counselling (cont.) co-morbidity 148 acknowledging emotions 37 cognitive function 156, 7 active listening 36 dental health 155 agreeing goals 39, 40 eating problems 154, 7, 158, 163, 4 clarifying points 36, 7 fluid intake 155 diabetic dietitian’s experience 45, 51 future research 164 empowerment 39, 40, 42 gastric emptying 157, 159 establishing rapport 35, 8 glycaemic control 148, 156, 7, 164 expert-led 33 hospital care 162, 4 exploring emotions 38 hypoglycaemia 159, 60 exploring problems 38, 9 intercurrent illness 160 facilitating change 39, 41 leg ulcers 153, 4 information overload 3, 4, 33, 4 medication 159, 60 key stages 35 normal physiological change 148 open discussion 37 nursing home care 160, 2, 163 open questions 35, 6 nutritional recommendations paraphrasing 36, 7 148, 54 patient-centredness 34, 42 oral health 155 practitioners’ skills 34, 5, 41, 2 physical activity 150, 151 prior to conception 93, 4 physical problems 156 reflection 36, 37 psychological function 156 weight loss motivation 118, 19, 120 residential home care 160, 2, 163 cystic fibrosis (CF) 77 sensory loss 153, 155 social aspects 156 dental health, elderly people 155 undernutrition 154, 7, 162, 4 diabetic pregnancies see pregnancies, wound healing 153, 4 diabetic energy balance 5, 7, 8 dialysis see renal disease, dialysis children 55, 56, 60 dietary education see education, dietary dietary fat, carbohydrate variations dietetic services 3, 4 171, 3, 190, 1 drinks, physical activity 28 elderly people 150 see also alcohol; fluid intake obesity 119, 20 drug therapy see medication realistic diets 181, 2 dyslipidaemia 115, 16, 136, 190, 192, 4, Type 2 diabetes 88 216, 17, 244, 5 energy requirements dialysis patients 233, 4, 237, 8, 241, eating disorders 75, 6, 113, 118 245 education, dietary pregnancy 95, 6, 99, 100, 101 carbohydrate assessment 66, 8 enteral feeding 220, 1, 222, 4, 227, 242 carbohydrate management 64, 8 exchange system 8, 66, 67, 68 children 45, 51, 62, 9, 74, 5 exercise counselling 33, 42 blood glucose levels 28, 29, 30 diabetic dietitian’s account 45, 51 contraindications 26, 122 exchange systems 8, 66, 67, 68 definition 21 food pyramids 64 dietary intake 27, 8, 29 intensive 68, 9 duration 22, 25 plate models 64, 65 frequency 22, 25 eggs 140 hypoglycaemia 24, 25, 6, 28, 29 elderly people with diabetes 147, 64 insulin therapy 25, 6, 28, 9, 30 body weight 149, 150, 151 intensity 21, 22, 25, 28, 9 clinical presentation 148 physiology 22, 4
INDEX 261
timing 25, 6, 28, 29 fibre 2, 9 see also physical activity children 60 dietary fat, carbohydrate variations families, children’s diabetes 73, 4, 76 172, 3, 175, 177, 178, 196, 197 fasting, dialysis patients 243, 4 elderly people 151 fat mass, Type 2 diabetes 114 inpatient nutritional support 222, fats, dietary 223, 4 cardiovascular risk 10, 11, 12, 58, 73, tube feeds 222, 223, 4 172 Type 2 diabetes 8, 196 diabetic pregnancies 101, 2 fish oils 11, 58 plasma lipids 137 cardiovascular risk 138, 9 Type 2 diabetes 137, 138, 9 diabetic pregnancies 102, 3 dialysis patients 245 elderly people 150 fat, carbohydrate variations 171, 83, renal transplant patients 252 189, 97 flavonoids 140, 210 blood glucose levels 192, 195, 196 fluid intake cardiovascular disease 172, 173, 190 dialysis patients 242 current recommendations 171, 2 elderly people 155 dyslipidaemia 192, 4 physical activity 28 fibre 172, 3, 175, 177, 178, 196, 197 foetal development future research 182, 3 diabetic pregnancies 92, 93, 4, 100 high-carbohydrate 172, 83, 191, non-diabetic pregnancies 96, 97 192, 193, 4, 195, 196, 197 folic acid high-MUFA 174, 6, 179, 190, 1 cardiovascular risk 140 historical perspectives 