Medical Nutrition Therapy for Diabetes
By Scott Roberts
Diabetes is one of America’s most troubling medical issues, with over 23.6 million children and adults in the United States currently diagnosed with it. Food and lifestyle choices are fundamental to diabetes care. The role of the dietitian in the treatment of diabetes’ patients is crucial not only while in the hospital, but in the continued management after they are discharged. A thorough nutritional assessment should be at the core of any diabetes’ patient care plan to help reach the goals of the entire multi-disciplinary team. In this paper, we will discuss the factors that go into the medical nutrition therapy of a patient with diabetes and the desired outcomes.
What is Diabetes?
Diabetes is a condition in which the body either does not produce enough, or does not properly respond to, insulin, a hormone produced in the pancreas. Insulin enables cells to absorb glucose in order to turn it into energy. In patients with diabetes, the body either fails to properly respond to its own insulin, does not make enough insulin, or both. This causes glucose to accumulate in the blood, often leading to various complications.
There are several types of Diabetes that result in different conditions, but it can mostly be classified into 3 major groups. Diabetes Mellitus Type 1: Once known as juvenile diabetes or insulin-dependent diabetes, this is a chronic condition in which the pancreas produces little or no insulin (the hormone needed to allow sugar (glucose) to enter cells to produce energy). Type 2 diabetes, which is far more common, occurs when the body becomes resistant to the effects of insulin or simply doesn’t make enough. Despite active research, type 1 diabetes has no cure, though it can be managed. With proper treatment, people who have type 1 diabetes can expect to live longer, healthier lives than ever before.
Diabetes Mellitus Type 2: Type 2 is the most common form of diabetes. In type 2 diabetes, either the body does not produce enough insulin or the cells ignore the insulin completely. Unlike type 1, type 2 patents don’t always rely on insulin and can take drugs to regulate insulin and blood sugar levels.
Gestational Diabetes: This is a type of diabetes that occurs only during pregnancy. Like other forms of diabetes, gestational diabetes affects the way your body uses sugar (glucose) — your body's main source of fuel. Gestational diabetes can cause high blood sugar levels that are unlikely to cause problems for the adult, but can threaten the health and life of an unborn baby.
Diabetes Mellitus Type 1: Various factors may contribute to type 1 diabetes, including genetics and exposure to certain viruses. Although type 1 diabetes typically appears during adolescence, it can develop at any age.
Diabetes Mellitus Type 2: This is caused by a complicated interplay of genes, environment, insulin abnormalities, increased glucose production in the liver, increased fat breakdown, and possibly defective hormonal secretions in the intestine. The recent dramatic increase indicates that lifestyle factors (obesity and sedentary lifestyle) may be particularly important in triggering the genetic elements that cause this type of diabetes.
Gestational Diabetes: During pregnancy, the placenta that surrounds the growing baby produces high levels of a variety of hormones. Almost all of them impair the action of insulin in the tissues, thereby raising blood sugar. Modest elevation of blood sugar after meals is normal during pregnancy.
As the baby grows, the placenta produces more and more insulin-interfering hormones. In gestational diabetes, the placental hormones provoke a rise in blood sugar to a level that can affect the growth and development of your baby. Gestational diabetes usually develops during the last half of pregnancy — rarely as early as the 20th week, but often not until later in the...
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