Nutrition Care for T2D (Guest Lecture) (Diabetes Week 9) Flashcards
(34 cards)
What are important lifestyle interventions for people with T2D?
- Nutrition
- physical activity
- stress management
- self-management and support
How much can nutrition therapy reduce A1c in people with T2D?
0.5-2%
Goals of nutrition care in diabetes
To support eating patterns that improve overall
health and
* Delay or reduce the risk of complications
* Achieve individualized glycemic, blood pressure and lipid goals
* Achieve and/or maintain individualized body weight goals
What individual patient factors need to be considered?
- Individual personal and cultural preferences
- Health literacy and numeracy
- Access to healthful foods
- Readiness for and barriers to behaviour change
Nutrition Education
Focus on survival and basic as main things for people just diagnosed to walk away with
what are some common approaches to nutrition for individuals with diabetes
There are many ways to eat to manage diabetes and have moved away from being prescriptive to focus more on dietary patterns
* mediterranean
* low GI
* DASH
* portfolio
* low carb
* intermittant fasting
Healthy dietary patterns
Suggested food substitutions
Key message about fibre
Focus on fibre
* Aim for 30 to 50 g per day
* 10 to 20 g as viscous soluble fibre
* Viscous soluble fibre can: ↓ A1c, ↓ fasting blood glucose, Improve lipid profile (↓ LDL-C)
hydration with fibre
important to help move things along and prevent GI disturbances
Evidence-based tips regarding nutrition
- Replace refined, sugar-sweetened, high sodium and/or high fat processed foods with: 30-60 g (1⁄4 to 1⁄2 cup) unsalted nuts most days, whole vegetables and fruit
- Consume lower carb veg and/ or protein first at a meal as a strategy to improve manage glycemic response.
- Choose whole grains high in beta-glucan (e.g. oats and barley) to improve lipid profile and glycemic management.
- Replace sugar-sweetened beverages and foods with dairy products with similar or reduced energy content (this can make huge impact)
How much to eat?
- The Balanced Plate and Handy Guide method
- Carbohydrate Counting
The balanced food plate
- specifically states non-starchy fruits and vegetables
- Starchy vegetables included with whole grains
- Using hands is also a good tool
Carbohydrate Counting
Usually healthy plate and portion guide is best for beginners
Carbohydrate counting education
Best practice for when to eat
- Space eating times over the day (every 4-6 hours)
- Breakfast/eating earlier in the day is beneficial for glycemic management
- Individualize snack recommendations (may not need)
- Fasting may be done safely using a coordinated approach
What might you consider if counselling about spacing and timing of eating?
- Lifestyle and quality of life
- Weight management and metabolic goals
- Culture, religious practices, and health beliefs regarding fasting
- Physical activity
- Diabetes medications (pharmacotherapy)
Tips for snacking
Prevalance of obesity with T2D
> 80% of individuals with T2D also live with obesity
What can weight loss improve?
5 to 10% of initial weight loss can improve:
* insulin sensitivity & glycemic management
* blood pressure & dyslipidemia
≥ 15% of initial body weight
* Remission of T2D
Intensive lifestyle intervention programs typically include a very-low energy diet with meal replacements for at least the first 12 months.
How do the different systems contribute to hyperglycemia
What are considerations beyond glycemic management regarding T2D pharmacotherapy?
- cardiovascular protection
- weight impact
- hypoglycemia risk
- cost
- side effects
What are the common medications for T2D?
Sites of action for diabetic medications
