目前用于预防和治疗糖尿病的营养治疗建议是基于对证据的系统回顾并回答重要的营养护理问题。首先,糖尿病营养治疗有效吗?临床试验以及系统和Cochrane综述报告了约1%-2%的血红蛋白A1c值降低以及营养治疗干预措施带来的其他有益结果,取决于糖尿病的类型和持续时间以及血糖控制水平。临床试验也为营养疗法预防糖尿病的有效性提供了证据。第二,减肥干预措施重要吗?何时有益?适度的减肥对于预防2型糖尿病和疾病早期很重要。然而,随着糖尿病的发展,体重减轻可能会或可能不会导致有益的血糖和心血管结局。第三,是否有理想百分比的常量营养素和饮食模式适用于所有糖尿病患者?没有理想百分比的常量营养素和各种饮食模式已被证明对糖尿病患者有效。治疗目标,个人偏好(例如,传统,文化,宗教,健康信念,经济学),临床医生和/或教育者在咨询和教育糖尿病患者时,必须考虑个体改变生活方式的能力和意愿。一种健康的饮食模式,强调适当份量的营养丰富的食物,有规律的身体活动,和支持是所有糖尿病患者的优先事项。糖尿病前期或2型糖尿病患者的能量摄入减少以及胰岛素与计划的碳水化合物摄入相匹配是需要考虑的干预措施。第四,是如何在临床实践中实施营养治疗干预的问题。这需要营养护理策略。
Current nutrition therapy recommendations for the prevention and treatment of diabetes are based on a systematic review of evidence and answer important nutrition care questions. First, is diabetes nutrition therapy effective? Clinical trials as well as systematic and Cochrane reviews report a ~1%-2% lowering of hemoglobin A1c values as well as other beneficial outcomes from nutrition therapy interventions, depending on the type and duration of diabetes and level of glycemic control. Clinical trials also provide evidence for the effectiveness of nutrition therapy in the prevention of diabetes. Second, are weight loss interventions important and when are they beneficial? Modest weight loss is important for the prevention of type 2 diabetes and early in the disease process. However, as diabetes progresses, weight loss may or may not result in beneficial glycemic and cardiovascular outcomes. Third, are there ideal percentages of macronutrients and eating patterns that apply to all persons with diabetes? There is no ideal percentage of macronutrients and a variety of eating patterns has been shown to be effective for persons with diabetes. Treatment goals, personal preferences (eg, tradition, culture, religion, health beliefs, economics), and the individual\'s ability and willingness to make lifestyle changes must all be considered by clinicians and/or educators when counseling and educating individuals with diabetes. A healthy eating pattern emphasizing nutrient-dense foods in appropriate portion sizes, regular physical activity, and support are priorities for all individuals with diabetes. Reduced energy intake for persons with prediabetes or type 2 diabetes as well as matching insulin to planned carbohydrate intake are intervention to be considered. Fourth, is the question of how to implement nutrition therapy interventions in clinical practice. This requires nutrition care strategies.