DOCSLIB.ORG

The Effects of a Low-Glycemic Index Diabetes Management Program On

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Effects of a Low-Glycemic Index Diabetes Management Program On Louisiana Tech University Louisiana Tech Digital Commons Master's Theses Graduate School Spring 5-25-2019 The ffecE ts of a Low-Glycemic Index Diabetes Management Program on Weight, Body Mass Index, Triglycerides, Cholesterol and Hemoglobin A1C Values Morgan Williston Louisiana Tech University Follow this and additional works at: https://digitalcommons.latech.edu/theses Part of the Community Health and Preventive Medicine Commons, Dietetics and Clinical Nutrition Commons, and the Nutritional and Metabolic Diseases Commons Recommended Citation Williston, Morgan, "" (2019). Thesis. 15. https://digitalcommons.latech.edu/theses/15 This Thesis is brought to you for free and open access by the Graduate School at Louisiana Tech Digital Commons. It has been accepted for inclusion in Master's Theses by an authorized administrator of Louisiana Tech Digital Commons. For more information, please contact [email protected]. THE EFFECTS OF A LOW-GLYCEMIC INDEX DIABETES MANAGEMENT PROGRAM ON WEIGHT, BODY MASS INDEX, TRIGLYCERIDES, CHOLESTEROL AND HEMOGLOBIN A1C VALUES by Morgan Williston, B.S., RDN, LDN A Thesis Presented in Partial Fulfillment of the Requirements of the Degree Master of Science SCHOOL OF HUMAN ECOLOGY COLLEGE OF APPLIED AND NATURAL SCIENCES LOUISIANA TECH UNIVERSITY May 2019 LOUISIANA TECH UNIVERSITY GRADUATE SCHOOL Click here to enter a date. March 29, 2019 Date of thesis defense We hereby recommend that the thesis prepared by Morgan Williston, B.S., RDN, LDN entitled The effects of a low-glycemic index diabetes management program on weight, body mass index, triglycerides, cholesterol, and hemoglobin A1c values be accepted in partial fulfillment of the requirements for the degree of Master of Science in Nutrition & Dietetics Dr. Catherine Fontenot, Supervisor of Thesis Research Dr. Ethel Jones, Head of Human Ecology Members of the Thesis Committee: Dr. Janet Pope Dawn Erickson Approved: Approved: _____________________________ _____________________________ Gary A. Kennedy Ramu Ramachandran Dean of Applied & Natural Sciences Dean of the Graduate School GS Form 13 (01/19) ABSTRACT The purpose of this study was to evaluate effects of a low-glycemic index diet on weight, body mass index (BMI), triglycerides, cholesterol levels, and hemoglobin A1c (HbA1c) following participation in a 12-hour outpatient diabetes self- management education (DSME) program. This DSME program is unique as it focuses on a low-glycemic index diet rather than the traditional carbohydrate consistent diet to control blood glucose levels. Health outcomes obtained post participation were compared to baseline data. Participants were 283 individuals with type 2 diabetes including 94 (33%) men and 189 (67%) women, with a mean baseline HbA1c of 8.7 ±2.2%. Statistically significant improvements were seen in mean BMI (-0.7±2.0 kg/m2, p<0.05), HbA1c (-1.1±1.9%, p<0.05), and total cholesterol (-12.3±37.3 mg/dL, p<0.05). No statistically significant differences in changes between men and women were found for the outcomes measured. Although males showed improvements in HDL cholesterol (+1.7±8.1 mg/dL, p =0.052), results were not statistically significant, unlike the significant improvements for the female group (+1.6±10.1 mg/dL, p<0.05). Traditionally, a carbohydrate consistent diet has been supported as the primary diet for diabetes management. This research shows a low-glycemic index diet can also be beneficial. Future research should include long-term randomized control trials to compare the two approaches to diabetes management. The effects of the low-glycemic index diet on medication use and quality of life also should be explored. iii APPROVAL FOR SCHOLARLY DISSEMINATION The author grants to the Prescott Memorial Library of Louisiana Tech University the right to reproduce, by appropriate methods, upon request, any or all portions of this Thesis. It is understood that “proper request” consists of the agreement, on the part of the requesting party, that said reproduction is for his personal use and that subsequent reproduction will not occur without written approval of the author of this Thesis. Further, any portions of the Thesis used in books, papers, and other works must be appropriately referenced to this Thesis. Finally, the author of this Thesis reserves the right to publish freely, in the literature, at any time, any or all portions of this Thesis. Author Date March 29, 2019 TABLE OF CONTENTS ABSTRACT...................................................................................................................... iii LIST OF TABLES............................................................................................................ vii CHAPTER 1 INTRODUCTION ....................................................................................... 1 Statement of the Problem........................................................................................ 1 Purpose of the Study .............................................................................................. 5 Hypotheses.............................................................................................................. 5 Justification............................................................................................................. 6 CHAPTER 2 REVIEW OF LITERATURE……...…………………………………….... 8 Prevalence of Diabetes……...…………………………………………................. 8 Diagnostic Criteria for Diabetes…….…………………….……………............. 10 Complications of Diabetes…………...…………………………………............. 