Diabetes Nutrition - Endo

Question 1

Goals of DM2 Nutrition therapy

Answer 1

• Maintain as near-normal blood glucose levels as possible
• Achieve optimal blood pressure and lipid levels
• Provide appropriate calories for achieving and maintaining a healthy, desirable body weight
• Manage risk factors and prevent complications of diabetes
• Address individual nutrition needs, incorporating personal and cultural preferences, willingness to change, and maintaining the pleasure of eating by restricting choice only when clearly appropriate

Question 2

5 Areas of focus

Answer 2

• Caloric intake
• Weight loss
• Consistency in day-to-day carbohydrate intake
• Nutritional content
• Exercise

Question 3

Weight Loss

Answer 3

• Overweight (BMI >25) and Obese (>30)
• Weight loss of 8.6% in 1 year improved lipids and DM goals
• Weight loss goals = lose 5-10 % of initial body weight and add 30min of moderate activity most days of the week
• Goal 3-6lbs weight loss in the first 6 weeks
• Goal 10-20lbs weight loss in the first year

Question 4

Weight loss options

Answer 4

• Counting Calories and fat grams (1200-1800kcal/day with 40-60 fat grams)
• “Energy In” “Energy out”
• Meal Replacements
• Weight loss = shakes/bars replace 2 meals a day and 2 snacks a day
• Weight maintenance= 1 meal and 1 snack
• Exchange System – complicated
• Weight loss meds
• Bariatric surgery (BMI >35)

Question 5

Carbohydrate Consistency

Answer 5

• Most important for DM2 using Insulin or Sulfo
• Carb counting (reading labels)
• DM2 healthy weight = suggested targets are 30 -45 grams at meals and 15 -20 grams for snacks,
• Minimum130 grams of carbohydrate per day
• 3 types of Carbs
• Starch (potatoes, grains, beans)
• Sugar
• Fiber (plants—beans, whole wheat, nuts)

Question 6

Daily Dietary Composition

Answer 6

• Low carb and low fat diets are OK short term
• 14 grams of fiber
• < 2300mg sodium (goal <1500mg sodium)
• High in fruits, veggies, low-fat dairy
• Sugar, alcohol, sweeteners in moderation
• 1 drink for women, 2 drinks for men
• Drink with food

Question 7

Increase Activity

Answer 7

• Institute of medicine recommends 30 minutes of moderate intense activity most day of the week
• 60-90 minutes of intense activity most days of the week for weight loss
• **make sure DM2 patients using meds that cause hypoglycemia have a snack with exercise
• Start small – 10min a day 3 x a week
• Everyday choices = walk vs drive, stairs vs elevator, stretch during commercials, walk malls/paths
• 10,000 steps a day
• Check BS before and after walking activities, bring snack along if BS <70
• Stretch before, drink water, good shoes, good posture