Nutritional considerations in type 1 diabetes mellitus
- Linda M Delahanty, MS, RD
Linda M Delahanty, MS, RD
- Assistant Professor in Medicine
- Harvard Medical School
- David K McCulloch, MD
David K McCulloch, MD
- Washington Permanente Medical Group
- Section Editors
- Irl B Hirsch, MD
Irl B Hirsch, MD
- Section Editor — Diabetes Mellitus
- Professor of Medicine
- University of Washington School of Medicine
- Timothy O Lipman, MD
Timothy O Lipman, MD
- Section Editor — Nutrition
- GI-Hepatology-Nutrition Section
- Washington DC Veterans Affairs Medical Center
Diet and physical activity are critically important in the treatment of type 1 diabetes. Basic principles of nutritional management, however, are often poorly understood, by both clinicians and their patients.
The nutrition prescription for patients with type 1 diabetes should aim to optimally manage the "ABCs" of diabetes control: glycated hemoglobin (A1C), blood pressure and low-density lipoprotein (LDL)-cholesterol. The prescription must also be tailored for the individual patient to address diabetes complications and other concomitant conditions. The nutritional goals for people with type 1 diabetes are to:
●Maintain as near-normal blood glucose levels as possible, by integrating insulin therapy into each individual's diet and physical activity patterns.
●Achieve optimal blood pressure and lipid levels.
●Provide adequate calories for achieving and maintaining a reasonable body weight, normal growth, and development.
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- MEDICAL NUTRITION THERAPY
- CARBOHYDRATE CONSISTENCY
- Meal planning
- - Basic carbohydrate counting
- - Exchange system
- - Sample menus
- Insulin adjustments
- - Advanced carbohydrate counting
- - Elevated blood glucose levels
- - Treatment of hypoglycemia
- PHYSICAL ACTIVITY/EXERCISE
- WEIGHT MANAGEMENT
- Weight gain with intensive therapy
- Estimating desirable body weight
- Estimating caloric intake
- NUTRITIONAL CONTENT
- Glycemic index and glycemic load
- Alcohol intake
- Dietary recommendations
- MEAL-INSULIN TIMING
- EATING DISORDERS
- PROMOTING DIETARY COMPLIANCE
- SOCIETY GUIDELINE LINKS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS