III.
Moses, Robert, 1946, [DNLM: 1.
Diabetes Mellitus- -diet therapy. 2.
Diabetic Diet.
WK 818 N9768 2003] RC662.N89 2003 616.40 620654- -dc21 2003049741 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library ISBN 0 471 49751 7 Typeset in 10/12pt Times by Dobbie Typesetting Ltd, Tavistock, Devon Printed and bound in Great Britain by Biddles Ltd, Guildford and Kings Lynn This book is printed on acid-free paper responsibly manufactured from sustainable forestry in which at least two trees are planted for each one used for paper production.
Contents List of Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi
1 Nutritional Recommendations in Diabetes Management . . . . . . . . . . 1 Norma McGough
2 Diabetes and Physical Activity. . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Pamela Dyson
3 Counselling in Diabetes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Tracey Parkin
4 Dietitian and Diabetic: Thoughts on Working and Living with Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Jo Sutton
5 The Nutritional Management of Children’s Diabetes . . . . . . . . . . . . 53 Sheridan Waldron, Peter Swift, Lindsey Oliver and Deborah Foote
6 An Introduction to Type 2 Diabetes . . . . . . . . . . . . . . . . . . . . . . . . 85 Gary Frost
7 The Dietary Management of Diabetic Pregnancies . . . . . . . . . . . . . . 91 Anne Dornhorst and Gary Frost
8 Obesity and Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 Karen Slevin, Jacqueline Cleator and John Wilding
9 Nutritional Management of Cardiac Risk Factors in Type 2 Diabetes 133 Audrey Brynes
vi CONTENTS
10 Nutritional Management of the Elderly Person with Diabetes . . . . . 147 Mary Hickson and Lucy Wright
11 The Role of Carbohydrate in the Management of Diabetes . . . . . . . 169 Janette C. Brand-Miller and Susanna H. A. Holt
12 Effect of Variations in Amount and Kind of Dietary Fat and Carbohydrate in the Dietary Management of Type 2 Diabetes . . . . . 189 Gerald M. Reaven
13 Diabetes and Alcohol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201 Linda Carter and Joanne Boyle
14 Inpatient Nutritional Support of Sick Patients with Diabetes . . . . . . 215 Hilary Peake
15 Diabetes and Renal Replacement Therapy . . . . . . . . . . . . . . . . . . . 231 Marie Kelly and Thushara Dassanayake
16 Nutritional Management of Diabetic Renal Transplant Recipients . . 249 Barbara Engel
Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257
List of Contributors
BOYLE, JOANNE Nutrition and Dietetic Department, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK
BRAND-MILLER, Human Nutrition Unit, Department of JANETTE C. Biochemistry, University of Sydney, NSW 2006, Australia
BRYNES, AUDREY Research Dietitian, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK
CARTER, LINDA Nutrition and Dietetic Department, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK
CLEATOR, JACQUELINE Diabetes and Endocrinology Clinical Research Group, Clinical Sciences Centre, University Hospital Aintree, Longmoor Lane, Liverpool L9 7AL, UK
DASSANAYAKE, THUSHARA Senior Renal Dietitian, Nutrition and Dietetic Department, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK
DORNHORST, ANNE Nutrition and Dietetic Research Group, Depart- ment of Metabolic Medicine and Nutrition and Dietetics, Division of Investigational Science, Hammersmith Hospital Campus, Faculty of Medicine, Imperial School of Medicine, Du Cane Road, London W12 0NN, UK
viii LIST OF CONTRIBUTORS
DYSON, PAMELA Diabetes Specialist Dietitian, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Headington, Oxford OX3 7LJ, UK
ENGEL, BARBARA Senior Renal Dietitian, Department of Nutrition and Dietetics, Charing Cross Hospital, Fulham Palace Road, London W6 7RS, UK FOOTE, DEBORAH Senior Dietitian, Diabetes Centre, Level 10 Queen Mary Building, Royal Prince Alfred Hospital, Grose Street, Camperdown, NSW 2050, Australia
FROST, GARY Nutrition and Dietetic Research Group, Depart- ment of Metabolic Medicine and Nutrition and Dietetics, Division of Investigational Science, Hammersmith Hospital Campus, Faculty of Medicine, Imperial School of Medicine, Du Cane Road, London W12 0NN, UK
