Increased consumption of calcium from fat-free milk, energy-restricted diet and educational activities improves metabolic control in overweight type 2 diabetic patients.

We assessed the effects of increased Ca consumption from fat-free milk in an energy-restricted diet and educational activities in the metabolic control of overweight type 2 diabetes mellitus (T2DM) patients. Fourteen subjects with T2DM (BMI 29·4 (sd 4·5) kg/m2, low habitual Ca consumption (<600 mg/d)) were included in this randomised, crossover clinical trial. Subjects were randomly allocated to one of the two interventions: drink containing 700 mg of Ca (DAIR) or drink containing 0 mg of Ca (CONT) for ninety consecutive days each. Energy-restricted diets (-500 kcal/d; -2092 kJ/d), containing 800 mg of Ca from dietary sources/d, were prescribed for both groups. Questionnaires were applied at baseline and at the end of the study to assess the subjects' knowledge on the disease and on self-care, biochemical variables and physical activity. Blood pressure, food intake, body composition and anthropometry were assessed at baseline, days 45 and 90. There was a higher reduction of body fat %, waist circumference, hip circumference, neck circumference, waist:hip ratio, sagittal abdominal diameter, diastolic/systolic blood pressure and an increase in fat-free mass % in DAIR than in CONT. Uric acid, fasting glucose, Hb1Ac, parathyroid hormone and alanine aminotransferase concentrations reduced and vitamin D concentration increased after 90 d in DAIR compared with CONT. The consumption of energy-restricted diet containing 1200 mg Ca/d seems to favour metabolic control in subjects with T2DM. The educational activities increased the knowledge on the disease care.

Dietary goal attainment measures and psychosocial factors among Mexican Americans and non-Hispanic whites with type 2 diabetes.

Diabetes education programs need improved measures of goal setting for dietary control of diabetes. Additionally, measures of patient experiences with dietary goal setting are needed to better prepare patients for diabetes self-management. Measures of dietary goals and strategies were investigated via survey of 100 Mexican Americans and non-Hispanic whites with type 2 diabetes at a community clinic. Analyses tested novel goal measures as stages of change and goal attainment with a food plan compared to a traditional measure of food plan adherence. Ethnic groups varied in some reported experiences with goal setting education and goal attainment, but did not differ in most clinical characteristics of diabetes. Results indicated that different measures of goal setting vary in their psychosocial predictors, suggesting changes in how health care providers use and monitor goal setting for patients. At the time this research was conducted, Dr. Briggs Early was a doctoral candidate in the Department of Food Science and Human Nutrition at Washington State University. She is currently an Assistant Professor of Biochemistry and Nutrition at Pacific Northwest University of Health Sciences - College of Osteopathic Medicine, and a certified diabetes educator, and insulin pump trainer in Yakima, Washington.

Manejo práctico del paciente con diabetes mellitus en la atención primaria de salud / Practical Management of patients with diabetes mellitus in primary health care

La diabetes mellitus es una enfermedad de primera importancia a nivel de salud pública en todo el mundo, por ser una de las enfermedades no transmisibles más frecuentes, y por la severidad y diversidad de sus complicaciones crónicas. Se realiza una revisión actualizada sobre el manejo de las personas con diabetes mellitus. Incluye definición, diagnóstico y clasificación, algoritmo para el pesquisaje de la enfermedad, conducta ante una persona con diabetes mellitus en la Atención Primaria de Salud, pilares de tratamiento y metas de control metabólico. Tiene como objetivo exponer elementos prácticos para el abordaje del paciente con diabetes mellitus tipo(AU)

Diabetes mellitus is a disease of major importance for public health throughout the world. This is mainly caused by its status as one of the most common non-communicable diseases and the severity and diversity of its chronic complications. An updated literary review on the management of patients with diabetes mellitus was conducted. It includes definition, diagnosis and classification, algorithm for diseases screening, appropriate management of a patient with diabetes mellitus in primary health care, treatment pillars and goals for metabolic control. This review is aimed at exposing practical elements when approaching a patient suffering from diabetes mellitus(AU)