10 Effectiveness of Nutrition Therapy in Diabetes Management .....….................... 11 Nutrition Therapy Interventions …………….......………………....….. 13 Prevalence of Nutrition Therapy ……………...…...………….....….… 14 Weight Loss Intervention and Glycemic Control……………………...........….. 15 Low-Glycemic Diet and Diabetes Management. .…...…………………............. 17 Carbohydrate Restriction ……………………..............……….....…….. 21 v Non-Nutritive Sweeteners…….............……………………………....... 22 Fats……………………………….........…………………………......… 24 Dietary Patterns and Diabetes Management……………........……..….............. 26 DASH Dietary Pattern…….……………………….……………......….. 26 Low-Fat Dietary Pattern……….........…………………………......…… 27 Vegetarian Dietary Pattern……………………………………….......… 27 Mediterranean Dietary Pattern……………………………………......... 28 Summary……….....……………..…………………………………...........…... 29 CHAPTER 3 METHODS ................................................................................................ 30 Subjects................................................................................................................. 30 Instruments............................................................................................................ 31 Data Collection..................................................................................................... 31 Data Analysis........................................................................................................ 32 CHAPTER 4 RESULTS................................................................................................... 33 CHAPTER 5 DISCUSSION............................................................................................. 39 APPENDIX A................................................................................................................... 47 A-1 Data Collection Instrument............................................................................ 48 APPENDIX B................................................................................................................... 49 B-1 Letter of Approval from HUC ...................................................................... 50 B-2 Letter of Approval from BRG’s IRB ............................................................ 51 REFERENCES................................................................................................................. 53 vi LIST OF TABLES Table 1: Low-Glycemic Index Diabetes Management Program Participant Demographics.................................................................................................... 34 Table 2: Clinical Baseline Data For Program Participants........................................... 35 Table 3: Clinical Follow-Up Data For Program Participants........................................ 35 Table 4: Changes In Outcomes Measures Following Participation In A Low-Glycemic Index Focused Diabetes Management Program In Participants......................... 37 Table 5: Changes In Outcome Measures Following Participation In A Low-Glycemic Index Focused Diabetes Management Program Based on Gender..................... 38 vii CHAPTER 1 INTRODUCTION According to the American Diabetes Association (ADA), diabetes is characterized by hyperglycemia triggered by an abnormal surge in insulin and/or a defect in insulin action (2014). The development of diabetes can be caused by autoimmune damage to pancreatic B-cells, promoting an insulin deficiency and defects in tissue insulin sensitivity. Often, diminishing insulin secretion and insulin resistance can occur simultaneously in the same individual, and it can be unclear which defect is the primary cause of hyperglycemia (ADA, 2014). Two general etiopathogenetic groups, Type 1 and Type 2 diabetes, categorize the majority of diabetes cases (ADA, 2014). Individuals diagnosed with type 1 diabetes have the inability to secrete insulin (ADA, 2014). On the other hand, individuals with both insulin resistance and insufficient compensatory insulin secretory response are
Load more

Recommended publications
  • Association Between High Fat-Low Carbohydrate Diet Score and Newly Diagnosed Type 2 Diabetes in Chinese Population*
    Biomed Environ Sci, 2012; 25(4): 373-382 373 Original Article Association between High Fat-low Carbohydrate Diet Score and Newly * Diagnosed Type 2 Diabetes in Chinese Population HE Yu Na1,2,#, FESKENS EJ2, LI Yan Ping1, ZHANG Jian1, FU Ping1, MA Guan Sheng1, and YANG Xiao Guang1,# 1. National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing 100050, China; 2. Division of Human Nutrition, Wageningen University, the Netherlands Abstract Objective To study the association between high fat-low carbohydrate diet score and newly diagnosed type 2 diabetes in Chinese population. Methods Data about 20 717 subjects aged 45-59 years from the cross-sectional 2002 China National Nutrition and Health Survey were analyzed. High fat-low carbohydrate diet was scored according to the energy of carbohydrate, fat, and protein. Results Of the 20 717 subjects, 1 332 were diagnosed with hyperglycemia and 662 were newly diagnosed with type 2 diabetes. Multivariate adjusted analysis showed that the highest score of type 2 diabetes patients was 2.75 (95% CI: 2.09-3.61). The score of type 2 diabetes patients was 1.87 (95% CI: 1.35-2.58) after further adjustment for their socioeconomic status and physical activity. No significant difference was found in the odds ratio after further adjustment for BMI, blood pressure, lipid level, and energy intake. No evidence was observed for the relation between high fat-low carbohydrate-diet score in type 2 diabetes patients due to high family income, less education, physical activity, overweight, hypertension, high TG, or low HDL level.
    [Show full text]
  • Diabetes and Diet: Food Choices
    Diabetes and diet: food choices CENTRALE LANDBOUWCATALOGU S 0000 0330 5675 Promotoren:dr .J.G.A.J .Hautvast ,hoogleraa ri nd elee rva nd evoedin g end evoedselbereidin g dr.ir.N.G .Röling ,hoogleraa ri nd evoorlichtingskund e A.C. Niewind Diabetes anddiet : food choices PROEFSCHRIFT terverkrijgin gvei nd egraa dva n doctori nd elandbouwwetenschappen , opgeza gva nd erecto rmagnificus , dr.H.C .va nde rPlas , inhe topenbaa rt everdedige n opwoensda g7 jun i198 9 desnamiddag st evie ruu ri nd eaul a vand eLandbouwuniversitei tt eWageninge n BIBLIOTHEEK LANDBOUWUNIVERSITEIT WAGENINGEN HetDiabete sProjec twaarva nd estudies ,di ei ndi tproefschrif tworde n beschreven,dee luitmaken ,wer dfinanciee londersteun ddoo rhe tMinisteri eva n Welzijn,Volksgezondhei de nCultuu re ndoo rd eLandbouwuniversitei t Wageningen. (OWC7CH, \d&ô STELLINGEN 1. Mensenme tdiabete slegge nzichzel fonnodig ee ni nhe tlich tva n gezondevoedin gonjuist ebeperkinge no pi nhu nvoedselkeuze . (ditproefschrift ) 2. Veeldieetadvieze ndi eaa ndiabete nworde ngegeven ,zij nnie tgeën to p dehuidig ewetenschappelijk einzichten . (ditproefschrift ) 3. Voordiabete ni she tvolge nva nhe tdieetadvie she tmoeilijkst easpec t vand ebehandelin gva ndiabetes . (o.a.di tproefschrift ) 4. Bijhe tverandere nva nvoedingsgewoonte nmoe te rva nuitgegaa nworde n datvoedse lzowe lgezondheidswaard eal sgenotswaard eheeft . 5. Aaninsuline-afhankelijk ediabete nzonde rovergewich tzo ugee nvast e hoeveelheidenergi ei nd evoedin gmoete nworde nvoorgeschreven . 6. Dieet/voedingsadviezenworde nte nonrecht egeïnterpreteer d inge -e n verboden. 7. Wanneerdiabete ndieetadvieze nnie topvolgen ,i sdi tnie tt ewijte naa n onvoldoendemotivatie ,maa raa nonvoldoend ekenni sva nhe tdoe lva nhe t dieete naa nontoereikend evoorlichting . 8. Iti smuc heasie rt ochang ea ninsuli nregime ntha nt ochang ea person'seatin ghabits .
