Nutrition in Diabetes Mellitus

1. See Also
   1. Carbohydrate Count
   2. Nutrition in Diabetes Mellitus Type I
   3. Nutrition in Diabetes Mellitus Type II
2. Approach: Pearls
   1. Omit sugar beverages (soda, energy drinks) and juices
      1. Improves Glucose control immediately
      2. Use Non-nutritive Sweeteners in drinks or water
   2. Avoid skipping meals (3) and planned snacks (2)
      1. Increases Hypoglycemia risk
      2. Increases baseline hepatic Glucose output
      3. Appetite becomes dysregulated
   3. Additional points
      1. No set ADA diet
      2. No set caloric restriction
      3. Modify on an individual basis
3. Approach: Protein
   1. No Nephropathy
      1. Same intake as general population
      2. Percent of calories per day: 10-20%
   2. Nephropathy
      1. Normal GFR: <0.8 grams/kg/day Protein
      2. Falling GFR: <0.6g/kg/day Protein
4. Approach: Carbohydrates
   1. Complex carbohydrates are generally preferred
   2. Simple carbohydrates (fruit juice, sucrose)
      1. Limit to occasional treats
   3. Nutritive sweeteners (Fructose)
      1. No benefit
   4. Non-nutritive Sweeteners (e.g. Aspartame, Acesulfame-K, Sucralose)
      1. Safety confirmed
5. Approach: Dietary Fiber
   1. See Dietary Fiber
   2. Same recommendations as general population
6. Approach: Fat
   1. First Priority: Blood Sugar control
   2. Second Priority: Weight control
   3. Third Priority: Dietary changes
7. Approach: Alcohol
   1. Limit to 2 drinks per day
   2. Risk of Hypoglycemia if Insulin taken and Fasting