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Clinical Diabetes 25:101-103, 2007
DOI: 10.2337/diaclin.25.3.101
© 2007 by the American Diabetes Association
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Practical Pointer

Nutrition 911: The First Responders' Guide to Food and Diabetes

Dianne L. Davis, RD, LDN, CDE and Rebecca P. Gregory, MS, RD, LDN, CDE

The first 20% of the full text of this article appears below.


   Introduction
 
Although benefits of medical nutrition therapy (MNT) in the management of diabetes have been well established, lack of time to address nutrition or the many other diabetes self-management tasks is an obstacle for most physicians. This article offers some simple strategies for physicians to use to address nutrition with both type 1 and type 2 diabetes patients before they are able to see a registered dietitian (RD).


   Why Weight Loss Is not Always enough for Patients With Type 2 Diabetes
 
Weight loss is not always enough to bring blood glucose values into target range. There are several potential reasons:

  • If loss of β-cell function is severe, weight loss is unlikely to compensate.
  • Weight loss does not address postprandial blood glucose excursions.
  • Many patients have failed at weight loss or the maintenance of weight loss and need success to build confidence.

Although weight loss is important for a variety of reasons, asking patients who have made multiple unsuccessful attempts at long-term weight loss to again attempt dieting can be frustrating for both patients and physicians. Patients with a poor weight loss track record may tune out additional weight loss advice. Changing the focus from losing weight to controlling carbohydrate intake may allow this type of patient to gain success and build confidence.


   Initial nutritional counseling for Patients With Type 2 Diabetes
 
Identifying and reducing excessive carbohydrate intake may reduce postprandial glucose excursions. High postprandial blood glucose has been shown to be an independent risk factor for cardiovascular disease; targeting it has been shown to improve blood glucose control. To assist patients in this goal:


   SMBG and Patients With Type 2 Diabetes
 

   Nutritional considerations for Patients With Type 1 Diabetes
 

   Preparing Patients for an RD Visit
 

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Copyright © 2007 by the American Diabetes Association.