UNCONTROLLED HYPERGLYCEMIA MANAGEMENT

TRADITIONAL MYTHS ABOUT DIABETIC DIET
1) Traditionally diet is a first-line management issue
2) Traditionally diet is often forgotten in drug-treated diabetes
3) Traditionally diet is often thought to manage hyperglycemia
4) Traditionally sugar, sweets, honey, etc are avoided
5) Traditionally we refer to a thing called a diabetic diet
6) It is now evidence-based to say that all these are wrong and of no value

LOADD TRIAL AND LOADD DIET
1) Lifestyles Over and Above Drugs in Diabetes Trial
2) Macronutrient composition carbos 45-60%, ports 10-20%, fats < 30%,
3) Emphasis on healthy eating strategy
4) Structured meal plans
5) Weight loss of 5-7%
6) Education on portion size and control
7) Foods allowed vegetables, fruit, legumes, wholegrain cereals, fish (preferably oily), nuts, low-fat dairy products, and appropriate fats and oils. Meat, when consumed, was to be lean.

 

 

REFERENCES
1) Finnish DPS (Diabetes Prevention Study) Tuomilehto J, Lindstrom J, Eriksson J et.al., Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with glucose tolerance. N Engl J Med 2001;344;1343-1350.
2) US DPP (US Diabetes Prevention Program) Knowler WC, Barrett-Connor E,Fowler SE et.al., Reduction in the incidence of type 2 diabetes mellitus with lifestyle intervention or metformin. N Engl J Med 2002;346;393-403.
3) Guidelines for the Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack. A Guideline for Healthcare Professionals From the American. Guidelines for the Prevention of Stroke in Patients With Stroke or Transient. http://stroke.ahajournals.org - published Oct 10th 2010
4) OmniHeart. OmniHeart diets provide more options for heart health. Available at: http://www.omniheart.org/OmniDiets.pdf Accessed October 7, 2008.
5) Salas-Salvadó. J, Bullo M, Babio N et al. Reduction in the incidence of type 2 diabetes with the Mediterranean Diet: Results of the PREDIMED-Reus Nutrition Intervention Randomized trial. Diabetes Care 2010: DOI:10.2337/dc10-1288. Available at: http://care.diabetesjournals.org. Abstract
6) Can gestational weight gain be modified by increasing physical activity and diet counseling? A meta-analysis of interventional trials. Ina Streuling, Andreas Beyerlein, and Rüdiger von Kries. Am J Clin Nutr October 2010 vol. 92 no. 4 678-687
7) Effects of a low–glycemic load diet in overweight and obese pregnant women: a pilot randomized controlled trial. Am J Clin Nutr December 2010 vol. 92 no. 6 1306-1315. Erinn T Rhodes, Dorota B Pawlak, Tamara C Takoudes, Cara B Ebbeling, Henry A Feldman, Margaret M Lovesky, Emily A Cooke, Michael M Leidig, and David S Ludwig
8) Harvard Report on Cancer Prevention
9) In 2001 71% of all deaths in Sri Lanka were due to heart diseases, brain disesaes, blood pressure, diabetes, respiratory diseases, renal diseases ans cancers. The National Policy and Strategic Framework for Prevention and Control of Chronic Non-Communicable. DIseases – 2009. Publication of Ministry of Healthcare and Nutrition Sri Lanka. http://203.94.76.60/Act/NCDPolicy-English.pdf
10) Coppell KJ, Kataoka M, Williams SM et.al., Nutritional Intervention in Patients With Type 2 Diabetes Who Are Hyperglycaemic Despite Optimised Drug Treatment--Lifestyle Over and Above Drugs in Diabetes (LOADD) Study: Randomised Controlled Trial. 08/03/2010; BMJ © 2010 BMJ Publishing Group
11) Ryan DH, Espeland MA, Foster GD, Haffner SM, Hubbard VS, Johnson KC, Kahn SE, Knowler WC, Yanovski SZ: Look AHEAD (Action for Health in Diabetes): design and methods for a clinical trial of weight loss for the prevention of cardiovascular disease in type 2 diabetes. Control Clin Trials 24:610–628, 2003

 

» SYMPTOM, SIGNS, SYNDROMES GLOSSARY