Dietary management in diabetes.
BACKGROUND
Type 1 diabetes is primarily an autoimmune disease and type 2 diabetes is primarily a metabolic condition. However, medical nutrition therapy is an integral part of management for both types of diabetes to improve glycaemic control and reduce the risk of complications.


OBJECTIVE
To outline the principles of dietary management in type 1 and type 2 diabetes and provide strategies to assist in overcoming common difficulties related to diet.


CONCLUSIONS
All people with diabetes should be provided with quality professional education on medical nutrition therapy upon diagnosis, and at regular intervals thereafter. For children and adolescent patients with type 1 diabetes, the challenge is to maintain good glycaemic control while providing adequate energy for growth and development. Modification in dietary advice is required, depending on developmental stage. In type 2 diabetes, the initial challenge is to achieve weight loss of 5-10% body weight, normalise blood glucose and reduce cardiovascular risk factors. Specific strategies include a kilojoule controlled diet with reduced saturated fat, trans fat and sodium; moderate protein; and high in dietary fibre and low glycaemic index carbohydrates. Carbohydrates should be spread evenly throughout the day and matched to medication.
Barclay
Alan
A
Glycemic Index Foundation Sydney, New South Wales. awbarclay@optus-net.com.au
Gilbertson
Heather
H
Marsh
Kate
K
Smart
Carmel
C
D000293:Adolescent; D001315:Australia / Q000453:epidemiology; D001786:Blood Glucose; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000178:diet therapy* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy* / Q000453:epidemiology; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D002149:Energy Intake; D038321:Glycemic Index; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000150:complications; D010353:Patient Education as Topic
D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D007328:Insulin