Foundations in Continuing Education

The Dental Patient with Diabetes

Chapter Fourteen - Prevention and Treatment of DM


Chapter 1: Glucose Metabolism and Hormonal Regulation Review

Chapter 2: Diabetes Mellitus

Chapter 3: Diabetes Mellitus Type 1

Chapter 4: Diabetes Mellitus Type 2

Chapter 5: Gestational Diabetes Mellitus (GDM)

Chapter 6: Pre Diabetes: Impaired Glucose Homeostasis

Chapter 7: Other Specific Types of Diabetes

Chapter 8: Diagnosing Diabetes

Chapter 9: Diagnosis

Chapter 10: Glucose Monitoring

Chapter 11: Complications of Diabetes

Chapter 12: The Dental Patient with Diabetes

Chapter 13: Successful Intervention of Diabetic Emergencies

Introduction
Diet/Nutrition
Exercise
Pharmacological
Intervention

Administration
Method of Injection
Oral Hypoglycemic
Agents

Secretagogues
Biguanides (Metformin)
Thiazolidinediones
(Actos, Avandia)

Glucosidase Inhibitors
(Precose, Glyset)

Combination
Medications

Chapter 15: Diabetes Medications

Chapter 16: Conclusion

Glossary

Appendices

References

Post Examination

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Diet/Nutrition

The foundation of diabetic therapy is nutrition. Type 1 diabetics need the same amount of food that would normally be consumed if they did not have diabetes. Insulin amounts need to compliment the amount of food required to maintain a healthy weight. Type 1 diabetics should strive to be consistent in both the choice of food and the timing of meals. Individuals with Type 2 may need only dietary modification in order to control blood glucose levels (See Table 7).

Table 7: Diabetic Diet Modification (24)

Component
Goal
Calories Sufficient to maintain reasonable weight
Protein 10 - 20% of total caloric intake
Fat 30% of total calories
Fiber 20 - 35 grams per day
Carbohydrates Up to 55 - 60% of total calories (modest amount from refined sugars)

The American Diabetes Association recommends the following goals for nutritional therapy:

  1. Restore blood glucose and optimal lipid levels.

  2. Maintain normal growth rate in children and adolescents as well as the attaining and maintaining of reasonable body weight in adolescents and adults.

  3. Provide adequate nutrition for pregnant women, the fetus and lactation.

  4. Stay consistent in the timing of meals and snacks to prevent nordinate swings in blood glucose levels for people using exogenous insulin.

  5. Determine a meal plan appropriate for the individuals' lifestyle and based on a diet history.

  6. Manage weight of obese people with Type 2.

  7. Improve the overall health of people with diabetes through optimal nutrition.

A dietician should be consulted to assist in tailoring nutrition concerns to the diverse needs of the individual. Dietary plans should be directed toward lifestyle and health status of the individual. (3,17,24,25)

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