    [Show full text]
  • Effect of Low-Calorie Versus Low-Carbohydrate Ketogenic Diet in Type 2 Diabetes
    Nutrition 28 (2012) 1016–1021 Contents lists available at ScienceDirect Nutrition journal homepage: www.nutritionjrnl.com Applied nutritional investigation Effect of low-calorie versus low-carbohydrate ketogenic diet in type 2 diabetes Talib A. Hussain M.B., Ch.B., R.C.G.P. a, Thazhumpal C. Mathew M.Sc., Ph.D., F.R.C.Path. b, Ali A. Dashti M.Sc., Ph.D. b, Sami Asfar M.B., Ch.B., M.D., F.R.C.S., F.A.C.S. c, Naji Al-Zaid B.Sc., Ph.D. d, Hussein M. Dashti M.D., Ph.D., F.I.C.S., F.A.C.S. c,* a Al Shaab Family Medicine Medical Center, Ministry of Health, Kuwait b Department of MLS, Faculty of Allied Health Sciences, Health Sciences Center, Kuwait University, Kuwait c Department of Surgery, Faculty of Medicine, Health Sciences Center, Kuwait University, Kuwait d Department of Physiology, Faculty of Medicine, Health Sciences Center, Kuwait University, Kuwait article info abstract Article history: Objective: Effective diabetic management requires reasonable weight control. Previous studies from Received 13 June 2011 our laboratory have shown the beneficial effects of a low-carbohydrate ketogenic diet (LCKD) in Accepted 16 January 2012 patients with type 2 diabetes after its long term administration. Furthermore, it favorably alters the cardiac risk factors even in hyperlipidemic obese subjects. These studies have indicated that, in Keywords: addition to decreasing body weight and improving glycemia, LCKD can be effective in decreasing Obesity antidiabetic medication dosage. Similar to the LCKD, the conventional low-calorie, high nutritional Body mass index value diet is also used for weight loss.
    [Show full text]
  • Diet in Diabetes
    Diet in Diabetes Jaya Dewani*, Shilpa S Joshi**, Shashank R Joshi*** *Consultant Dietician, **Consultant Dietician, Diet and Health Care, Mumbai; ***Consultant Endocrinologist, Lilavati & Bhatia Hospital; Hon. Ass. Prof. Grant Medical College & Sir J. J. Group of Hospitals, Mumbai. 56 Diabetes a metabolic disorder is characterized by high blood delay or arrest long term complications To enable them to lead sugar. From where does this extra sugar come? Sugar (glucose) a normal well-adjusted life.The objectives can be achieved with the main source of fuel for the body comes from the food we eat regular self-monitoring and proper combination of diet, exercise and is also made in liver and muscles. Blood carries the glucose and medications. to all the cells in your body. Insulin a hormone produced by DIET IN DIABETES pancreas is the key that unlocks cells and lets the glucose enter, thus providing energy for cell functions. In people with diabetes, Diabetic diet is not about avoiding sugar, sweets, rice, banana, however the pancreas either produces little or no insulin or the cell potato etc. Principle of diabetic diet is to match the nutritional does not respond appropriately to the insulin (insulin résistance). requirements with balanced diet (A balanced diet contains the Without effective insulin utilization of glucose is impaired as a optimum amounts of nutrients in order to promote health). result glucose builds up in the blood. High blood glucose can The nutritional requirements of diabetics are the same as in lead to both the short term and long term complications non-diabetics. The nutrient intake has to be tailor made to the individual based on the age, sex, weight, height, physical activity Acute complications include hypoglycemia (low blood glucose) and physiological needs of the patient.
    [Show full text]
  • Combined Maternal and Postnatal High-Fat Diet Leads to Metabolic Syndrome and Is Effectively Reversed by Resveratrol
    www.nature.com/scientificreports OPEN Combined maternal and postnatal high-fat diet leads to metabolic syndrome and is efectively Received: 10 November 2017 Accepted: 26 March 2018 reversed by resveratrol: a multiple- Published: xx xx xxxx organ study Jiunn-Ming Sheen1, Hong-Ren Yu 1, You-Lin Tain1,2, Wan-Long Tsai1, Mao-Meng Tiao1, I-Chun Lin1, Ching-Chou Tsai3, Yu-Ju Lin3 & Li-Tung Huang1,4 This study aimed to study the impact of a combination of maternal and post-weaning high-fat diets and whether resveratrol was benefcial. Sprague-Dawley dams were fed either chow or a high-fat diet, before mating, during pregnancy, and into lactation. At weaning, their ofspring were randomly fed chow or a high-fat diet. Four experimental groups were generated: CC (maternal/postnatal chow diet), HC (maternal high-fat/postnatal chow diet), CH (maternal chow/postnatal high-fat diet), and HH (maternal/postnatal high-fat diet). A ffth group consisted of HH plus resveratrol. The 4 month- old ofspring of HH group had higher body weight, higher levels of plasma triglycerides, leptin, angiotensin I and angiotensin II and abnormal intraperitoneal glucose tolerance test results, which fulflled the features of metabolic syndrome. The dysregulation of the renin-angiotensin system was seen in multiple organs. Sirtuin 1 expression/abundance was reduced by a maternal/postnatal high-fat diet, in all the organs examined. Resveratrol ameliorated most of the features of metabolic syndrome and molecular alterations. The administration of a high-fat diet in both periods showed interactive metabolic efects in the plasma and many organs.
