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Medical Nutrition Therapy in Type 2 Diabetes

  • Chapter
Type 2 Diabetes Mellitus

Part of the book series: Contemporary Endocrinology ((COE))

  • 3941 Accesses

summary

Medical Nutrition Therapy is a cornerstone of diabetes management. While its effectiveness to reduce A1C by 1–2% has been demonstrated when delivered by registered dietitians, all members of the medical care team need to understand the basic elements of MNT to reinforce the care plan. Although an integral part of the treatment strategy, patients with type 2 diabetes are particularly challenged by the need for weight loss. However, there are other strategies besides a calorie-restricted diet that will improve metabolic measures. Patients and providers alike may be confused by the myriad messages related to level of carbohydrate recommended, glycemic index, fiber and the diet-of-the-day in the popular press. This chapter, divided in three sections, includes 1) an overview of popular messages, separating fact from fiction, 2) a summary of the evidence based nutrition recommendations for each nutrient and 3) guidelines for weight reduction.

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    PubMed  CAS  Google Scholar 

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    Article  PubMed  CAS  Google Scholar 

  39. Engelman HM, Alekel DL, Hanson LN, Kanthasamy AG, Reddy MB.Blood lipid and oxidative stress responses to soy protein with isoflavones and phytic acid in postmenopausal women. Am J Clin Nutr 2005;81(3):590–596.

    PubMed  CAS  Google Scholar 

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    Article  PubMed  CAS  Google Scholar 

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    Article  PubMed  CAS  Google Scholar 

  42. Abraham AS, Brooks BA, Eylath U.The effects of chromium supplementation on serum glucose and lipids in patients with and without non-insulin-dependent diabetes mellitus. Metab Clin Exp 1992;41:768–771.

    PubMed  CAS  Google Scholar 

  43. Pittler MH, Stevinson C, Ernst E.Chromium picolinate for reducing body weight: a meta-analysis of randomized trials . Int J Obes Relate Metab Disord 2003;27:522–529.

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    Google Scholar 

  52. American Diabetes Association.Standards of medical care in diabetes. Diabetes Care 2006;29:S4-S42.

    Google Scholar 

  53. Pastors JG, Warshaw H, Daly A, Franz M, Kulkarni, K.The evidence for the effectiveness of medical nutrition therapy in diabetes management. Diabetes Care 2002;25:608–613.

    Article  PubMed  Google Scholar 

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    Google Scholar 

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    Article  Google Scholar 

  56. Castaldo J, Nester J, Wasser T, et al.Physican attitudes regarding cardiovascular risk reduction: the gaps between clinical importance, knowledge, and effectiveness. Dis Manag 2005;8:93–105.

    Article  PubMed  Google Scholar 

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    Google Scholar 

  58. Bodenheimer T, Lorig K, Holman H, Grumbach K.Patient self-management of chronic disease in primary care. J Am Med Assoc 2002;288(19):2469–2475.

    Article  Google Scholar 

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    Article  PubMed  CAS  Google Scholar 

  60. Franz M, Bantle JP, Beebe CA, et al.Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care 2002;25:148–198.

    Article  PubMed  Google Scholar 

  61. Foster-Powell H, Holt SH, Brand-Miller JC.International table of glycemic index and glycemic load values: 2002. Am J Clin Nutr 2002;76:5–56.

    Google Scholar 

  62. Brand-Miller J, Hayne S, Petocz P, Colagiuri S.Low-glycemic index diets in the management of diabetes: a meta-analysis of randomized controlled trials. Diabetes Care 2003;26(8)2261–2267.

    Article  PubMed  Google Scholar 

  63. Mayer-Davis E, Dhawan A, Liese AD, Teff K, Schulz M.Towards understanding of glycaemic index and glycaemic load in habitual diet: associations with measures of glycaemia in the Insulin Resistance Atherosclerosis Study. Br J Nutr 2006;95(2):397–405.