Visão retrospectiva em fibras alimentares com ênfase em beta-glucanas no tratamento do diabetes / In retrospect, with emphasis on dietary fiber beta-glucan in the treatment of diabetes

Fibra alimentar refere-se aos componentes de plantas ou carboidratos análogos que são resistentes à digestão e absorção no intestino delgado humano. A American Dietetic Association recomenda ingestão de 20-35g de fibras ao dia. Evidências sugerem que uma dieta rica em fibras traz benefícios à manutenção da saúde, redução de risco e tratamento de doenças crônicas como a obesidade, doenças cardiovasculares, diverticulite e diabetes. As fibras são classificadas de acordo com a sua solubilidade em solúveis e insolúveis, com efeitos fisiológicos distintos. As insolúveis são responsáveis pelo aumento do bolo fecal e diminuição do tempo de trânsito intestinal. As solúveis retardam o esvaziamento gástrico e a absorção de glicose diminuindo a glicemia pós-prandial e reduzem o colesterol sérico devido à sua característica física de conferir viscosidade ao conteúdo luminal. As beta-glucanas são fibras altamente viscosas e seu consumo está relacionado à atenuação da resposta glicêmica e insulínica pós-prandial. A beta-glucana tem efeito sobre a degradação do amido e sobre o carboidrato disponível e conseqüentemente, sobre o índice glicêmico dos alimentos ingeridos. Recomenda-se sua ingestão com o objetivo de modular a glicemia e a necessidade de insulina, no tratamento da obesidade, doenças cardiovasculares e do diabetes. Este trabalho visa fornecer uma visão geral sobre beta-glucanas no tratamento do diabetes.

Dietary fibers are defined as the component of the plants or analog carbohydrates that are resistant to digestion and absorption in the human small bowel. The America Dietetic Association recommends an ingestion of 20-30g of fiber per day. Evidences suggest that a diet rich in fibers brings benefits to health maintenance, by reducing the risk and the time of treatment of chronic diseases such as obesity, cardiovascular diseases, diverticulitis and diabetes. Fibers are classified as a soluble and insoluble with distinct physiological effects. Ingestion of insoluble fibers increases the fecal bolus and reduces the transit time of food through the bowel. Soluble fibers delay gastric emptying and glucose absorption reducing the post prandial glycemia and reduce blood cholesterol levels due to a physic characteristic that confers viscosity to the luminal content. Beta-glucans are highly viscous and their consumption has been related to the attenuation of post-prandial glycemic and insulin response. Dietary beta-glucans have impact on starch degradation and carbohydrates availability and consequently at the glycemic index of the ingested food. Consumption of beta-glucans is recommended aiming to modulate the glycemia and the insulin needs, to manage the obesity, cardiovascular diseases and diabetes. This paper brings information about dietary fibers and the use of beta-glucans on the treatment of diabetes.

Diet and diabetes in the Caribbean

The problem is that in many Caribbean countries, especially Trinidad and Tobago, Barbados and the Bahamas, an incipient scourge has developed. Referred to sometimes as "sugar" or "sweet blood", diabetes is our most expensive disease and the one responsible for the most deaths. Diabetes has everything to do with the way we eat and live. Statistics for Trinidad, which are most up to date, show that we need not look far to find someone with diabetes. One- but possibly as many as two- out of every ten people have it. These days it's a cultural problem. Sadly, even the very cuisine on which we pride ourselves has become a source of health problems. That together with two much 'liming', social drinking, and smoking are now all on a national bad list. So, now it is time we weigh the benifits of our lifestyle against its consequences.