HICKSON, MARY Research Dietitian, Hammersmith Hospitals NHS Trust, Dietetic Department, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK
HOLT, SUSANNA H. A. Human Nutrition Unit, Department of Biochemistry, University of Sydney, NSW 2006, Australia
KELLY, MARIE Chief Dietitian, Nutrition and Dietetic Department, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK
MCGOUGH, NORMA Freelance Dietitian, The Auction Room, 20 Temple Street, Aylesbury, Bucks HP20 2RQ, UK MOSES, ROBERT Director of Diabetes Services, Illawarra Area Health Service, 4/393 Crown Street, Wollongong, NSW, 2500, Australia
OLIVER, LINDSAY Lead Diabetes Dietitian for Northumbria Trust, Diabetes Resource Centre, North Tyneside General Hospital, Rape Lane, North Tyneside, UK
LIST OF CONTRIBUTORS ix
PARKIN, TRACEY Diabetes Specialist Dietitian, Diabetes Centre, Queen Alexandra Hospital, Cosham, Portsmouth, Hants PO6 3LY, UK PEAKE, HILARY Dietetic Department, Hammersmith Hospital, 150 Du Cane Road, London W12 0HS, UK REAVEN, GERALD M.
Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA SLEVIN, KAREN Diabetes and Endocrinology Clinical Research Group, Clinical Sciences Centre, University Hospital Aintree, Longmoor Lane, Liverpool L9 7AL, UK SUTTON, JO Consultant Dietitian, PO Box 780, Knaphill, Woking, Surrey GU21 2TL, UK SWIFT, PETER Consultant Paediatrician, Leicester Royal Infirmary, Leicester LE1 5WW, UK WALDRON, SHERIDAN Diabetes Specialist Dietician (Paediatric), 49 Swithland Lane, Rothley, Leics LE7 7SG, UK WILDING, JOHN Diabetes and Endocrinology Clinical Research Group, Clinical Sciences Centre, University Hospital Aintree, Longmoor Lane, Liverpool L9 7AL, UK WRIGHT, LUCY Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK
Introduction The Ancient Greeks were the first to advocate diet and lifestyle management for people with diabetes.
Until the discovery and use of insulin in the 1920s and suphonylureas in the 1940s, diet and lifestyle intervention were the only treatment options available.
For people with Type 1 diabetes this was woefully ineffective and consisted of near starvation diets imposed on already severely malnourished individuals.
While such diets may have prolonged life by a few months, an inevitable early death from ketoacidosis was all too often replaced with death from infections due to the severe malnutrition and other co- morbidities.
The introduction of insulin radically reduced the death rates from ketoacidosis and problems associated with malnutrition, however, survival brought other lethal problems in the form of microvascular and macrovascular disease.
The dietary management of Type 1 diabetes over the last 80 years has had to adapt to the many changes in insulin formulations as well as changes in staple foods and eating patterns.
Over the years the premise for the dietary advice given, of optimising growth while minimising diabetes associated complica- tions, has not changed.
By contrast the dietary advice given has radically changed in response to advances in our understanding of the biochemical and physiological mechanisms involved in diabetic complications.
Today the dietary advice offered for people with Type 1 diabetes has little resemblance to the advice given by R.
D.
Lawrence three-quarters of a century ago.
R.
D.
Lawrence’s diet advocating a high-fat and low-carbohydrate intake has been replaced by the more healthy low-fat and high-carbohydrate diets of today.
To what extent today’s dietary advice will resemble that in 75 years time, will, we believe, reflect the quality of the scientific evidence behind this advice.
Since the advent of insulin and oral agents, other changes to the dietary management of diabetes have included the way dietary advice is imparted.
There has been a move away from prescriptive diets given by authoritarian
Nutritional Management of Diabetes Mellitus. Edited by G. Frost, A. Dornhorst and R. Moses & 2003 John Wiley & Sons, Ltd. ISBN 0 471 49751 7
xii INTRODUCTION