    Article  PubMed  CAS  Google Scholar 

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    Article  Google Scholar 

  65. Foster, GD, Wyatt HR, Hill JO, et al.A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med 2003;348:2082–2090

    Article  PubMed  CAS  Google Scholar 

  66. Dansinger ML, Gleason JA, Griffith JL, Selker HP, Schaefer EJ. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. JAMA 2005;293(1):43–53.

    Article  PubMed  CAS  Google Scholar 

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    Article  CAS  Google Scholar 

  68. Wing RR and Phelan S.Long-term weight loss maintenance. Am J Clin Nutr 2005;82(suppl):222S–225S.

    Google Scholar 

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    Article  PubMed  CAS  Google Scholar 

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    Google Scholar 

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    Google Scholar 

  73. American Diabetes Association.A Quick Guide to the Medicare MNT Benefit. http://www.diabetes.org/for-health-professionals-and-scientists/recognition/mnt-guide.jsp Accessed February 19, 2006.

    Google Scholar 

  74. American Dietetic Association. Find a nutrition professional. http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/home_4874_ENU_ HTML.htm Accessed February 19, 2006.

    Google Scholar 

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    Google Scholar 

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    Article  PubMed  Google Scholar 

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    Google Scholar 

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    Google Scholar 

  79. Lacey K, Pritchett E.Nutrition care process and model: ADA adopts road model to quality care and outcomes. J Am Diet Assoc. 2003;103:1061–1072.

    Google Scholar 

  80. American Dietetic Association. Nutrition Practice Guidelines for Type 1 and Type 2 Diabetes http://www.eatright.org/ cps/rde/xchg/ada/hs.xsl/3926_1290_ENU_HTML.htm Accessed August 20, 2006.

    Google Scholar 

  81. Klein S, Sheard NF, Pi-Sunyer FX, et al.Weight management through lifestyle modification for the prevention and management of type 2 diabetes: rationale and strategies: a statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition. Diabetes Care 2004;27:2067–2073.

    Article  PubMed  Google Scholar 

  82. McAuley KA, Smith KJ, Taylor RW, McLay RT, Williams SM, Mann JI.Long-term effects of popular dietary approaches on weight loss and features of insulin resistance. Int J Obes 2006;30:342–349.

    Article  CAS  Google Scholar 

  83. Joslin Diabetes Center Clinical Guidelines Committee. Clinical nutrition guideline for overweight and obese adults with type 2 diabetes. 2005. http://www.joslin.org/managing_your_diabetes_joslin_clinical_guidelines.asp Accessed March 18, 2006

    Google Scholar 

  84. Third report of the NCEP expert panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel III). NIH publication no.01–3670, May 2001. Available at: www.nhlbi.nih.gov/guidelines/ (Accessed March 18, 2006)

    Google Scholar 

  85. Chobanian AV, Bakris GL, Black HR, et al.The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003;289:2560–2572.

    Article  PubMed  CAS  Google Scholar 

  86. Chandalia M, Garg A, Lutjohann D, vonBergmann K, Grundy SM, Brinkley LJ.Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus. N Engl J Med. 2000;342:1392–1398.

    Article  PubMed  CAS  Google Scholar 

  87. Joslin Diabetes Center Clinical Guidelines Committee. Guidelines for Diabetes in Pregnancy. 2005. http://www.joslin.org/ managing_your_diabetes_joslin_clinical_guidelines.asp Accessed: March 18, 2006.

    Google Scholar 

  88. Krauss RM, Eckel RH, Howard B, et al. AHA Dietary Guidelines: Revision 200: A Statement for Healthcare Professionals from the Nutrition Committee of the American Heart Association. Circulation 2000;102;2284–2299.

    Google Scholar 

  89. Gannon MC, Nuttall FQ.Effect of a high-protein, low-carbohydrate diet on blood glucose control in people with type 2 diabetes. Diabetes 2004;53:2375–2382.

