Longterm Dietary Advice For The Mother And Her Child

As most women with GDM are obese and all have at least one child at increased risk of adolescent obesity and diabetes, providing dietary education and advice that extends beyond the pregnancy is extremely important. Lifestyle changes encompassing diet and exercise have been shown to reduce the risk of GDM in subsequent pregnancies as well as delaying the progression to Type 2 diabetes (59,95,96). Women with a history of GDM are an ideal group to target, not only because of their own heightened...

Preconception Nutritional Counselling In Diabetic Pregnancies

All women attempting pregnancy should take a minimum of 400 mg folic acid supplements a day to prevent neural tube defects 8 . The higher dose of 5 mg folic acid a day is frequently recommended for diabetic women, despite any actual trial evidence for this, the rationale being that neural tube defects are commoner in this group. In Britain, where the dietary folate intakes are relatively low despite numerous public health campaigns, less than 10 of women actually take folate supplements in...

Carbohydrate And Insulin Sensitivity

Daly et al. 28 have recently reviewed the evidence and clinical implications of dietary carbohydrates and insulin sensitivity. This is a controversial area. Extensive studies in animals show a detrimental effect of diets very high in fructose or sucrose, particularly in association with induction of hypertrigly-ceridaemia. The more limited results in human studies show conflicting results, partly because of heterogeneity of design. Certain groups of subjects such as the elderly, sedentary...

Hunt P. 1995 Dietary Counselling Theory Into Practice. J Inst Health Educ 33 4-8

Davidson C, Kowalska AZ, Nutman PN, Pearson GC. Dietitian-patient communication a critical appraisal and approach to training. Human Nutr Appl Nutr 1987 41A 381-389. 2. Vickery CE, Hodges PAM. Counselling strategies for dietary management expanded possibilities for effecting behaviour change. J Am Diet Assoc 1986 86 924-928. 3. Rollnick S. Behaviour change in practice targeting individuals. Int J Obes 1996 20 Suppl 1 S22-S26. 4. Coles C. Diabetes education theories of practice. Pract...

Vitamin And Minerals

The National Diet and Nutrition Survey of people aged 65 years and over provides valuable data on the current eating practices and nutritional status of elderly people in the UK 16 . Areas of concern highlighted in this report were the inadequate intakes of folate, vitamin D, vitamin C, vitamin K, iron and magnesium. Of the survey population 10-40 were shown to have multiple vitamin deficiencies and 10 were anaemic. Levels of deficiencies were higher when an individual was receiving...

References

Brydon P, Smith T, Proffitt M, Gee H, Holder R, Dunne F. Pregnancy outcome in women with Type 2 diabetes mellitus needs to be addressed. Int J Clin Prac 2000 54 418-419. 2. Casson IF, Clarke CA, Howard CV et al. Outcomes of pregnancy in insulin dependent diabetic women results of a five year population cohort study. Br Med J 1997 315 275-278. 3. Hawthorne G, Robson S, Ryall E, Sen D, Roberts SH, Ward Platt MP. Prospective population based survey of outcome of pregnancy in diabetic women...

Delayed Gastric Emptying

Hyperglycaemia delays gastric emptying 62 as do multiple other factors, many of which remain poorly understood. Physiological inhibitory pathways exist that control gastric emptying and involve small intestinal receptors that are stimulated by nutrients in the lumen of the gut. Posture, meal size and meal composition all influence gastric emptying through activating these receptors. Dietary fat empties at a slower rate than protein or carbohydrate and liquids empty faster than solids. A modest...

The Objectives Of The Dietary Management Of Diabetes

The goals of dietary management are clear beyond dispute and they apply equally to both Type 1 and Type 2 diabetes. They should achieve Near normal blood glucose with minimal risk of hypoglycaemia Reduced risk of microvascular and macrovascular complications as assessed by a variety of direct and surrogate measures, including blood lipids, clotting factors, blood pressure Weight loss in overweight patients Normal growth and development in children Healthy outcomes for mother and child in...

Ketoacidosis

Alcohol ingestion can cause ketoacidosis in people with diabetes and non-diabetics, as a result of relative insulin deficiency. Starvation, causing a depletion of glycogen stores and alcohol metabolism, leads to an increase in NADH NAD ratio which inhibits gluconeogenesis. This is responsible for causing an increased glucagon insulin ratio, which increases ketogenesis 16,17 . Diabetic ketoacidosis is a potentially life-threatening condition and requires prompt diagnosis and treatment of...

Introduction

Studies in the general population show an improvement in mortality and morbidity from light to moderate ingestion of alcohol. This improved mortality was greatest amongst those individuals with the highest risk of ischaemic heart disease 1 . The definition of light to moderate intake is, however, confusing and varies between researchers from one to three drinks per day, 3-4 units for men and 2-3 units for women per day, 0.5-1.0 g kg body weight, or 'moderate drinking is the level below which...

Dp

Other titles in the Wiley Diabetes in Practice Series Diabetes in Pregnancy An International Approach to Diagnosis and Management Edited by Anne Dornhorst and David R. Hadden 047196204X Edited by Simon Court and Bill Lamb 0471970034 Brian M. Frier andB. Miles Fisher 0471982644 Edited by Bill Burr and Dinesh Nagi 0471984965 Edited by Frank Snoek and T. Chas Skinner 0471977039 Edited by A. J. M. Boulton, Henry Connor and P. R. Cavanagh 0471489743 Nutritional Management of Diabetes Mellitus Edited...

Energy Requirements for Dialysis Patients

Energy requirements to achieve neutral nitrogen balance in stable diabetic dialysis patients are similar to those of healthy non-diabetic adults 35kcal kg body weight , with lower requirements for subjects over 65 years of age 30-35kcal kg body weight 19 . Patients on CAPD receive part of their energy requirements from dialysate glucose see below 20 . If CAPD patients have difficulty in meeting their recommended dietary energy intakes due to early satiety, they should be encouraged to eat after...