Diet Management of Diabetes

Uddi malenya
Lifestyle modification
Diet and Nutrition
 INTRODUCTION

• The overall goal of diabetes management is to help individuals with

diabetes and their families gain:
– The necessary knowledge,
– Life skills,
– Support needed to achieve optimal health
• Diet and nutritional therapy is an integral component of diabetes
management and diabetes self-management.

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 INTRODUCTION

• Nutritional management of diabetes is based on the

principles of healthy eating and still remains the
cornerstone of effective diabetes therapy
• A qualified nutritionist/dietician is a key member of
the diabetes management team.

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 Aims of diet therapy

• The objective of nutritional therapy is to help people with diabetes

learn how to make appropriate lifestyle choices.
• These choices can help people them to achieve optimum metabolic
control and prevent diabetes complications through:
• Good blood glucose levels
• Optimum lipid profile
• Controlled blood pressure levels
• Optimum body weight
 Aims of diet therapy cont…
• To prevent and treat obesity, dyslipidaemia,
cardiovascular disease, hypertension and
nephropathy through modification of diet
and lifestyle
• To consider the person’s nutritional needs
while taking into account personal and
cultural preferences and lifestyle issues
• Respect the individual’s rights, decisions
and willingness to change
• Optimize quality of life
Goals of Nutrition Therapy for Diabetes
• To attain and maintain optimal metabolic outcomes
• To improve health through healthy food choices and physical activity
• To address individual nutritional needs
• To maintain near-normal blood-glucose levels by balancing food
intake with insulin or oral medication and physical activity levels.
Goals of Nutrition Therapy for Diabetes Cont …

• To prevent, delay or treat acute insulin-

related complications such as
hypoglycaemia, short-term illness and
exercise-related problems.
• To assist in the prevention and
treatment of acute and chronic
complications.
• To promote physical, social and psychological
well being.
 The Nutritional Care Process

• Proper Nutritional Care is integral to the successful management of obesity,

diabetes and hypertension.
• Compliance with the nutrition and meal planning principles, however, remains
one of the most challenging aspects of care.
• An important first step in initiating Nutritional Care is evaluating the nutrition
status of the individual.
 Nutrition assessment

• Must be completed for every person with obesity, diabetes or

hypertension who presents for initial care.
• It is an important tool for identifying existing or potential problems
and identify clients needing a more comprehensive screening.
• It generates the information needed for a comprehensive approach to
nutrition intervention.
 Nutrition Assessment Cont….

• It is a pre-requisite for conducting dietary counseling.

• It enables the diabetes educator to provide optimal nutrition therapy
that is individualized
• Some parameters will need to be assessed each time the individual
presents for care and they include:
– weight,
– blood pressure,
– dietary intake and
– blood glucose.
Nutrition Assessment Cont…..

• In defining the level of nutrition intervention for the

targeted diseases, a total review of patient data is
important. This will include:
– Age,
– Gender,
– Socio-economic circumstances
– Literacy and numeracy.
– Ability and willingness to change nutritional
habits and practices.
– Emotional state, especially if newly diagnosed.
– Clinical Information
 The Assessment Process

• This is a systematic process of collecting objective

information about the client, his/her environment and the
support system.
• It provides some insight into some of the challenges the
client may face and the resources that are available to cope
with them.
 The Assessment Process

Historical Data
• Provides an insight into any relevant past illnesses or circumstances
that may directly or indirectly impact on the client’s nutrition needs
and health status.
• Important historical data to be reviewed include:
– Past medical history
– Social economic history
– Diet history
The Assessment Process
Data Collection
• Anthropometric • Biochemical
– Weight, – Blood Glucose,
– Height, – Lipid Profile,
– BMI, – RFTs,
– Waist – LFTs,
Circumference, – HBA1c
– Hip
Circumference,
 The Assessment Process
Data Collection
• Clinical • Behavioral
– Signs and symptoms of Information
– Alcohol Intake,
the disease(s) – Smoking,
– Symptoms of – Physical activity
Hyper/hypoglycemia • Dietary information
– Diagnosis and treatment – Diet History,
– Food security,
information – Food Preferences/Choices,
– Problems relating to – Taboos and beliefs
intake, e.g. chewing, – misconceptions,
– Allergies
swallowing
– Gastrointestinal
problems
– Blood Pressure,
 Other important assessment

• Determination of exercise/activity level

• Assessment of client's ability and readiness to participate in
care plan
• Assessment of client support network – home/community
• Interpretation of data
• Use of the data to provide appropriate care
 Nutritional Care Plan

• The nutrition recommendations that are integrated into the

overall management plan for the client are based on:
– Nutrition assessment
– Desired treatment outcomes
– Modification of lifestyles including eating behaviors
 Nutritional Care Plan cont…

• The Nutritional Care Plan should outline:

– Objectives for meeting nutrition and educational needs
– Content of the counseling sessions
– Time frame for achieving the objectives
• Counseling sessions should then be planned to provide instructions
and recommendations for the client.
• The counseling process may require several sessions to address the
care plan, the diet and to evaluate the client’s understanding as well
as responses to the plan.