How To Control Diabetes Type 2 With Diet – The Analytical Science and Politics of Nutrition Diet and Nutrition Strategies for the Prevention and Control of Type 2 Diabetes, 2018; 361 doi: https://doi.org/10.1136/.k2234 (Published June 13, 2018) Cite this as: 2018;361:k2234 Food for thought Click here to read other articles. in this collection
Said Nita G Foruhi and colleagues.
Dietary factors are very important in the management and prevention of type 2 diabetes. Despite progress in developing evidence-based dietary guidelines, controversy and confusion remain. In this article, we examine the evidence of Agreement, as well as uncertainty or ongoing controversy, regarding dietary guidelines for type 2 diabetes. What is the best diet? Is it possible for type 2 diabetes to be cured with lifestyle changes? Or is it an inevitable condition that is debilitating? We also examined the implications of specific nutritional changes and demographic factors in a global context. and discuss future directions for better nutritional and nutritional practices in the management of type 2 diabetes and their implementation.
Diabetes is one of the world’s greatest public health problems. The prevalence is expected to increase from 425 million in 2017 to 629 million by 2045, at the associated health, social and economic costs. direction is needed This is particularly due to investments in modifiable factors such as diet, exercise and weight. Diet is a major contributor to disease and mortality worldwide, according to the Global Burden of Disease study conducted in 188 countries2. The importance of diet in managing and preventing type 2 diabetes from its impact on weight and metabolic regulation is clear. However, diet is one of the most complex and difficult aspects of managing type 2 diabetes.
The idea of a “diet” for a chronic lifestyle condition like diabetes is enough to turn people off, because knowing what to eat and maintaining a healthy eating pattern can be challenging. Clinical nutrition therapy was developed as a systematic and evidence-based approach to managing the diabetic diet. and its effectiveness has been proven3 But the problem persists. Although most diabetes guidelines recommend starting drug treatment only after lifestyle changes in diet and exercise have been made. But this is not always followed throughout the world. Many physicians are not trained in nutritional approaches and this poses a barrier to advising patients45. in most places outside a specialized diabetes center with a trained nutritionist/educator The nutritional advice for diabetes is It is best to print out the list for the patient. in a resource-poor environment When type 2 diabetes is diagnosed, patients often leave the clinic with a list of new medications and little else. There has been a dramatic shift in the use of diet modification alone in the management of type 2 diabetes. For example, there are It is estimated to be less than 5-10% of people with type 2 diabetes in India6 and 31% in the UK. even if the patient receives treatment with lifestyle Procedures can be more closely controlled than in patients taking medications for type 2 diabetes. 7 Although there is usually a system to record and track steps in the diabetes care process in the medical record, it is necessary to achieve control. adequate blood sugar levels Family physicians and hospital clinics should collect this information on a regular basis. But how to do that is challenging 58.
There is progress in understanding the best nutritional recommendations for diabetes. But widespread problems remain. For example, many dietary recommendations recommend increasing the amount of fruits and vegetables. But the cost is high in many situations: the price of two portions of fruit and three portions of vegetables per day per person. 9 Expensive. The market for registered diets for diabetics also exists, with products often unhealthy and sometimes less healthy than regular diets. Following new EU legislation, food regulations in some countries, including the UK, were recently updated to prohibit it. Misleading label in July 2016. This case is nowhere else. And what will happen to such controls after the UK leaves the European Union remains unclear. which underlines the importance of the political environment.
In some developed countries Dietary guidelines for diabetes management have shifted from an emphasis on low-fat diets to recognizing that the most important factor is the quality of macronutrients (i.e. type and amount of macronutrients) by avoiding eating processed foods (part of large are carbohydrates and processed sugars) and overall eating patterns. Many systematic reviews and national dietary guidelines have evaluated the evidence for optimal nutritional recommendations. And we will not review the evidence repeatedly, the place of uncertainty. But we start by identifying three basic elements.
First, the understanding of healthy eating for the prevention and control of type 2 diabetes is largely based on longitudinal prospective studies and limited evidence from randomized controlled trials in the general population, supplemented by evidence. From people with type 2 diabetes, many published guidelines and review using planning criteria And this evidence is often of moderate quality in the range of evidence that puts randomized controlled trials at the top elsewhere. that assessed robustness in multiple research designs, including multicenter prospective studies based on clinical endpoints. Randomized controlled trials of clinical outcomes. and where should randomized trials of combined clinical outcomes be used for evidence-based nutritional recommendations. 19
Second, it is well known that nutritional recommendations for the prevention and control of type 2 diabetes should be integrated. and should not be treated separately (Figure 1). However, for people with type 2 diabetes, the level of glycemic control and the type and amount of diabetic medication should be consistent with dietary intake. Or reduce diabetes medication and follow up closely as will be discussed in the next section.
Thirdly, while we recognize the importance of diet for weight management, There is now a better understanding of 10 ways in which dietary factors affect health through independent mechanisms of obesity and obesity. Influence of nutrition on weight blood sugar And glucose-insulin homeostasis is directly important for glycemic control in diabetes. while other outcomes, such as cardiovascular problems, were more influenced by the effect of diet on blood lipids. apolipoprotein, blood pressure, termination thrombosis, coagulation, systemic inflammation and adhesion of blood vessels The effects of diet and nutrients on the gut microbiome may be important in the pathogenesis of diabetes. But more research is needed. Therefore, the long-term quality and quantity of food is important for the prevention and control of diabetes and its complications through various metabolic and physiological processes.
Type 2 diabetes is often associated with being overweight or obese. and insulin resistance Therefore, weight loss and maintenance of a normal weight are an important part of clinical management. Weight loss is also associated with improvements in blood sugar, blood pressure and lipid levels, so it may delay or prevent complications. especially cardiovascular events
Most guidelines recommend promoting weight loss in people who are overweight or obese by reducing their energy intake. Portion control is a strategy to reduce energy intake alongside a healthy eating pattern that focuses on eating whole or unprocessed foods, along with physical activity and support. continuously
Evidence suggests the promotion of dietary patterns that include fruits, vegetables, whole grains. Legumes, nuts, and dairy products like yogurt, but there are a few caveats. First, some diets (such as low-carb diets) recommend limiting your intake of fruit. whole grain and legumes due to the amount of sugar or starch for fruit consumption especially among patients with diabetes Scientists and physicians are divided on opinion (see appendix). Most guidelines continue to recommend fruit, however, on the basis that fruit-based fructose intake is better than sucrose or isocaloric starch consumption. This is because fruit contains additional micronutrients, phytochemicals and fiber. Second, despite evidence from randomized controlled trials and prospective studies10 that peanuts can help prevent type 2 diabetes, but some concerns There is (perhaps unreasonably) still about the high amount of energy. Further research on people with type 2 diabetes should help clarify this.
There is also consensus on the benefits of certain named eating patterns, such as the Mediterranean diet, for the prevention and control of type 2 diabetes. Expert recommendations also support other healthy eating patterns that take into account factors. socio-cultural and personal preferences
There is consensus on reducing or avoiding consumption of processed red meat. refined grains
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