    [Show full text]
  • Diet and Diabetes
    FOCUS Diet and diabetes Gary Deed, John Barlow, Dev Kawol, Gary Kilov, Anita Sharma, Liew Yu Hwa Background iabetes mellitus is expected to be the leading cause of chronic disease in Australia by 2023. Being overweight Guidelines for the prevention and management of type 2 Dor obese carries significant risks for developing type 2 diabetes mellitus (T2DM) reinforce lifestyle management, yet diabetes mellitus (T2DM). Lifestyle modification remains the advice to guide general practitioners on principles around bedrock of management of T2DM and its related comorbidities dietary choices is needed. in Australian and international treatment guidelines.1,2 Once Objective T2DM develops, the combination of diet, lifestyle changes and physical activity has a major impact on glycaemic control, weight This article provides current evidence regarding the differing management and complication prevention. diets in diabetes prevention and management once T2DM arises, including the role in management of complications such The role of diet in diabetes prevention as hypoglycaemia. It is estimated that 16.4% of Australians have prediabetes.3 This is defined as impaired fasting glucose (IFG) and impaired Discussion glucose tolerance, or an HbA1c of 6.0–6.4% (42– 46 mmol/ mol).4 Prediabetes carries an independent risk for cardiovascular Diets should incorporate weight maintenance or loss, while 3 complementing changes in physical activity to optimise disease, separate from the risks of developing T2DM. Thus, the metabolic effects of dietary advice. Using a structured, prediabetes risk prevention must address the prevention team-care approach supports pragmatic and sustainable of cardiovascular risks as much as managing progressive 3 individualised plans, while incorporating current evidence- dysglycaemia.
    [Show full text]
  • Diet, Lifestyle and Type 2 Diabetes in China
    Diet, lifestyle and type 2 diabetes in China Yuna He Thesis committee Promotor Prof. Dr E.J.M. Feskens Personal chair at the Division of Human Nutrition Wageningen University Co-promotors Prof. Dr G. Ma National Institute for Nutrition and Food Safety Chinese Center for Disease Control and Prevention,Beijing, China Prof. Dr X. Yang National Institute for Nutrition and Food Safety Chinese Center for Disease Control and Prevention, Beijing, China This research was conducted under the auspices of the Graduate School VLAG (Advanced studies in Food Technology, Agrobiotechnology, Nutrition and Health Sciences). Diet , lifestyle and type 2 diabetes in China Yuna He Thesis submitted in fulfillment of the requirements for the degree of doctor at Wageningen University by the authority of the Rector Magnificus Prof.DrM.J.Kropff, in the presence of the Thesis Committee appointed by the Academic Board to be defended in public on Monday 2 June 2014 at 1:30 p.m. in the Aula. Yuna He Diet, lifestyle and type 2 diabetes in China, 162 pages. PhD thesis, Wageningen University, Wageningen, NL (2014) With references, with summaries in English, Dutch and Chinese ISBN:978-90-6173-921-6 Abstract Background Over the past two decades, China has been undergoing rapid socio-economic and nutrition transitions. Along with these transitions, chronic non-communicable diseases, such as obesity and type 2 diabetes, are becoming serious public health problems. However, only few studies on determinants of type 2 diabetes, such as fetal exposure, dietary patterns, physical activity, and obesity, have been carried out in China. Method The 2002 China National Nutrition and Health Survey (CNNHS), which is a nationally representative cross-sectional survey, was the source of data for this study.
