Nutritional Strategies for the Diabetic/Prediabetic Patient PDF

Preface

One of the first questions usually asked by a newly diagnosed patient with diabetes is "Doctor, what should I eat?" Many physicians would prefer not to answer this question, not only because of the time it takes to do so properly, but because they do not feel confident doing so. Most physicians have been poorly trained in nutrition, yet we are frequently asked to advise patients in this area. Clearly, there is never a simple answer to the question. Although nutrition is central to the management of diabetes, there is no one "diabetic diet." The nutritional prescription will depend on the person's type of diabetes, food preferences, lifestyle, treatment regimen, comorbidities, state of heath, and the route of caloric administration. Nutritional counseling ideally starts before the diagnosis of diabetes in the patient with prediabetes (i.e., those with metabolic syndrome or impaired glucose regulation). For these patients, diabetes may be prevented by appropriate diet and weight loss. As the prevalence of obesity continues to increase at an alarming rate, early identification of prediabetic patients and aggressive nutritional intervention become critical.

This book was written primarily for physicians to advance their knowledge in nutrition as it relates to diabetes and provide evidence-based recommendations to their diabetic patients. Dietitians and diabetes educators who desire an in-depth understanding of the pathophysiology and medical treatment of diabetes will also find this book useful. Contributors to the book include basic scientists, clinicians from various subspecialties, registered dietitians, and certified diabetes educators, each with expertise on a different aspect of diabetes care. Molecular mechanisms of disease and drug therapy are reviewed in detail. Recommendations for management are provided and the level of evidence indicated where appropriate. In areas where little research data are available, recommendations are based on extensive clinical experience. There is a particular focus on the synchronization of nutrient intake with medications. Unique clinical management tools are provided and meant to be replicated for patient use. We hope that this book will serve to fill some of the gaps in the clinician's knowledge and help to optimize care of the diabetic and prediabetic patient.