Building Competency in Diabetes Education THE ESSENTIALS

TREATMENT MODALITIES: LIFESTYLE| 5-25

NUTRITIONAL GOALS OF DIABETES MANAGEMENT

Effective nutritional SME requires an individualized approach appropriate to the lifestyle and goals of the person living with diabetes. A nutritional assessment is used to determine individual nutrition therapy, based on treatment goals. Canada is a country rich in ethnocultural diversity. Different ethnocultural groups have distinct and shared foods, food preparation techniques, dining habits, dietary patterns, and lifestyles that directly impact the nutrition therapy. A “transcultural” approach to nutrition therapy that takes into account these issues should be adopted (35). General meal planning Receiving a diagnosis of diabetes can be a very traumatic experience, and part of this trauma is the belief on the part of many people that they must now follow a “diabetic diet”. Discuss patient concerns with him or her and provide reassurance, pointing out that there is no such thing as a “diabetic diet”. Rather, the word diet comes from the Greek word dieta , which means “way of life”. In and of itself, the word has no negative connotations. The same general nutrition recommendations apply to those with diabetes as to those without. However, it is also important to communicate that people living with diabetes will likely suffer more consequences of a poor diet than people without diabetes. A plan for meals, snacks and diabetes medications should be based on an assessment of the patient’s lifestyle and goals. Important aspects of carbohydrate intake to consider when meal planning for someone with diabetes are as follows: type of carbohydrate, distribution of carbohydrate, timing of carbohydrate intake, consistency of carbohydrate intake and amount of carbohydrate/weight gain. Type of carbohydrate People are encouraged to choose lower-GI foods and foods high in fibre. But, just as for the general population, intake of sweets is acceptable (see Sugars, above) and becomes a concern only if intake is in excess of recommendations, or if sweets are replacing healthy, nutrient dense foods. Those who take multiple daily insulin injections can learn to adjust their insulin dose according to the amount of carbohydrate they consume, so that even if they eat sweets in addition to their usual carbohydrate intake, they can still achieve good glycemic control. Those who take multiple daily injections have more flexibility with carbohydrate intake; for those who rely on any other treatment modality to control their BG, excess intake of any type