Effective management of diabetes cannot be achieved without an appropriate diet.
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 Advice
General guidance on healthy eating should be advised initially, based on “The Eatwell Plate” (Food Standards Agency – eatwell.gov.uk).
- Encourage regular eating habits/meals.
- Include low glycaemic index carbohydrate foods with each meal.
- Increase fruit and vegetable intake.
- Reduce fat intake. Replace saturated fats with unsaturated fats.
- Reduce sugar intake.
- Reduce salt.
- Safe and sensible alcohol consumption (see patient information leaflet (Alcohol and Diabetes)
- Monitor body weight encouraging weight maintenance and weight reduction as necessary
For further information, see patient information leaflet Healthy Eating and Your Diabetes.
(As recommended by Evidence based nutritional guidelines for the prevention and management of diabetes, Diabetic Medicine 28, 1282-1288 (2011)).
Weight Reduction
Weight management should be the primary nutrional straetgy in managing glucose control in people with Type 2 diabetes who are overweight or obese. Weight reduction for the overweight or obese person with Type 2 diabetes is efective in improving glycaemic control and cardiovascular risk factors.
Weight loss in overweight and obese individuals improves insulin sensitivity and glucose tolerance. Aim for weight loss of 5-10%, which can improve health outcomes. People with diabetes requiring support with weight management can be signposted to a locally run programme such as Winning Weigh if appropriate. Individuals with a BMI > 30, who are motivated to address their weight, can be referred to the Tayside Adult Weight Management Service (TAWMS). This service is for weight management issues and not for diabetes specific dietary support.
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 further 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