Diet and diabetes Flashcards
the goals of medical nutrition therapy in diabetics are dependent upon what two factors?
- type of diabetes
- age
what are the goals of medical nutrition therapy in diabetics?
- healthful eating pattern to improver overall health
- attain individualized glycemic, BP, lipid goals
- achieve and maintain body weight goals
- delay or prevent diabetic complications
what is the goal HbQA1c level?
below 7%
what is the goal BP in diabetic patients?
under 140/80
what is the goal LDL cholesterol for diabetic patients? HDL for men and women?
- LDL: under 100 mg/dL
- HDL men: over 40 mg/dL
- HDL women: over 50 mg/dL
how are MNT goals for diabetics achieved?
regulation of carbohydrates consumed
what is the most important nutrient to consider in the treatment of diabetes? why?
carbohydrates - they have the greatest postporandial effect on glucose levels
what are the approaches to regulating carbohydrate intake?
- carb counting
what are the key concepts of level 1 (basic) carb counting?
- awareness of which foods contain CHO
- portion sizes
- avoidance of sweets
- CHO consistency
what are the key concepts of level 2 (intermediate) carb counting?
- understand how blood glucose is affected and managed by food, medication, and physical activity
- pattern management
- reducing body weight
what are the key concepts of level 3 (advanced) carb counting?
- teaching how to calculate CHO to insulin ratios when using multiple daily injection or insulin pump
what is the starting goal for number of carbs to have per meal?
45-60 g
what is measured by the glycemic index?
GI measures the QUALITY of a CHO by determining how high it raises blood glucose
how are high GI foods treated by the GI tract? what is the result?
- rapidly digested and absorbed
- will result in large fluctuations in glucose levels
how do fats and fibers affect the GI of a food?
fats and fibers tend to lower the GI
how does eating foods with high GI with protein, fats, and other low GI carbs affect the GI of that food?
lowers the GI
limitations of GI
- affected by combination of other foods
- variation in GI reports for the same food
- does not factor in calories (risk of overconsumption)
- individual glucose responses to different types of carbs
- lower GI carb does not always mean better carb
- GI changes with food preparation
what is the glycemic load? what does it tell you?
QUALITY (GI) of carbs + QUANTITY of carbs
provides a way to determine blood glucose values of different types and amounts of carbs
are high protein diets beneficial to diabetic patients without renal disease?
no - no difference when compared to normal healthy eating guidelines
what are the protein recommendations for diabetic patients with renal disease?
- no evidence of benefit of reduced protein in diet
- sensible to avoid high protein diet
what are the fat recommendations for diabetic patients?
same as general population - 20-35% of energy from fat
what was the primary goal of the diabetes prevention program (DPP)?
determine if modest weight loss through dietary changes and physical activity OR treatment with the oral diabetes drug metformin could prevent or delay the onset of type II diabetes
what were the inclusion criteria for the DPP?
- overweight
- diagnosed with prediabetes
what were the treatment groups in the DPP?
- lifestyle intervention group
- drug treated group #1 - metformin
- drug treated group #2 - troglitazone
- control group (placebo 2x/day)
what were the outcomes of the DPP for pre-diabetics?
- pre-diabetics can delay or avoid developing type II diabetes with regular exercise and utilizing a diet low in calories and fat
what were the outcomes of the DPP for the diet and exercise group?
effect was seen in all participating minority and gender groups
how did diet and exercise compare with metformin in the DPP study?
the incidence of diabetes was reduced by 58% with the lifestyle intervention and by 31% with metformin as compared with placebo
