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The evolution of the nutritional management of diabetes

Published online by Cambridge University Press:  07 March 2007

Maeve Moran
Maeve Moran*
Affiliation:
St Vincent's Hospital, Elm Park, Dublin 4, Republic of Ireland
*
Corresponding author: Maeve Moran, fax +353 1 2838 624, email [email protected]
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Abstract

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Diet and lifestyle advice for individuals with diabetes has changed dramatically. The changes in nutritional recommendations have largely been in response to advances in the knowledge of the biochemical and physiological mechanisms of impaired glucose metabolism and the micro- and macrovascular complications of diabetes. The most recent guidelines for the nutritional management of diabetes were set out by Diabetes UK in 2003. This consensus-based advice paper builds on the previous evidence-based review papers of the European Association for the Study of Diabetes in 2000 and the American Diabetes Association in 2002. The changes from previous recommendations include a more liberal use of sucrose, in line with healthy eating recommendations for the general population, and allow for greater flexibility in energy derived from carbohydrate and monounsaturated fat. In addition, monounsaturated fats are promoted as the fat of choice and active promotion of carbohydrate foods with a low glycaemic index is encouraged. These guidelines emphasise the practical application of nutritional management of diabetes and the need to provide education and support in a structured way that will facilitate change in diet and lifestyle behaviour. Structured educational programmes have been shown to be effective in reducing the progression to diabetes and also in slowing the onset and progression of the complications of diabetes. These programmes require ongoing intensive input to maintain behavioural change in diet and lifestyle. Considerable energy and resources are required to set up and maintain these educational programmes, but the cost per individual is small compared with the costs of treating the complications of diabetes.

Keywords

DiabetesNutritional managementDiet and lifestyleEducational programmes
Type
Symposium on ‘Recent developments in diabetes care’
Information
Proceedings of the Nutrition Society , Volume 63 , Issue 4 , November 2004 , pp. 615 - 620
Copyright
Copyright © The Nutrition Society 2004

