Nutritional Strategies in Type 2 Diabetes Mellitus
Weight loss is a key goal in the management of patients with type 2 diabetes mellitus. There are conflicting weight-loss strategies, including low-carbohydrate diets, low-glycemic-index diets, low-fat vegan diets, conventional low-fat diets, and high protein and high-monounsaturated fat diets. There is no evidence to suggest that 1 nutrional strategy is clearly the best. The most successful strategy is one that the patient can adopt and follow in the long term. Mt Sinai J Med 76:257-268, 2009. (C) 2009 Mount Sinai School of Medicine
Available from: Dongjun Kim
- "Macronutrients including carbohydrate, protein, and fat have varying effects on blood glucose level. Considering that carbohydrate is the single major dietary component affecting the postprandial glucose level compared to protein and fat, carbohydrate intake is much more important in advanced diabetes, which generally shows marked postprandial hyperglycemia . In far-east Asia, rice is the major staple food and the major source of daily energy intake, which is quite different compared to Western countries. "
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ABSTRACT: Major macronutrients for energy intake vary among countries and cultures. Carbohydrates, including rice, are the major component of daily energy intake in Korea. The aim of this study was to examine the association of daily energy intake or each proportion of macronutrients, especially carbohydrates, with glycemic control in diabetic Koreans.
A total of 334 individuals with diabetes (175 men, age 57.4±0.8 years; 159 women, age 60.9±0.9 years) who participated in the 2005 Korean National Health and Nutrition Examination Survey were examined. Glycemic control was categorized based on concentration of glycated hemoglobin (HbA1c; HbA1c ≤6.5%; 6.6% to 8.0%; ≥8.1%). Dietary intake was assessed by using a 24-recall item questionnaire.
High total energy intake was associated with poor glycemic control (HbA1c ≤6.5%, 1,824±75 kcal; 6.6% to 8.0%, 1,990±57 kcal; ≥8.1%, 2,144±73 kcal; P value for trend=0.002). Each proportion of protein, fat, or carbohydrate was not associated with glycemic control. Even after adjusting for several parameters, the association of daily energy intake with glycemic control still persisted.
Total energy intake may be more closely related to glycemic control than each proportionof macronutrients in Korean diabetics.
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ABSTRACT: Type 2 diabetes mellitus is a heterogeneous disease characterized by an inability to transport glucose from the blood into
the cells. The disease has genetic and lifestyle determinants and probably results from the interaction of these risk factors.
While this notion is widely accepted and endorsed, the available evidence is far from concrete. In this chapter the evidence
that implicates physical inactivity and common genetic variation in type 2 diabetes risk will be described. Then, the fundamental
concepts of gene × exercise interactions in type 2 diabetes will be defined by summarizing the evidence from epidemiological
studies and clinical trials that have tested related hypotheses. The penultimate section of this chapter discusses the strengths
and limitations of existing studies of interaction and outlines some of the common methodological hurdles inherent when testing
hypotheses of gene × exercise interactions. The chapter concludes with a short section looking forward to where this field
of research is heading and the possibilities for clinical translation.
KeywordsType 2 diabetes-Genetics-Genotype-Interaction-Effect-modification-Epidemiology-Clinical trials-Exercise-Physical activity
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