DIETARY ADVICE FOR PATIENTS WITH DIABETES
Effective management of diabetes cannot be achieved without an appropriate diet. All patients with newly diagnosed diabetes should receive educational advice from a dietitian as soon as possible after diagnosis. For further information see Tayside Diabetes Education Programme (TDEP - only available within NHS Tayside Intranet.)
Click here for Tayside guidance for access to dietetic services for people with diabetes.
Aims of Dietary Advice
- To provide knowledge of healthy eating
- To encourage lifestyle changes in order to reduce obesity and ensure optimal weight.
- To maintain blood glucose and lipids as near normal as possible.
- To reduce the acute complications of diabetes i.e. hypoglycaemia / hyperglycaemia.
Objectives of Dietary Advice
- To tailor dietary advice to suit individuals needs, taking account of eating habits, physique, occupation, culture and religious beliefs.
- To provide realistic advice.
- To provide dietary education to allow patients to understand their diabetes and to achieve independence in management.
Dietary Goals
(As recommended by the implementation of nutritional advice for people with diabetes. Diabetes UK 2003. Diabetic Medicine 20.786-807)
- Ensure an adequate and balanced nutritional intake.
- Aim to provide 45-60% energy intake from carbohydrate by increasing intakes of complex carbohydrate / fibre rich foods.
- Limit rapidly absorbed carbohydrate intake (up to 10% total energy - provided it is eaten in the context of a healthy diet).
- Ensure that complex carbohydrate foods (starchy foods) are eaten at each meal / snack.
- Reduce fat intakes to <35% of energy intake of which:
<10% are saturated and transaturated fats
<10% n-6 polyunsatrurated fats
<10% n-6 polyunsatrurated fats
n-3 polyunsaturated fats
10-20% cis-monounsaturated fats
- Salt <6g sodium chloride per day.
- Protein - not more than 1g per kg of body weight.
Weight Reduction
Weight loss in overweight and obese individuals improves insulin sensitivity and glucose tolerance. Aim for weight maintenance and modest weight loss i. e. 5-10 kg in one year, which can improve health outcomes.
General guidance on healthy eating should be advised initially:
- Increasing intake of starchy carbohydrate foods.
- Encourage regular eating habits/meals
- Increasing fruit and vegetable intake.
- Reducing fat intake.
- Reducing sugar intake.
- Reducing salt
- Safe and sensible alcohol consumption, see patient leaflet Alcohol and Diabetes
- Monitor body weight encouraing weight maintenance and weight reduction as necessary.
Sequence of Diet Therapy
For further information, see patient information leaflet Healthy Eating for Diabetes, which contains a sample menu.
On referral to the dietitian the patient will be given an individually tailored eating plan.
Targets for weight loss should be realistic, possible and desired by the patient
Lifestyle
Patients should follow dietary advice as part of lifestyle modification including appropriate exercise regimes and smoking cessation. For futher information see Lifestyle Advice
Information required by the Dietitian at referral
- Demographic details including CHI number.
- Weight
- Height
- HbA1c or glucose profile
- Lipid profile
- Co-existing medical conditions, e.g. hypertension or thyroid status, where relevant
See Diabetes UK site for further information on healthy eating, including recipes suitable for diabetes
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