Other Nutritional Therapy

Other nutritional therapy:

1. There is insufficient evidence to suggest the modification of protein intake (15–20% of energy) for individuals with diabetes and normal renal function. (ADA, 2008-2011)
2. The vitamin and mineral recommendation for those individuals with diabetes is the same with general population as study found that there is yet clear evidence about the benefit of vitamin in diabetes management. (MOH, 2009)

      What is resistant starch?

•       It can be found in some legumes, raw potato, and high amylose food.
•       A type of starches that escapes the digestion in small intestine and are completely digested in the colon.
•       It provides slightly increase in the blood glucose level after meal. However, it improves insulin sensitivity over other digestible starches but long term effect of resistant starches on health is not confirmed yet. 

      What is plant sterol?

•       Known as phytochemicals has been proven to block the absorption of cholesterol.
•       Help in lowering the LDL cholesterol by more than 10 %.
•      There are variety of food products with added phytosterols nowadays such as margarine spreads, juices, yogurts, cereals, and even granola bars. 

      What is Sugar alcohol (polyol)?

•      A hydrogenated monosaccharide.
•       Examples such as orbitol, mannitol, erythritol, xylitol and D-tagatose.
•      They are partially absorbed from the small intestine, characterized by reduced energy per gram.
•      At average, they provide energy with only 2 kcals/gm or 0.5 kcals/gm.
•      They cause less increase in blood glucose level after meal than sucrose and glucose.
•      However, they can cause diarrhea, especially in children. 

      What is non-nutritive sweetener?

•      Provides less or insignificant amount of energy without elimination of sweet sensation
•       They do not increase the blood glucose level or insulin concentration.
•      Examples which are approved by FDA:

      What are the two types of nutritive sweeteners?

      This kind of carbohydrate sources should be limited especially for patients with diabetes. 

      Recommendation for patients to overcome hypoglycemia.

•       Consume 15-20g glucose with any form of glucose.
•       Observe the response of the treatment within 10-20 minutes.
•       Test the plasma glucose level in approximately 60 minutes to decide whether additional treatment is necessary. 

      Sources:

v     Medical nutrition therapy guidelines for type 2 diabetes. MOH, 2005. 

v  Alison Gray, RD, 2011, MBA - Senior Clinical Research Scientist, Lilly USA LLC; DC 2231. Chapter18 – Medical Nutritional Therapy for the Patient With Diabetes http://www.endotext.org/diabetes/diabetes18/diabetes18.htm

v ADA. Nutrition Recommendations and Interventions for Diabetes.Journal of care diabetes org. http://care.diabetesjournals.org/content/31/Supplement_1/S61.full