References

American Diabetes Association (2002) American Diabetes Association Position Statement. Evidence based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care 25, S50–S60.CrossRefGoogle Scholar
Anonymous (1998) Why and how should people lose weight. Drug and Therapeutics Bulletin 36, 89–92.CrossRefGoogle Scholar
Boule, NG, Haddad, E, Kenny, GP, Wells, GA, Sigal, RJ (2001) Effects of exercise on glycaemic control and body mass index in type 2 diabetes mellitus: A meta analysis of controlled clinical trials. Journal of the American Medical Association 286, 1218–1227.CrossRefGoogle ScholarPubMed
Campbell, L, Rossner, S (2001) Management of obesity in patients with type 2 diabetes. Diabetic Medicine 18, 345–354.CrossRefGoogle ScholarPubMed
Canadian Diabetes Association (2004) About diabetes. http://www.diabetes.caGoogle Scholar
Care Interventions Team (2001) Needs of the Recently Diagnosed. Report and Recommendations of the Listening Project. London: Diabetes UK.Google Scholar
Cavan, D, Cradock, S (2004) Structured education programmes and type 2 diabetes. Diabetic Medicine 21, Suppl. 1,1–21.CrossRefGoogle ScholarPubMed
Clinical Standards Advisory Group (1994) Standards of Clinical Care for People with Diabetes. London: H. M. Stationery Office.Google Scholar
DAFNE Study Group (2002) Training in flexible, intensive insulin management to enable dietary freedom in people with type 1 diabetes: dose adjustment for normal eating (DAFNE). Randomised controlled trial. British Medical Journal 325, 746–751.CrossRefGoogle Scholar
Delahanty, LM (1998) Clinical significance of medical nutrition therapy in achieving diabetes outcomes and the importance of the process. Journal of the American Medical Association 98, 28–30.Google ScholarPubMed
Department of HealthDepartment of Health (2002) National Service Framework for Diabetes. Delivery Strategy, London: Department of Health.Google Scholar
Diabetes and Nutrition Study Group of the European Association for the Study of Diabetes (2000) Recommendations for the nutritional management of patients with diabetes mellitus. European Journal of Clinical Nutrition 54, 353–355.CrossRefGoogle Scholar
Diabetes Prevention Program Research Group (2002) Reduction in the incidence of type 2 diabetes with lifestyle intervention or Metformin. New England Journal of Medicine 346, 393–403.CrossRefGoogle Scholar
Franz, MJ, Bantle, JP, Beebe, CA, Brunzell, JD, Chiasson, JL, Gang, A et al. (2002) Evidence based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care 25, 148–198.CrossRefGoogle ScholarPubMed
Franz, MJ, Splett, PL, Monk, A, Barry, B, McClaink, M, Weaver, T, Upham, P, Bergenstal, R, Mazze, RS (1995) Cost effectiveness of nutrition therapy by dietitians for people with non insulin dependent diabetes mellitus. Journal of the American Dietetic Association 95, 1018–1024.CrossRefGoogle ScholarPubMed
Frost, GS, Dornhurst, A, Moses, R (2003) Nutritional Management of Diabetes Mellitus, 1st ed. London: John Wiley and Sons Ltd.CrossRefGoogle Scholar
Garg, A (1998) High-monounsaturated-fat diets for patients with diabetes mellitus. A meta-analysis. American Journal of Clinical Nutrition 67, 577S–582S.CrossRefGoogle ScholarPubMed
Grylls, WK, McKenzie, JE, Horwath, CC, Mann, JI (2003) Lifestyle factors associated with glycaemic control and body mass index in older adults with diabetes. European Journal of Clinical Nutrition 57, 1386–1393.CrossRefGoogle ScholarPubMed
Ha, TK, Lean, MEJ (1998) Technical review. Recommendations for the nutritional management of patients with diabetes. European Journal of Clinical Nutrition 52, 467–481.CrossRefGoogle Scholar
McNulty, SJ, Ur, E, Williams, G (2003) A randomised trial of Sibutramine in the management of obese type 2 diabetic patients treated with Metformin. Diabetes Care 26, 125–131.CrossRefGoogle ScholarPubMed
Muhlhauser, I, Berger, M (2002) Patient education – evaluation of a complex intervention. Diabetologia 45, 1723–1733.Google ScholarPubMed
Nutrition Sub Committee of the British Diabetic Association Professional Advisory Committee (1992) Dietary recommendations for people with diabetes. An update for the 1990's. Diabetic Medicine 9, 189–202.CrossRefGoogle Scholar
Nutrition Sub Committee of the Diabetes Care Advisory Committee of Diabetes UK (2003) The implementation of nutritional advice for people with diabetes. Diabetic Medicine 20, 786–807.CrossRefGoogle Scholar
Pan, XR, Li, GW, Hu, YH, Wang, JX, Yang, WY, An, ZX et al. (1997) Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care 20, 537–544.CrossRefGoogle Scholar
Robson, T, Blackwell, D, Waine, C, Kennedy, RL (2001) Factors affecting the use of dietetic services by patients with diabetes mellitus. Diabetic Medicine 18, 295–300.CrossRefGoogle ScholarPubMed
Sanders, LJ (2001) The Philatelic History of Diabetes, Alexandria, VA: ADA.Google Scholar
Scottish Intercollegiate Guidelines Network (2001) Management of Diabetes.A National Clinical Guideline, Edinburgh: SIGN Executive.Google Scholar
The Diabetes Control and Complications Trial Research Group (1993) The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. New England Journal of Medicine 329, 977–986.CrossRefGoogle Scholar
Tuomilehto, J, Lindstrom, J, Eriksson, JG, Valle, TT, Hamalainen, H, Iianne-Parikka, P et al. (2001) Prevention of type 2 diabetes mellitus by change in lifestyle among subjects with impaired glucose tolerance. New England Journal of Medicine 344, 1343–1350.CrossRefGoogle ScholarPubMed
UK Prospective Diabetes Study Group (1998) Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes. Lancet 352, 854–865.CrossRefGoogle Scholar