    [Show full text]
  • Diet in Diabetes with Special Relevance to Dietary Fat Intake 245
    244 Medicine Update Diet in Diabetes with Special 43 Relevance to Dietary Fat Intake SUNIL GUPTA Diet is a cornerstone of treatment for diabetes. Every women. Reduced energy intake is an important aspect diabetic should receive detailed advice from a skilled of management for obese patients as well as for dietician, explaining the types and amounts of food that prevention of T2DM in susceptible individuals. Even will enable dietary compliance. In fact, the “diabetic” those patients with T2DM who do not appear obese may diet is nothing more than a normal balanced diet, that is have truncal obesity and could benefit from small rich in complex high fiber carbohydrates and low in amounts of weight loss (5-10%)7. Instances where saturated fat and cholesterol. Meals should be taken patients with T2DM may need increased energy intake regularly in every 3-4 hours (2 major meals and 3 snacks). beyond maintenance levels include—following The total energy content should be adjusted in an effort significant weight loss at diagnosis, during chronic to maintain body weight within normal range. infections, during severe illness, during a postoperative period. Such patients lose not only body fat but also lean Medical Nutrition Therapy (MNT) plays a role in all body mass that needs to be recovered. three levels of diabetes related prevention. Primary prevention interventions seek to delay or halt the Two approaches may be considering for reduction development of diabetes in individuals with obesity and of total energy intake: Very-low-calorie diet (VLCD, less prediabetics (IGT and IFG). Secondary and tertiary than 800 kcal per day) or low-calories diet (LCD, 800- prevention intervention include MNT for individuals 1500 kcal per day).
    [Show full text]
  • Dietary Carbohydrate Restriction As the First Approach in Diabetes
    Nutrition 31 (2015) 1–13 Contents lists available at ScienceDirect Nutrition journal homepage: www.nutritionjrnl.com Critical Review Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base Richard D. Feinman Ph.D. a,*, Wendy K. Pogozelski Ph.D. b, Arne Astrup M.D. c, Richard K. Bernstein M.D. d, Eugene J. Fine M.S., M.D. e, Eric C. Westman M.D., M.H.S. f, Anthony Accurso M.D. g, Lynda Frassetto M.D. h, Barbara A. Gower Ph.D. i, Samy I. McFarlane M.D. j, Jörgen Vesti Nielsen M.D. k, Thure Krarup M.D. l, Laura Saslow Ph.D. m, Karl S. Roth M.D. n, Mary C. Vernon M.D. o, Jeff S. Volek R.D., Ph.D. p, Gilbert B. Wilshire M.D. q, Annika Dahlqvist M.D. r, Ralf Sundberg M.D., Ph.D. s, Ann Childers M.D. t, Katharine Morrison M.R.C.G.P. u, Anssi H. Manninen M.H.S. v, Hussain M. Dashti M.D., Ph.D., F.A.C.S., F.I.C.S. w, Richard J. Wood Ph.D. x, Jay Wortman M.D. y, Nicolai Worm Ph.D. z a Department of Cell Biology, State University of New York Downstate Medical Center, Brooklyn, New York, USA b Department of Chemistry, State University of New York Geneseo, Geneseo, NY, USA c Department of Nutrition, Exercise and Sports, Copenhagen University, Denmark d New York Diabetes Center, Mamaroneck, NY, USA e Department of Radiology (Nuclear Medicine), Albert Einstein College of Medicine, Bronx, New York, USA f Duke University Medical Center, Durham, NC, USA g Department of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA h Department of Medicine, University of California San Francisco,
    [Show full text]
  • Dietary Management of Diabetes: Focus on Ketogenic Diet
    THIEME Review Article 75 Dietary Management of Diabetes: Focus on Ketogenic Diet Rajiv Singla1 Rahul Rosha2 Sanjay Kalra3 1Department of Endocrinology, Kalpavriksh Healthcare, New Delhi, India Address for correspondence Sanjay Kalra, MD, DM, Department of 2Department of Nutrition, Novique Healthcare, Pune, Maharashtra, India Endocrinology, Bharti Hospital, Karnal 132001, Haryana, India 3Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India (e-mail: [email protected]). J Soc Health Diab 2018;6:75–79. Abstract In an era of ever-increasing burden of obesity and diabetes, an out-of-the-box thinking is required to challenge the status quo. With dismal results of current nutritional and therapeutic armamentarium, ketogenic diet can provide this opportunity. Ketogenic Keywords diet has profound pathophysiological as well as evolutionary basis for it to be used as a ► ketogenic diet tool in diabetes management. Despite progressively accumulating evidence for clinical ► evolution efficacy and safety, widespread adoption of ketogenic diet remains low due to lack of ► diet in diabetes expertise and standard guidelines. Introduction caloric value, has been shown to be very effective.7 A total of 306 individuals between 20 and 65 years of age, duration Importance of lifestyle changes, including diet and exercise, of diabetes less than 6 years, and with body mass index of has always been undermined in the management of diabetes, 27 to 45 kg/m2 were recruited from National Health Service especially in the western literature. The main reason, often centers in England and Scotland. Participants were started cited, is nonsustainability of these measures. There has been on meal replacements with approximately 850 Kcal/day and recent evolution in the literature to challenge this notion.