    Article  PubMed  CAS  Google Scholar 

  90. Engelman HM, Alekel DL, Hanson LN, Kanthasamy AG, Reddy MB. Blood lipid and oxidative stress responses to soy protein with isoflavones and phytic acid in postmenopausal women. Am J Clin Nutr 2005;81(3):590–596.

    PubMed  CAS  Google Scholar 

  91. Wannamethee SG, Shaper AG.Type of alcoholic drink and risk of major coronary heart disease events and all-cause mortality. Am J Public Health 1999;89:685–690.

    PubMed  CAS  Google Scholar 

  92. Anderson RA, Cheng N, Bryden NA, et al.Beneficial effects of chromium for people with diabetes. Diabetes 1997;46:1786–1791.

    Article  PubMed  CAS  Google Scholar 

  93. Abraham AS, Brooks BA, Eylath U.The effects of chromium supplementation on serum glucose and lipids in patients with and without non-insulin-dependent diabetes mellitus. Metab Clin Exp 1992;41:768–771.

    PubMed  CAS  Google Scholar 

  94. Pittler MH, Stevinson C, Ernst E.Chromium picolinate for reducing body weight: a meta-analysis of randomized trials. Int J Obes Relate Metab Disord 2003;27:522–529.

    Article  CAS  Google Scholar 

  95. Hasanain B, Mooradian AD.Antioxidant vitamins and their influence in diabetes mellitus. Curr Diab Rep 2002;2:448–256.

    Article  PubMed  Google Scholar 

  96. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/ Accessed March 20, 2006.

    Google Scholar 

  97. Kulkarni, K.Diabetes medications and weight management. In: Diabetes and the obesity epidemic. On the Cutting Edge. American Dietetic Association Diabetes Care and Education Practice Group Newsletter. 2003; 24:15–17.

    Google Scholar 

  98. The Practical Guide: Identification, Evaluation and Treatment of Overweight and Obesity in Adults.Washington DC: US Department of HHS; 2000. NIH Publication No.02–4084.http://www.nhlbi.nih.gov/guidelines/obesity/practgde.htm (Accessed March 18, 2006)

    Google Scholar 

  99. Delehanty LM. Evidence-based trends for achieving weight loss and increased physical activity: Applications for diabetes prevention and treatment. Diabetes Spectrum 2002; 15:183–188.

    Article  Google Scholar 

  100. American Diabetes Association.Nutrition recommendations and interventions for diabetes – 2006. A position of the American Diabetes Association. Diabetes Care 2006;29:2140–2157.

    Article  Google Scholar 

  101. Borushek, A.The Doctor’s Pocket Calorie, Fat & Carbohydrate Counter, Costa Mesa, CA: Family Health Publications, 2004. (also www.calorieking.com. Accessed April 28, 2006.)

    Google Scholar 

  102. Maryniuk M. Medical nutrition therapy in diabetes: clinical guidelines for primary care physicians. In: Leahy JL, Clark NG, Cefalu WT ed. Medical Management of Diabetes Mellitus, Marcel Dekker, Inc., 2000.

    Google Scholar 

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Authors
  1. Melinda D. Maryniuk
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  2. Mary Jean Christian
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Editor information

Editors and Affiliations

  1. Duke University Medical Center Durham, NC, USA

    Mark N. Feinglos MD, CM  & M. Angelyn Bethel MD  & 

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© 2008 Humana Press, a part of Springer Science+Business Media, LLC

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Maryniuk, M.D., Christian, M.J. (2008). Medical Nutrition Therapy in Type 2 Diabetes. In: Feinglos, M.N., Bethel, M.A. (eds) Type 2 Diabetes Mellitus. Contemporary Endocrinology. Humana Press. https://doi.org/10.1007/978-1-60327-043-4_8

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  • DOI: https://doi.org/10.1007/978-1-60327-043-4_8

  • Publisher Name: Humana Press

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