171 diabetic pregnancies 93 insulin secretion 192, 195, 196 elderly people 150, 153 insulin sensitivity 174, 5, 176, 177, 8, renal transplant patients 253 191 food pyramids 64 low GI 175, 7, 178, 180, 183, 195, fructose 9, 138, 181 197 metabolic effects 191, 7 garlic 140 realistic diets 181, 2 gastric bypass surgery 124, 5 satiety value 179, 80 gastric emptying sucrose restriction 180, 1 elderly people 157, 159 Type 2 diabetes 175, 177, 9, 189, 97 enteral tube feeding 224 weight control 178, 80, 190, 1 genetic defects of beta-cell function inpatient nutritional support 221, 222, 77, 8 225, 226 gestational diabetes mellitus (GDM) 93, insulin sensitivity 137, 174, 5, 176, 95, 98, 104 177, 8, 191 glibenclamide lower fat snacks 59, 60 diabetic pregnancies 93 nutritional recommendations 2, 5, 7, dialysis patients 245 11, 14, 171, 2 elderly people 159, 60 cardiovascular risk 137 glucokinase deficiency 78 children 55, 57, 60, 73 glucose elderly people 150 blood levels see blood glucose levels gestational diabetes 100, 3 dialysis patients 237, 238 scientific basis 172, 3, 174, 5 glucose metabolism parenteral nutrition 225, 226 insulin resistance syndrome 134 renal transplant patients 252, 253 non-diabetic pregnancies 96, 97 tube feeds 222 physiology of exercise 23, 24
262 INDEX
glucose transfer, gestational diabetes non-diabetic pregnancies 96, 97 100, 1 physical activity 23, 24 glycaemic control hospital care benefits 170 elderly people 162, 4 cardiovascular disease 137, 170, 189, 90 inpatient nutritional support 215, 28, children 62, 71, 74, 75 242 diabetic pregnancies 92, 93, 4, 97, hyperglycaemia 98, 9, 101 children 70, 71, 2, 76 dialysis patients 232, 243, 4, 245, 6 enteral feeds 223, 4 dietary fat, carbohydrate variations foetal 92, 94 172, 174, 192, 197 gastric emptying 157 elderly people 148, 156, 7, 164 inpatient nutritional support 215, 28 inpatient nutritional support 216, 17, maternal 92, 94 223, 4, 225, 8 hyperinsulinaemia microvascular complications 189 dialysis patients 244 obese diabetic patients 115, 119, 20, dietary carbohydrates 138 122, 123 dietary fat 137 parenteral nutrition 225, 6, 227, 8 foetal 92 physical activity 20, 70 hyperkalaemia 239, 241, 242 renal transplant patients 252 hypernatraemia 242 tube feeds 223, 4, 227 hyperphosphataemia 239, 241, 2 Type 2 diabetes 88, 94, 115, 137, hypertension 189, 90 alcohol 208, 9 glycaemic index (GI) 8 elderly people 153 carbohydrate food values 27, 177 obese diabetic patients 115, 122 diet variations 175, 7, 178, 180, 183, Type 2 diabetes 13, 89, 115, 208 195, 197 hypoalbuminaemia 240, 1 inpatient nutritional support 221 hypoglycaemia insulin sensitivity 176, 178 alcohol-induced 61, 202, 3, 206, 7 obesity treatment 119 children 71 guidelines, nutritional see nutritional alcohol 61 recommendations carbohydrate, insulin balancing 69, 70 haemodialysis (HD) 233, 238, 239, 240, illness 72 241, 242, 243 insulin analogues 70 haemoglobinopathies 77 intensive nutrition education 68, 9 heart disease see cardiovascular disease parties 76 high-density lipoprotein (HDL) 2, 6, 10, physical activity 70 11 school 74 cardiovascular risk 137, 138, 140, 173, weight management 62 194, 209, 10 diabetic pregnancies 93, 94, 97, 103 dialysis patients 244 dialysis patients 244 dietary fat, carbohydrate variations elderly people 159, 60 173, 174, 175, 191, 193, 194, 195 gastric emptying 157 obesity 114, 115, 121 physical activity 24, 25, 6, 28, 29, 70, soya protein 140 122 Type 2 diabetes 136, 194 HNF-1a deficiency 78 illness, intercurrent homocysteine 140, 1, 253 children 72, 77, 8 hormonal responses elderly people 160 alcohol 207, 8 impotence, alcohol-related 212