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Dietary therapy in diabetes mellitus. Is there a single best diet?

Abstract

The ideal diet for diabetic patients remains to be determined. Recommendations generally call for low-fat high-carbohydrate diets. The primary purpose of this recommendation is to reduce the risk for coronary heart disease, a major killer of diabetic patients. Some investigators also suggest that high-carbohydrate diets also improve glucose tolerance, even in patients with non-insulin-dependent diabetes mellitus (NIDDM). Another potential advantage of a low-fat diet (high percentage of carbohydrate) is that it may promote weight reduction. High-fat diets are thought by many investigators to stimulate weight gain. Thus, in obese NIDDM patients a trial of a low-fat weight-reduction diet may be worthwhile. However, if after an adequate trial of this diet, weight reduction is not achieved, this suggests that the patient is consuming large quantities of carbohydrates. The continued feeding of a high-carbohydrate diet to a persistently obese patient with NIDDM may have several untoward effects. For example, it can heighten hyperglycemia, raise plasma triglycerides, and lower high-density lipoproteins. In such dietary failures, it may be better to replace carbohydrate with fat to avoid these responses. Ideally, the fat should not raise the serum cholesterol level, and hence it should be unsaturated. Monounsaturated fatty acids seem preferable to polyunsaturated fatty acids, because polyunsaturates may increase the risk for cancer or promote the oxidation of low-density lipoprotein, another potentially atherogenic change. Many NIDDM patients, particularly obese patients in the earlier stages of diabetes, tolerate weight-maintenance high-carbohydrate diets without deterioration of glucose tolerance.(

ABSTRACT

TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

Center for Human Nutrition, University of Texas Southwestern Medical Center, Dallas 75235-9052.

Source

Diabetes care 14:9 1991 Sep pg 796-801

MeSH

Diabetes Mellitus
Diabetes Mellitus, Type 2
Diet, Diabetic
Dietary Carbohydrates
Feeding Behavior
Humans
Lipid Metabolism
Lipoproteins
Obesity
United States

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

1959473

Citation

Grundy, S M.. "Dietary Therapy in Diabetes Mellitus. Is There a Single Best Diet?" Diabetes Care, vol. 14, no. 9, 1991, pp. 796-801.
Grundy SM. Dietary therapy in diabetes mellitus. Is there a single best diet? Diabetes Care. 1991;14(9):796-801.
Grundy, S. M. (1991). Dietary therapy in diabetes mellitus. Is there a single best diet? Diabetes Care, 14(9), pp. 796-801.
Grundy SM. Dietary Therapy in Diabetes Mellitus. Is There a Single Best Diet. Diabetes Care. 1991;14(9):796-801. PubMed PMID: 1959473.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary therapy in diabetes mellitus. Is there a single best diet? A1 - Grundy,S M, PY - 1991/9/1/pubmed PY - 1991/9/1/medline PY - 1991/9/1/entrez SP - 796 EP - 801 JF - Diabetes care JO - Diabetes Care VL - 14 IS - 9 N2 - The ideal diet for diabetic patients remains to be determined. Recommendations generally call for low-fat high-carbohydrate diets. The primary purpose of this recommendation is to reduce the risk for coronary heart disease, a major killer of diabetic patients. Some investigators also suggest that high-carbohydrate diets also improve glucose tolerance, even in patients with non-insulin-dependent diabetes mellitus (NIDDM). Another potential advantage of a low-fat diet (high percentage of carbohydrate) is that it may promote weight reduction. High-fat diets are thought by many investigators to stimulate weight gain. Thus, in obese NIDDM patients a trial of a low-fat weight-reduction diet may be worthwhile. However, if after an adequate trial of this diet, weight reduction is not achieved, this suggests that the patient is consuming large quantities of carbohydrates. The continued feeding of a high-carbohydrate diet to a persistently obese patient with NIDDM may have several untoward effects. For example, it can heighten hyperglycemia, raise plasma triglycerides, and lower high-density lipoproteins. In such dietary failures, it may be better to replace carbohydrate with fat to avoid these responses. Ideally, the fat should not raise the serum cholesterol level, and hence it should be unsaturated. Monounsaturated fatty acids seem preferable to polyunsaturated fatty acids, because polyunsaturates may increase the risk for cancer or promote the oxidation of low-density lipoprotein, another potentially atherogenic change. Many NIDDM patients, particularly obese patients in the earlier stages of diabetes, tolerate weight-maintenance high-carbohydrate diets without deterioration of glucose tolerance.(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0149-5992 UR - https://www.unboundmedicine.com/medline/citation/1959473/Dietary_therapy_in_diabetes_mellitus__Is_there_a_single_best_diet L2 - http://www.diseaseinfosearch.org/result/2236 DB - PRIME DP - Unbound Medicine ER -