Nutrition

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Table of Contents
Nutrition Therapy 1
Nutrition Consult 1
Meal planning 2
Body Weight Considerations 2
Psychosocial support. 3
Calorie Intake 4
Nutrient Composition of the Diet 4
Fat Intake 5
Carbohydrate Intake 6
Sucrose 6
Fructose 6
Vitamins and Minerals 7
Alcohol Intake 7
References 8

Nutrition Therapy
The most fundamental component of the diabetes treatment plan for all patients with type II diabetes is medical nutrition therapy. Specific goals of nutrition therapy in type II diabetes are to:[1]

Achieve and maintain as near-normal blood glucose levels as possible by balancing food intake with physical activity, supplemented by oral hypoglycemic agents or insulin (endogenous or exogenous) as needed

Normalize blood pressure

Normalize serum lipid levels

Help patients attain and maintain a reasonable body weight (defined as the weight an individual and health-care provider acknowledge as possible to achieve and maintain on a short- and long-term basis)

Promote overall health through optimal nutrition and lifestyle behaviors.
Because no single dietary approach is appropriate for all patients, given the heterogeneous nature of type II diabetes, meal plans and diet modifications should be individualized to meet a patient's unique needs and lifestyle. Accordingly, any nutrition intervention should be based on a thorough assessment of a patient's typical food intake and eating habits and should include an evaluation of current nutritional status.

Some patients with mild-to-moderate diabetes can be effectively treated with an appropriate balance of diet modification and exercise as the sole therapeutic intervention, particularly if their fasting blood glucose level is < 200 mg/dL. The majority of patients, however, will require pharmacologic intervention in addition to diet and exercise prescriptions. It is important to note that ...

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...ng insulin or sulfonylureas are susceptible to hypoglycemia if alcohol is consumed on an empty stomach. Therefore, these individuals should make sure to take any desired alcohol with a meal. Patients with diabetes and coexisting medical problems such as pancreatitis, dyslipidemis, or neuropathy may need to reduce or abstain from alcohol intake.

References
American Diabetes Association. Medical Management of Non-insulin-dependent (Type II) Diabetes, 3rd ed. Alexandria, Va: American Diabetes Association; 1994:22-39.
American Diabetes Association. Diabetes 1996 Vital Statistics. Alexandria, Va: American Diabetes Association; 1996.
Davidson MB. Diabetes Mellitus: Diagnosis and Treatment, 3rd ed. New York, NY: Churchill Livingstone; 1991:35-93.
Henry RR. Protein content of the diabetic diet. Diabetes Care. 1994;17:1502-1513.
Mudaliar SR, Henry RR. Role of glycemic control and protein restriction in clinical management of diabetic kidney disease. Endocr Pract. 1996;2:220-226.
American Diabetes Association. Clinical practice recommendations 1995. Position statement: nutrition recommendations and principles for people with diabetes mellitus. Diabetes Care. 1995;18(suppl 1):16-19.

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