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Diabetes - Dietary and Lifestyle Recommendations
Diabetes - Dietary Recommendations

Other Conditions

 

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Coeliac Disease

There is an increased prevalence of coeliac disease with type 1 diabetes.

Expert dietary advice is required from a dietitian.

The classic signs of coeliac disease may not be present and when untreated there is an increased risk of hypoglycaemia unpredictable swings in blood glucose.

Gluten-free products are available on prescription.

Calcium supplements are required to minimise the risk of osteoporosis if dietary intake is <1500mg/day.

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Cystic Fibrosis

An individual with diabetes and cystic fibrosis may be underweight. A high-energy diet with extra calories from fat and no restriction on carbohydrate is required.

Specialist dietary advice is required.

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Illness

There are issues regarding the diet in diabetes when there are other factors which affect oral intake such as other illnesses e.g. cancer. This may have effects on glucose control and the medication needed.

General diabetes dietary recommendations may not be appropriate for ill patients who have a poor oral intake. These patients are at greater risk of malnutrition.

Palatable sugar-containing foods may help stimulate the appetite of a person eating very little.

The inclusion of high-fat foods can be valuable in helping to maximise energy intake in small portions.

A high-fibre diet may limit food intake by causing high satiety.

The addition of high-energy snacks with protein may be sufficient to boost nutrient intake without the need for nutritional supplements.

Glycaemic control requires monitoring and management as high blood glucose can lead to weight loss, compromised nutritional status and delayed wound healing. This may require changes in diabetes medication

Contact your Dietitian or Diabetes Nurse Specialist for further advice.

 

See - 3 steps to gain weight Fact Sheet

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Nutritional Supplements
Food first approach is recommended for a month initially. This involves nourishing foods, drinks and snacks, and food fortification. See leaflet above for further details. On review, if this proves ineffective, please refer to a dietitian for advice on nutritional supplements.

Nutritional supplements such as, Build-Up, Complan, Ensure, Fortisip, Enlive, Fortijuice, are suitable for people with diabetes. All nutritional supplements contain some form of sugar and are likely to have a similar effect on the blood glucose. The use of a wide variety of supplements prevents taste fatigue.

There are no significant different in glycaemic response between fibre rich nutritional supplements and standard formulas. Both formulae have a low to moderate GI value.

At the introduction of nutritional supplements or when changing frequency, timing or choices of food supplements, blood glucose monitoring should be considered on an individual basis. Medication review may be required to avoid hyperglycaemia and to match new nutritional supplement regime.

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Tube Feeding

All tube feeds are similar in that they contain some form of sugar and are likely to have a similar effect on the blood glucose. The choice of feed is based on clinical need.

To date there is no evidence that feeding at any particular time of day is beneficial in those with diabetes

The timing of feeds will be based on clinical needs.

Blood glucose monitoring should be initiated and diabetes treatment should be reviewed with the input of a diabetes specialist nurse.

When changing frequency, timing or choices of enteral feeding, diabetes medication needs to be matched to the new regime.

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Microalbuminuria
 

Microalbuminuria has been shown to be predictive of cardiovascular mortality and morbidity. Refer to dietary advice to improve glycaemic control and the advice for dyslipidaemia, hypertension and weight reduction.

It is recommended that those with microalbuminuria have a protein intake at the lower end of the normal range.

Reduce salt intake.

 

See -  Nutrition & CVD - Salt Reduction

 

See - Salt Fact Sheet

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Proteinuria

Excess protein intake should be discouraged as it increases protein losses in the urine.

It is important to screen for malnutrition in patients with advanced renal failure. It has been shown that malnutrition worsens outcome in this patient group.

A reduction to 0.6-0.8g/kg per day may be beneficial to slow the progression of the disease with adequate energy intake in patients with advanced renal failure. However this is still controversial and not conclusive

Because of the potential for nutritional deficiencies and malnutrition this should be done under the supervision of a dietitian.

There is no conclusive evidence about the different properties of animal or vegetable proteins and their effect on diabetic renal disease.

Refer to the dietitian if dietary advice is required to control electrolyte levels such as potassium, phosphate.

See - High Potassium Food Fact Sheet

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Useful External Links & Resources

View

Coeliac UK

PDF File

3 steps to gain weight Fact Sheet

PDF File

High Potassium Foods Fact Sheet

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