    [Show full text]
  • The Ketogenic Diet and Its Clinical Applications in Type I and II Diabetes
    ISSN: 2377-3634 Pilla. Int J Diabetes Clin Res 2018, 5:092 DOI: 10.23937/2377-3634/1410092 Volume 5 | Issue 3 International Journal of Open Access Diabetes and Clinical Research Review ARticle The Ketogenic Diet and its Clinical Applications in Type I and II Diabetes * Check for Raffaele Pilla updates External Pharmacy, St. John of God - Fatebenefratelli Hospital, Benevento, Italy *Corresponding author: Raffaele Pilla, Pharm.D, PhD, External Pharmacy, St. John of God - Fatebenefratelli Hospital, Benevento, Italy, E-mail: [email protected] Introduction across the blood-brain barrier by monocarboxylic acid transporters to fuel brain function. Starvation or nutri- It has been shown that metabolic-based therapies, tional ketosis is an essential survival mechanism that such as nutritional ketosis, are effective to contrast sei- ensures metabolic flexibility during prolonged fasting or zure disorders and various acute and chronic neurolo- lack of carbohydrate ingestion [1]. Therapeutic ketosis gical disorders [1-4]. From a physiological perspective, leads to metabolic adaptations that may improve brain glucose is the primary metabolic fuel for cells. However, metabolism, restore mitochondrial ATP production, many neurodegenerative disorders have been recent- decrease reactive oxygen species production, reduce ly associated with impaired glucose transport and me- inflammation, and increase neurotrophic factors’ fun- tabolism and with mitochondrial dysfunction causing ction [12]. It has been shown that KD mimics the effects energy deficits, such as in Alzheimer’s disease, Parkin- of fasting and the lack of [13] glucose/insulin signaling, son’s disease, general seizure disorders, and traumatic which promotes a metabolic shift towards fatty acid uti- brain injury [5-9].
    [Show full text]
  • Dietary Information for Diabetes Patients
    DEPARTMENT OF ENDOCRINOLOGY, DIABETES & METABOLISM, CHRISTIAN MEDICAL COLLEGE, VELLORE DIETARY INFORMATION FOR DIABETES PATIENTS Role of Diet in Diabetes Diet plays an important role in the management of Diabetes Mellitus. Eating the right foods at the correct time is crucial for maintaining acceptable blood glucose values. Knowing what food to eat, when to eat and how much to eat, helps one to monitor blood glucose levels and maintain it within the normal range. This gives him/her the confidence to lead a healthy normal life and achieve his/her maximum potential. What is food composed of? Foods we eat contain various components. This includes nutrients, fibre and water. Their role in our body is explained below: • Fat- gives us energy • Vitamins –regulates body functions • Minerals- regulates body functions • Fibre- regulates blood glucose levels • Carbohydrates- gives us • Water- regulates various energy functions • Proteins- body building Carbohydrates directly cause an increase in the blood sugar levels.There are different types of carbohydrates and their effect on raising the blood sugar levels vary. What happens to Carbohydrates in the body? Carbohydrates are broken to sugars. This enters every body cell with help of insulin to provide energy.When food is broken into sugars, it enters the blood stream. Some foods are broken faster and appear in the blood stream quickly. Some foods take longer to be broken, hence appear slower in the blood stream. Glycaemic index of foods Glycaemic index is a measure of the rise in blood sugar after consumption of a particular food as compared to a reference food. Foods are classified according to their glycaemic index.
    [Show full text]