J Korean Diabetes.  2014 Mar;15(1):35-40. 10.4093/jkd.2014.15.1.35.

Nutritional Considerations for Diabetic Patients on Diabetes Medication

• Ju DL

• KMID: 1703381
• DOI: http://doi.org/10.4093/jkd.2014.15.1.35

Abstract

Individuals who have diabetes should receive individualized medical nutrition therapy (MNT) based on an assessment of the individual's current eating patterns, preferences, and metabolic goals. The dietician should be able to coordinate food choices with the type of diabetes medicine being taken. Knowledge of the actions, side effects, and contraindication of diabetes medicine can help the dietician coordinate appropriate MNT and physical activity, to assist the individual with diabetes to achieve optimal glycemic control without unwanted effects. Carbohydrate consistency is important for diabetic patients on oral diabetes medications. The primary side effects with initial treatment of biguanides, alpha-glucosidase inhibitors, and incretin mimetics include gastrointestinal discomfort, which can be minimized by taking the medication with food, starting at a low dosage, and increasing the dosage slowly. Common side effects from use of insulin and insulin secretagogues (sulfonylureas and meglitinides) are hypoglycemia and weight gain. Consistent meal times and carbohydrate consistency are important to reduce risk of hypoglycemia. Energy restriction, reduced fat intake, regular physical activity, and avoidance of frequent hypoglycemia can be beneficial in preventing or limiting weight gain. The insulin regimen should be fitted to the meal plan and adjusted over time based on the results of blood glucose monitoring.

Keyword

Diabetes mellitus; Medicine; Nutrition therapy

MeSH Terms

alpha-Glucosidases
Biguanides
Blood Glucose
Diabetes Mellitus
Eating
Humans
Hypoglycemia
Incretins
Insulin
Meals
Motor Activity
Nutrition Therapy
Nutritionists
Weight Gain
Biguanides
Blood Glucose
Incretins
Insulin
alpha-Glucosidases

Reference

References

1. American Diabetes Association. Standards of medical care in diabetes-2014. Diabetes Care. 2014; 37(Suppl 1):S14–80.

2. Korean Diabetes Association. Treatment guideline for diabetes. 4th ed.Seoul: Gold' Planning and Development;2011. p. 64–80.

3. Evert AB, Boucher JL, Cypress M, Dunbar SA, Franz MJ, Mayer-Davis EJ, Neumiller JJ, Nwankwo R, Verdi CL, Urbanski P, Yancy WS Jr. Nutrition therapy recommendations for the management of adults with diabetes. Diabetes Care. 2013; 36:3821–42.

4. Korean Diabetes Association Education Committee. The guide for diabetes education. 3rd ed.Seoul: Gold' Planning and Development;2013. p. 81–111.

5. American Dietetic Association. American Dietetic Association guide to diabetes medical nutrition therapy and education. Chicago: American Dietetic Association;2005. p. 81–105.

6. Inzucchi SE. Oral antihyperglycemic therapy for type 2 diabetes: scientific review. JAMA. 2002; 287:360–72.

7. Yoo HJ. Pharmacotherapy for postprandial hyperglycemia in type 2 diabetes. J Korean Diabetes. 2012; 13:39–43.

8. Franz MJ, Reader D, Monk A. Implementing group and individual medical nutrition therapy for diabetes. American Diabetes Association. Alexandria: American Dietetic Association;2002. p. 37–51.

9. Chun HJ, Kwon HS. Clinical efficacy of glucagon like peptide-1 (GLP-1) analogues. J Korean Diabetes. 2013; 14:125–7.

10. Warshaw HS, Bolderman KM. Practical carbohydrate counting: A how-to-teach guide for health professionals. 2nd ed.Alexandria: American Diabetes Association;2001. p. 51–68. 145–56.

11. American Diabetes Association. Intensive Diabetes Management. 3rd ed.Alexandria: American Dietetic Association;2003. p. 135–55.

12. Anderson EJ, Richardson M, Castle G, Cercone S, Delahanty L, Lyon R, Mueller D, Snetselaar L. Nutrition interventions for intensive therapy in the Diabetes Control and Complications Trial. The DCCT Research Group. J Am Diet Assoc. 1993; 93:768–72.

13. Warshaw HS, Kulkarni K. Complete guide to carb counting. Alexandria: American Diabetes Association;2001. p. 139–62.

14. Bolderman KM. Putting your patients on the pump. Alexandria: American Dietetic Association;2002. p. 47–52.