Diabetes Dietary Modification or Nutrition Therapy
Dietary modification forms an important part of the treatment and management of all types of diabetes. In Type 2 diabetes, it is almost always connected with the need to lose weight since the majority of people with this syndrome (75 per cent) are overweight or obese. Hence, even though there may be slightly different underlying reasons, the dietary advice for all forms of diabetes is essentially the same. Also, a good diet for people with diabetes conforms entirely to current nutritional guidelines on healthy eating for the population as a whole. It may be quite helpful for people newly diagnosed with diabetes to feel that they need to follow a 'healthy eating' plan rather than a 'diabetic diet' and that this plan is good for everyone else too! In fact, the whole concept of the diabetic diet is now considered to be outmoded as is any need for special 'diabetic foods'. These are still available, mainly from chemists and pharmacies, but they are both expensive and unnecessary since the person with diabetes can fulfil all nutritional requirements from ordinary foods.
The general aims behind dietary modification in diabetes can be summarized as follows:
- to improve carbohydrate and fat metabolism in order to help maintain blood glucose levels within an acceptable range
- to achieve an appropriate body weight (according to age, state of health etc.). This, in itself, very often improves glucose control in Type 2 diabetes
- to reduce the occurrence of hypoglycaemia (in those being treated with insulin or sulphonylureas)
- to help prevent or slow down the development of diabetic complications
- to reduce the risks of circulatory disease and hypertension (through weight control, often combined with physical exercise).
Each newly diagnosed person will have an interview with a dietitian so that his or her individual requirements can be
assessed. The person's current eating habits and lifestyle will be discussed in detail and suggestions made for easily incorporated adjustments which will improve diabetes. If the person needs to lose weight, sensible ways of achieving this will be looked into and included in the dietary plan. Often, a person has become overweight in the first place because of an over-reliance on foods high in (saturated) fats and sugar. Changing to a more healthy pattern of eating, especially when combined with an increased amount of exercise, will usually produce a sustained, gradual loss of weight without the person needing to go hungry. In fact, the whole aim of nutrition therapy in diabetes is to produce a pattern of eating which the person feels readily able to adopt and to set a realistic and achievable weight-loss target, if appropriate. Severe calorie-restriction diets, reliance on drugs, or extreme surgical measures normally have no place in this, except perhaps in very rare circumstances.
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