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African American History – 1865 to Present

9.1 Medical Nutrition Therapy for Type 1 and Type 2 Diabetes

4 min readLast Updated on August 9, 2024

Diabetes management is a balancing act of blood sugar, nutrition, and lifestyle. This section dives into the nitty-gritty of keeping glucose in check, from monitoring methods to carb counting. It's all about giving your body what it needs while keeping those sugar levels steady.

Nutrition therapy and lifestyle changes are the dynamic duo of diabetes care. We'll explore how to build a diet that works for you, get moving in ways that matter, and learn the ropes of self-management. It's not just about following rules, but finding what clicks for your life.

Blood Glucose Management

Monitoring Techniques and Technologies

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  • Blood glucose monitoring involves measuring blood sugar levels at specific times throughout the day
  • Traditional method uses glucometer requiring finger prick to obtain small blood sample
  • Continuous glucose monitoring (CGM) systems provide real-time glucose readings every few minutes
    • CGM devices consist of a small sensor inserted under the skin and a transmitter that sends data to a receiver or smartphone
    • Allows for better tracking of glucose trends and patterns (nocturnal hypoglycemia)
  • Time in range (TIR) measures percentage of time blood glucose levels stay within target range (typically 70-180 mg/dL)
    • Aim for at least 70% TIR for optimal glycemic control

Glycemic Control and Complications

  • Glycemic control refers to maintaining blood glucose levels within target range
  • HbA1c test measures average blood glucose levels over past 2-3 months
    • Target HbA1c for most adults with diabetes < 7%
    • Lower targets may be appropriate for some individuals (younger patients, shorter duration of diabetes)
  • Hypoglycemia occurs when blood glucose levels drop below 70 mg/dL
    • Symptoms include shakiness, sweating, confusion, and in severe cases, loss of consciousness
    • Treatment involves consuming fast-acting carbohydrates (glucose tablets, juice)
  • Hyperglycemia refers to high blood glucose levels, typically above 180 mg/dL
    • Short-term symptoms include increased thirst, frequent urination, and fatigue
    • Long-term complications include cardiovascular disease, kidney damage, and neuropathy
  • Glycemic variability measures fluctuations in blood glucose levels throughout the day
    • Minimizing glycemic variability reduces risk of complications and improves overall health outcomes

Nutrition Therapy

Carbohydrate Management Strategies

  • Carbohydrate counting involves tracking grams of carbohydrates consumed in meals and snacks
    • Essential for determining insulin doses in type 1 diabetes and some type 2 diabetes management plans
    • Typically aim for 45-60 grams of carbohydrates per meal, adjusted based on individual needs
  • Glycemic index (GI) ranks carbohydrate-containing foods based on their effect on blood glucose levels
    • Low GI foods (< 55) include most fruits, non-starchy vegetables, and whole grains
    • High GI foods (> 70) include white bread, potatoes, and sugary beverages
    • Combining high GI foods with protein or fat can help lower overall glycemic impact of a meal
  • Insulin-to-carbohydrate ratio determines amount of insulin needed to cover carbohydrates consumed
    • Typically ranges from 1:5 to 1:20 (1 unit of insulin for every 5-20 grams of carbohydrates)
    • Ratios may vary based on time of day, activity level, and individual insulin sensitivity

Balanced Nutrition and Fiber Intake

  • Macronutrient balance focuses on appropriate distribution of carbohydrates, proteins, and fats
    • General guidelines: 45-65% carbohydrates, 15-20% protein, 20-35% fat
    • Individualized based on patient preferences, cultural considerations, and metabolic goals
  • Fiber intake plays crucial role in blood glucose management and overall health
    • Aim for 25-30 grams of fiber per day from variety of sources
    • Soluble fiber (oats, legumes) helps slow digestion and improve blood glucose control
    • Insoluble fiber (whole grains, vegetables) promotes digestive health and satiety
  • Micronutrient considerations include adequate intake of vitamins and minerals
    • Focus on nutrient-dense foods to meet requirements while managing blood glucose levels
    • Special attention to vitamin B12, vitamin D, and magnesium, which may be deficient in individuals with diabetes

Lifestyle Interventions

Meal Planning and Weight Management

  • Meal planning involves creating structured eating patterns to optimize blood glucose control
    • Consistent meal timing helps regulate blood glucose levels and insulin requirements
    • Plate method simplifies meal planning: 1/2 plate non-starchy vegetables, 1/4 plate lean protein, 1/4 plate carbohydrates
  • Weight management crucial for individuals with type 2 diabetes or at risk of developing it
    • Modest weight loss (5-10% of body weight) can significantly improve insulin sensitivity
    • Strategies include portion control, increasing physical activity, and choosing nutrient-dense foods
    • Meal replacement products may be useful for some individuals in achieving weight loss goals

Physical Activity and Self-Management Education

  • Physical activity improves insulin sensitivity and helps manage blood glucose levels
    • Aim for at least 150 minutes of moderate-intensity aerobic activity per week
    • Resistance training 2-3 times per week improves muscle mass and insulin sensitivity
    • Adjust insulin doses or consume additional carbohydrates to prevent exercise-induced hypoglycemia
  • Diabetes self-management education (DSME) empowers individuals to effectively manage their condition
    • Topics include blood glucose monitoring, medication management, and problem-solving skills
    • Ongoing support helps individuals maintain behavior changes and adapt to new challenges
    • Utilize technology (smartphone apps, online resources) to enhance self-management skills
  • Stress management techniques important for overall diabetes management
    • Chronic stress can negatively impact blood glucose control
    • Incorporate relaxation techniques (meditation, deep breathing) into daily routine
    • Regular sleep patterns contribute to better glycemic control and overall health
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AP® and SAT® are trademarks registered by the College Board, which is not affiliated with, and does not endorse this website.


© 2025 Fiveable Inc. All rights reserved.
AP® and SAT® are trademarks registered by the College Board, which is not affiliated with, and does not endorse this website.

© 2025 Fiveable Inc. All rights reserved.
AP® and SAT® are trademarks registered by the College Board, which is not affiliated with, and does not endorse this website.
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