms such as simple sugars and complex carbohydrates have recently been abandoned since it is now recognized that their effects on blood glucose are similar. Sucrose does not need to be avoided by patients with diabetes mellitus, but when it is consumed, it should replace other carbohydrates in the diet.
Carbohydrate absorption may be altered by other foods in a mixed meal. For example, fat and fiber delay the absorption of carbohydrates and blunt the glycemic response. Terms such as simple sugars and complex carbohydrates have recently been abandoned since it is now recognized that their effects on blood glucose are similar. Sucrose does not need to be avoided by patients with diabetes mellitus, but when it is consumed, it should replace other carbohydrates in the diet.
Patients With Type 2 Diabetes Mellitus
Weight control and a controlled-energy diet are essential components of diabetes mellitus management to lower glucose levels and to reduce the risk for cardiovascular disease; cardiovascular risk is lowest when the body mass index is less than 25 kg/m2. Physical activity of 30 to 90 minutes per day lowers glucose levels and assists with weight loss or weight maintenance. Salt restriction to less than 1.5 g/d, in association with increased intake of fresh fruits and vegetables, is helpful in managing hypertension. If patients choose to consume alcohol, intake should be limited to 1 drink per day for women and 2 drinks per day for men.
Dietary modification to achieve target ranges for glucose, lipids, and blood pressure is a tertiary preventive strategy for the complications of diabetes mellitus.


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Revision as of 17:24, 21 September 2011

Diabetes mellitus Main page

Patient Information

Type 1
Type 2

Overview

Classification

Diabetes mellitus type 1
Diabetes mellitus type 2
Gestational diabetes

Differential Diagnosis

Complications

Screening

Diagnosis

Prevention

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3]

Overview

American Association of Clinical Endocrinologists - General Nutrition Recommendations (DO NOT EDIT)

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Nutrition and Diabetes

1) MNT is an essential component of any comprehensive diabetes mellitus management program (grade A).

2) Meal composition affects glycemic control and cardiovascular risk (grade A).

3) Tailor a diet for individual patients based on current weight, medication regimen, food preferences, lifestyle, and lipid profile (grade A).

4) No specific diet is endorsed by ACE/AACE for people with diabetes mellitus (grade D).

5) Total dietary carbohydrates should represent 45% to 65% of daily energy intake unless otherwise indicated (grade D).

6) Protein intake should be the same as for patients who do not have diabetes mellitus: 15% to 20% of daily energy intake (grade D).

7) Fiber should be consumed in amounts of 25 to 50 g/d or 15 to 25 g/1000 kcal ingested (grade A).

8) Total dietary fat should generally comprise less than 30% of daily energy intake (grade D):

9) Dietary monounsaturated fatty acids and n-3 polyunsaturated fatty acids have beneficial effects on the lipid profile and should comprise most fat intake (grade B).

10) Dietary saturated fat should be limited to less than 10% of daily energy intake with less than 300 mg/d of cholesterol (grade A).

11) If the patient's LDL-C level is greater than 100 mg/dL, consumption of saturated fat should be limited to less than 7% of daily energy intake, and cholesterol should be limited to less than 200 mg/d (grade A).

12) Trans-fat intake should be minimized, or preferably, eliminated (grade D). Basal-bolus insulin therapy using insulin analogs or continuous subcutaneous insulin infusion in conjunction with carbohydrate counting is the most physiologic treatment and provides the greatest flexibility in terms of food choices and timing of meals (grade B).

13) Basal-bolus therapy using a consistent carbohydrate meal plan can be equally effective for patients unable or unwilling to count carbohydrates (grade D).

14) Instruct patients who choose to consume alcohol to limit intake to 1 drink per day for women and 2 drinks per day for men (grade D).

15) Secondary prevention strategies for T2DM in individuals with impaired glucose regulation include a controlled-energy diet, exercise, and weight loss (grade A).

Clinical Considerations

All Patients With Diabetes Mellitus

Carbohydrate absorption may be altered by other foods in a mixed meal. For example, fat and fiber delay the absorption of carbohydrates and blunt the glycemic response. Terms such as simple sugars and complex carbohydrates have recently been abandoned since it is now recognized that their effects on blood glucose are similar. Sucrose does not need to be avoided by patients with diabetes mellitus, but when it is consumed, it should replace other carbohydrates in the diet.


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