Managing obesity and glycemic control in insulin-using patients: clinical relevance and practice recommendations.
In a number of large-scale studies, intensive therapy regimens have improved glycemic control while reducing the microvascular complications of type 2 diabetes. However, insulin use has been associated with weight gain, thereby hampering patient compliance with intensive insulin therapy. As the prevalence of type 2 diabetes and obesity continues to increase worldwide, health care providers must incorporate the management of weight gain in therapeutic strategies that promote glycemic control. The central component in any such strategy is a tailored program of medical nutrition therapy (MNT), which includes a healthy diet, physical activity, and education. This article reviews several dietary options within a MNT program, including the uses of liquid meal replacements, low-glycemic index carbohydrates, and foods rich in monounsaturated fatty acids. It also provides several practice recommendations to encourage compliance in patients with type 2 diabetes who wish to manage their weight while receiving insulin therapy.
University of Toronto, Credit Valley Hospital, 3539 Mississauga Road, North Mississauga, Ontario, Canada L5L1C6.
Irving
I
Gottesman
D001786:Blood Glucose / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000517:prevention & control; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use*; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control*; D015995:Prevalence
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin