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Non-Pharmacological Management of Non-Insulin-Dependent Diabetes

  • J. Köbberling
Part of the Handbook of Experimental Pharmacology book series (HEP, volume 119)

Abstract

There is broad consensus that energy intake and diet are major causes of obesity and thereby main contributors to non-insulin-dependent diabetes (NIDDM). Today’s diet, which is rich in fats and relatively low in carbohydrates and fibres, the so-called westernized diet, is highly associated with the occurrence of NIDDM. It is therefore concluded that dietary modifications are the mainstay of treatment for NIDDM. These modifications, concentrating on fat restriction to reduce energy intake and body weight, should be the starting point of long-term treatment of NIDDM. Many patients with this disease who comply with dietary advice will show improvement in the major metabolic abnormalities associated with the condition. The main goal will be to obviate the need for oral agents and insulin. But even for those who cannot be managed without drug therapy, attention to dietary advice may modify blood lipids and will thereby reduce the risk for coronary heart disease. Even in insulin-dependent diabetes mellitus (IDDM), the role of diet is not only to help minimize the short-term fluctuations of blood glucose but also to reduce the risk of long-term complications by helping to achieve optimum glycaemic control and satisfactory levels of blood lipids.

Keywords

Glycaemic Control Physical Training Sodium Intake Total Energy Intake Dietary Advice 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. American Diabetes Association (1987) Nutritional recommendations and principles for individuals with diabetes mellitus. Diabetes Care 10:126–132Google Scholar
  2. Aro A, Uusitupa M, Voutilainen E (1981) Improved diabetic control and hypocholesterolaemic effect induced by long term supplementation with guar in type 2 diabetics. Diabetologia 21:29–33PubMedCrossRefGoogle Scholar
  3. Bantle JP, Swanson JE, Thomas W, Laine DC (1992) Metabolic effects of dietary fructose in diabetic subjects. Diabetes Care 15:1468–1476PubMedCrossRefGoogle Scholar
  4. Bogardus C, Ravussin E, Robbins DC, Wolfe RR, Horton ED, Sims EAH (1984) Effects of physical training and diet therapy on carbohydrate metabolism in patients with glucose intolerance and non-insulin-dependent diabetes mellitus. Diabetes 33:311–318PubMedCrossRefGoogle Scholar
  5. Chi ZS (1988) Study on the cardiovascular complications of diabetes mellitus in Beijing and Tianjin. In: Mimura G, et al. (eds) Diabetes mellitus in East Asia. Experta Medica, Amsterdam, pp 23–28Google Scholar
  6. Cüppers HJ, Erdmann D, Schubert H, Berchtold P, Berger M (1982) Glucose tolerance, serum insulin and serum lipids in athletes. In: Berger M, Christacopoulos P, Wahren J (eds) Diabetes and exercise. Huber, Bern, pp 155–165Google Scholar
  7. DeFronzo RA, Sherwin RS, Kraemer N (1987) Effect of physical training on insulin action in obesity. Diabetes 36:1379–1385PubMedCrossRefGoogle Scholar
  8. Diabetes and Nutrition Study Group of the European Association for the Study of Diabetes (1988) Nutritional recommendations for individuals with diabetes mellitus. Diabet Nutr Metab 1:145–149Google Scholar
  9. Dodson PM, Pacy PJ (1984) A controlled trial of high fibre, low fat and low sodium diet for mild hypertension in type 2 (non-insulin-dependent) diabetic patients. Diabetologia 27:522PubMedCrossRefGoogle Scholar
  10. Du SF, Wang H (1990) Plasma glucose and insulin responses to mixed meals. In: Mimura G, et al. (eds) Recent trends of diabetes in East Asia. Experta Medica, Amsterdam, pp 167–168Google Scholar
  11. Durnin JVGA (1987) Microdiets: love them or leave them? Br Med J 294:1565CrossRefGoogle Scholar
  12. Evanoff GV, Thompson CS, Brown J, Weinman EJ (1987) The effect of dietary protein restriction on the progression of diabetic nephropathy: a 12-month follow up. Arch Intern Med 147:492PubMedCrossRefGoogle Scholar
  13. Fitz JD, Sperling EM, Fein HG (1983) A hypocaloric high-protein diet as primary treatment for adults with obesity related diabetes. Diabetes Care 6:328PubMedCrossRefGoogle Scholar
  14. Franz MJ (1993) Avoiding sugar: does research support traditional beliefs? Diabetes Educ 19:144–150PubMedCrossRefGoogle Scholar
  15. Gannon MC, Nuttall FQ (1987) Factors effecting interpretation of postprandial glucose and insulin areas. Diabetes Care 10:754–763CrossRefGoogle Scholar
  16. Garg A, Bonanome A, Grundy SM (1987) Comparison of high monoun-saturated fat and high carbohydrate diets for NIDDM. Diabetes 36 [Suupl I]:11AGoogle Scholar
  17. Geekie MA, Porteous J, Hockaday TDR, Mann JI (1986) Acceptability of high-fibre diets in diabetic patients. Diabet Med 3:52–55CrossRefGoogle Scholar
  18. Grundy SM (1987) Monounsaturated fatty acids, plasma cholesterol and coronary heart disease. Am J Clin Nutr 45:1168PubMedGoogle Scholar
  19. Haines AP, Sanders TA, Imeson JD, et al. (1985) Effects of fish oil supplement on platelet function, haemostatic variables, and albuminuria in insulin dependent diabetics. Thromb Res 43:643CrossRefGoogle Scholar
  20. Hansen BC (1988) Dietary care for obese diabetic subjects. Diabetes Care 11(2):183–186PubMedCrossRefGoogle Scholar
  21. James DE, Kraegen EW, Chisholm DJ (1985) Effects of exercise training on in vivo insulin action in individual tissues of the rat. J Clin Invest 76:657–666PubMedCrossRefGoogle Scholar
  22. Japan Diabetes Society (1985) Food exchange lists for diabetic treatment, 4th edn. Kyowakikaku-Tsushin Bunkodo, TokyoGoogle Scholar
  23. Jenkins DJA, Leeds AR, Gassull MA, Cochet B, Alberti KGMM (1977) Decrease in postprandial insulin and glucose concentrations for guar and pectin. Ann Intern Med 86:20–23PubMedCrossRefGoogle Scholar
  24. Jenkins DJA, Wolever TMS, Jenkins AL (1988) Starchy foods and glycemic index. Diabetes Care 11:149–159PubMedCrossRefGoogle Scholar
  25. Joslin EP (1959) The treatment of diabetes mellitus. In: Joslin EP, Root HF, White P, Marble A (eds) Treatment of diabetes mellitus, 10th edn. Lea and Febiger, Philadelphia, pp 243–300Google Scholar
  26. Kemmer FW, Berger M: Exercise (1992) In: Alberti K-G, DeFronzo RA, Keen H, Zimmet P (eds) International textbook of diabetes mellitus. Wiley, ChichesterGoogle Scholar
  27. Kemmer FW, Tacken M, Berger M (1987) On the mechanism of exercise induced hypoglycemia during sulfonylurea treatment. Diabetes 36:1178–1187PubMedCrossRefGoogle Scholar
  28. Kiehm TG, Anderson JW, Ward K (1976) Beneficial effects of a high carbohydrate, high fibre diet on hyperglycemic men. Am J Clin Nutr 29: 895–899PubMedGoogle Scholar
  29. Koivisto V, DeFronzo RA (1984) Exercise in the treatment of type II diabetes. Acta Endocrinol 107 [Suppl 1]: 107–111Google Scholar
  30. Konishi K (1983) Japanese cooking for health and fitnes. Gakken, TokyoGoogle Scholar
  31. Kromhout D, Bosschieter EB, Coulander C, de L (1985) The inverse relation between fish oil consumption and 20-year mortality from coronary heart disease. N Engl J Med 312:1205–1209PubMedCrossRefGoogle Scholar
  32. Krotkiewski M, Lönnroth P, Mandroukas K, et al. (1985) The effects of physical training on insulin secretion and effectiveness and on glucose metabolism in obesity and type 2 (non-insulin-dependent) diabetes. Diabetes 28:881–890Google Scholar
  33. Lewis-Barned NJ, Mann JI, Carter RC, Hockaday TDR (1987) Modified fat diet can achieve cholesterol lowering in diabetic patients over 10 years. Diabetologia 30:549AGoogle Scholar
  34. Lousley SE, Jones DB, Slaughter P, Carter RD, Jelfs R, Mann JI (1984) High Carbohydrate/high fibre diets in poorly controlled diabetes. Diabet Med 1:21–25PubMedCrossRefGoogle Scholar
  35. Mann JI (1989) Diet and diabetes. Diabetologia 18:89CrossRefGoogle Scholar
  36. McCulloch DK, Mitchell RD, Ambler J, Tattersall RB (1985) A prospective comparison of “conventional” and high carbohydrate/high fibre/low fat diets in adults with established type 1 (insulin-dependent) diabetes. Diabetologia 28:208PubMedCrossRefGoogle Scholar
  37. McLarty DG, Pollitt C, Swai ABM (1990) Diabetes in Africa. Diabet Med 7:670–684PubMedCrossRefGoogle Scholar
  38. Minuk HL, Hanna AK, Marliss EB, Vranic M, Zinman B (1980) Metabolic response to moderate exercise in obese man during prolonged fasting. Am J Physiol 238:E322–E329PubMedGoogle Scholar
  39. Mogensen CE, Christensen CK (1984) Predicting diabetic nephropathy in insulin dependent patients. New Engl J Med 311:89–93PubMedCrossRefGoogle Scholar
  40. National Institutes of Health (1987) Consensus development conference on diet and exercise in non-insulin-dependent diabetes mellitus. Diabetes Care 10:639–644Google Scholar
  41. Nuttal FO (1993) Dietary fiber in the management of diabetes. Diabetes 42:503–508CrossRefGoogle Scholar
  42. Pacy PJ, Dodson PM, Fletcher RF (1986) Effect of high carbohydrate, low sodium and low fat diet in type 2 diabetics with moderate hypertension. Int J Obes 10:43PubMedGoogle Scholar
  43. Peterson DB, Mann JI (1985) Guar: pharmalogical fibre or food fibre? Diabet Med 2:345–347PubMedCrossRefGoogle Scholar
  44. Peterson DB, Lambert J, Gerring S, et al. (1986) Sucrose in the diabetic diet — just another carbohydrate? Diabet Med 2:345CrossRefGoogle Scholar
  45. Raheja BS (1987) Diabetes-associated domplications and traditional Indian diet. Diabetes Care 10:382–383PubMedGoogle Scholar
  46. Raheja BS (1988) Indian diet — diabetes and its complications. Bull Int Diab Fed XXXIII: 14–17Google Scholar
  47. Reitman JS, Vasquez B, Klimes I, Nagulesparan M (1984) Improvement of glucose homeostasis after exercise training in non-insulin-dependent diabetes. Diabetes Care 7:434–441PubMedCrossRefGoogle Scholar
  48. Riccardi G, Rivellese A, Pacioni D, Genovese D, Mastranzo P, Mancini M (1984) Separate influence of dietary carbohydrate and fibre on the metabolic control in diabetes. Diabetologia 26:116–121PubMedCrossRefGoogle Scholar
  49. Rolls BJ (1991) Effects of intense sweeteners on hunger, food intake, and body weight: a review. Am J Clin Nutr 53:872–878PubMedGoogle Scholar
  50. Ruderman NB, Ganda OP, Johansen K (1979) The effects of physical training on glucose tolerance and plasma lipids in maturity onset diabetes. Diabetes 28 [Suppl l]:89–92PubMedGoogle Scholar
  51. Saltin B, Lindgarde F, Housten M, Horlin R, Nygaard E, Gad P (1979) Physical training and glucose tolerance in middle-aged men with chemical diabetes. Diabetes 28 [Suppl l]:30–32PubMedGoogle Scholar
  52. Schneider SH, Amorosa LF, Khachadurian AK, Ruderman NB (1984) Studies on the mechanism of improved glucose control during regular exercise in type-2 (non-insulin-dependent) diabetes. Diabetologia 26:355–360PubMedCrossRefGoogle Scholar
  53. Simpson HCR, Carter RD, Lousley S, Mann JI (1982) Digestible carbohydrate — an independent effect on diabetic control in type 2. Diabetologia 23:235–239PubMedCrossRefGoogle Scholar
  54. Skarfors ET, Wegener TA, Lithell H, Selinus I (1987) Physical training as treatment for type 2 (non-insulin-dependent) diabetes in elderly men. A feasibility study over 2 years. Diabetologia 30:930–933PubMedCrossRefGoogle Scholar
  55. Smith T (1983) Exercise: cult or cure-all? Br Med J 286:1637–1639CrossRefGoogle Scholar
  56. Sours HE, Fratelli VP, Brand CD (1988) Sudden death associated with very low calorie weight reduction regimes. Am J Clin Nutr 34:453Google Scholar
  57. Tanner M, Lukmanji Z (1987) Food consumption patterns in a rural Tanzanian community (Kikwawilla Village, Kilombero District, Morogoro region) during lean and post harvest season. Acta Trop 44:229–244PubMedGoogle Scholar
  58. Thorburn AW, Brand JC, Truswell AS (1986) The glycaemic index of foods. Med J Aust 144:580–582PubMedGoogle Scholar
  59. Trovati M, Carta Q, Cavalot F, et al. (1984) Influence of physical training on blood glucose control, glucose tolerance, insulin secretion and insulin action in non-insulin-dependent diabetic patients. Diabetes Care 7:416–420PubMedCrossRefGoogle Scholar
  60. Viberti GC, Keen H (1984) The patterns of proteinuria in diabetes mellitus: relevance to pathogenesis and prevention of diabetic nephropathy. Diabetes 33:686–692PubMedGoogle Scholar
  61. Vinik AI (1988) Report of the American Diabetes Association’s Task Force on Nutrition: introduction. Diabetes Care 11:127–128CrossRefGoogle Scholar
  62. Vinik AI, Jenkins DJA (1988) Dietary fibre in the management of diabetes. Diabetes Care 11:160–173PubMedCrossRefGoogle Scholar
  63. Vranic M, Berger M (1979) Exercise and diabetes mellitus. Diabetes 28:147–167PubMedGoogle Scholar
  64. Wake SA, Sowden JA, Storlien LH, James DE, Clark PW, Shine J, Chisholm DJ, Kraegen EW (1991) Effects of exercise training and dietary manipulation on insulin-regulatable glucose-transporter mRNA in rat muscle. Diabetes 40:275–279PubMedCrossRefGoogle Scholar
  65. Walker JD, Dodds RA, Murrells TJ, et al. (1989) Restriction of dietary protein and the progression of renal failure in diabetic patients. Lancet II: 1411 – 1415Google Scholar
  66. Warshaw HS (1990) Alternative sweeteners: past, present, pending and potential. Diabetes Spectrum 3:335–343Google Scholar
  67. Warshaw HS (1993) Today’s dietetic foods: definitions, ingredients, recommendations for use, and education issues. Clin Diabetes 11:136–142Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1996

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  • J. Köbberling

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