On WORLD DIABETES DAY (14 November), the question is increasing about what is the best diet to improve blood glucose level. Medical nutrition therapy plays an important role in the management of diabetes, it has a significant impact on T2DM patients. Counseling and education sessions for development of an individualized eating plan according to the metabolic needs of the individual patient, preferably provided by NUTRITIONIST. Encourage beneficial lifestyle changes such as maintaining a healthy weight, smoking cessation, and regular physical activity for diabetes patients.
DIET MODIFICATION ― Various eating patterns, including the DASH diet (Dietary Approaches to Stop Hypertension) and the Mediterranean diet, are effective for controlling glycemia and lowering cardiovascular risk factors.
- CARBOHYDRATES. Evidence is insufficient to support a specific amount of carbohydrate intake for all people with diabetes. Certain sources of carbohydrates are preferred over others for patients with type 2 diabetes. Whole grains, vegetables, fruits, legumes, and dairy products are foods that are higher in fiber and lower in glycemic load; these sources are preferable over others, especially those containing sugars. Reduce consumption of sugar-sweetened and nonnutritive sweetened beverages and encourage water as an alternative.
- FATS. Recommended total fat intake is equal to 20% to 35% of total calories. Emphasize consumption of healthy fats (e.g., long-chain ω-3 fatty acids, eicosapentaenoic acid, docosahexaenoic acid, α-linolenic acid) from food sources, such as fish, nuts, and avocados. Limit consumption of saturated fats (such as those from full-fat dairy, red meat, and tropical oils) and trans fats.
- PREOTEINS. Emphasize sources of protein that are low in saturated fat, such as fish, egg whites, and beans; avoid processed meats. Usual protein intake is 15% to 20% of total energy. For patients withOUT diabetic nephropathy, protein intake should approximate the recommended daily allowance for the general population (0.8 g/kg body weight). For people WITH diabetic nephropathy (micro- or macroalbuminuria), dietary protein restriction is not recommended, because it does NOT alter glycemic measures, cardiovascular risk measures, or the course of GFR decline.
― For patients with NON–dialysis-dependent diabetic kidney disease, the recommended daily dietary protein intake is the same as that of the general population (0.8 g/kg body weight). For patients receiving dialysis, consider higher levels of dietary protein intake. - SODIUM. Recommended total sodium is 2300 mg/day or less. Further sodium reduction (1500 mg/day or less) is recommended for concurrent hypertension.
PHYSICAL ACTIVITY ― Begin exercise slowly and gradually build up. Goal duration for optimal health benefit is at least 150 minutes of moderate intensity (50%-70% of maximum heart rate) aerobic exercise per week, spread out over at least 3 days per week AND avoid more than 2 consecutive days without exercise.
REFERENCES
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American Diabetes Association. 5. Facilitating Behavior Change and Well-being to Improve Health Outcomes: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021 Jan;44(Suppl 1):S53-S72. Available at: https://pubmed.ncbi.nlm.nih.gov/33298416
Wheeler ML, Dunbar SA, Jaacks LM, Karmally W, Mayer-Davis EJ, Wylie-Rosett J, Yancy WS Jr. Macronutrients, food groups, and eating patterns in the management of diabetes: a systematic review of the literature, 2010. Diabetes Care. 2012 Feb;35(2):434-45. Available at: https://pubmed.ncbi.nlm.nih.gov/22275443
American Diabetes Association. 11. Microvascular Complications and Foot Care: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021 Jan;44(Suppl 1):S151-S167. Available at: https://pubmed.ncbi.nlm.nih.gov/33298422