Avaliação do grau de satisfação da contagem de carboidratos em diabetes mellitus tipo 1 / Evaluation of how satisfactory is carbohydrate counting in patients with diabetes

INTRODUÇÃO: A contagem de carboidratos talvez seja o planejamento alimentar mais preciso e flexível, especialmente naqueles portadores de diabetes tipo 1 (DM1). OBJETIVO: Avaliar o grau de satisfação dessa abordagem em DM1 em programa de insulinoterapia intensiva. MÉTODOS: 50 pacientes com DM1 submetidos à contagem de carboidratos por 6 meses responderam um questionário relacionado ao estilo de vida. RESULTADOS: As respostas foram favoráveis acima de 80 por cento aos quesitos relacionados à escolha do número de refeições, comer fora de casa, horário das refeições, planejamento das atividades sociais e diárias, realização de glicemia e leituras de rótulos dos alimentos; entre 60 e 80 por cento, na escolha do tipo de alimento, na quantidade de comida, no consumo de alimentos ricos em açúcar e participação de atividades de última hora. CONCLUSÕES: Conforme a opinião dos participantes, a contagem de carboidratos é um procedimento muito bem aceito, permitindo uma melhor qualidade de vida.

[Evaluation of how satisfactory is carbohydrate counting in patients with diabetes]. / Avaliação do grau de satisfação da contagem de carboidratos em diabetes mellitus tipo 1.

INTRODUCTION: Carbohydrate counting is probably the most precise and flexible meal planning approach available, especially for those with type 1 diabetes (DM1). OBJECTIVE: To evaluate the degree of satisfaction of that approach in patients treated by intensive insulin therapy. METHODS: 50 DM1 patients submitted to carbohydrate counting for 6 months answered a questionnaire related to the lifestyle. RESULTS: The answers were favorable in: >80% to requirements related to the choice of the number of meals, to eat out, schedules of meals and social and daily activities, glycemic monitorization and interest in reading food labels; 60% to 80% answered favorably to topics related to the choice of the food type, the amount of food, the consumption of food rich in sugar and the participation of last minute activities. CONCLUSIONS: According to the participants' opinion, carbohydrate counting is a very well accepted procedure, allowing a better lifestyle.

Diabetes mellitus, actividad física y nutrición. Una estrategia de calidad de vida y control de la enfermedad

El progreso en el conocimiento de la enfermedad ha posibilitado la actulización de la clasificación de la diabetes basada en criterios patogénicos y la persecución de objetivos terapeúticos, lo cual ha propiciado la revisión y puesta al día del papel del ejercicio físico en el tratamiento de la diabetes...(AU)

Plan de alimentación en la diabetes mellitus gestacional / Meal planning during gestational diabetes mellitus

El propósito de este artículo es proporcionar de forma accesible, tanto al médico como a la paciente con diabetes mellitus gestacional, los conocimientos básicos acerca de la composición y contenido calórico de los nutrientes, su organización y equivalencia en el sistema y listas de intercambio de alimentos, de tal forma que dependiendo de los requerimientos calóricos del embarazo y de la actividad física que se desarrolle, facilite la elaboración del plan de alimentación (con gran diversidad de menús) para que la paciente con diabete mellitus logre un buen control metabólico (cifras de glucosa dentro de los límites normales) y disminuya así el riesgo de morbimortalidad perinatal

Edulcorantes y productos dietéticos / Sweeteners and dietetic products

Los edulcorantes son productos útiles empleados muy comúnmente en la alimentación de los pacientes diabéticos y en regímenes hipocalóricos. Se presenta un análisis crítico de los diferentes edulcorantes calóricos y no calóricos actualmente disponibles en el mercado nacional analizando el aporte energético así como las ventajas y desventajas de cada uno de ellos. Se describen las características químicas y metabólicas del aspartame, endulzante no calórico y se comentan las investigaciones que se realizaron para lograr la autorización de su uso por la Federal Drug Administration (FDA). Se hace énfasis en que el profesional de la salud, debe tener conocimientos sobre los edulcorantes y productos dietéticos, a objeto de instruir a los pacientes para la correcta selección de ellos