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Diabetes Mellitus: Non-Pharmacological Therapy--MNT!

 NON PHARMACOLOGICAL THERAPY 

  1. MNT
  2. Glycemic Index
  3. Dietary supplements
  4. Weight measurements
  5. Physical Activity
  6. Psychological assessment
  7. Immunizations

1. MEDICAL NUTRITION THERAPY (MNT) 

"Medical Nutrition Therapy (MNT) is a term used by the ADA to describe the optimal condition of caloric intake with other aspects of diabetes therapy (Insulin, Exercise, Weight loss)".

The ADA has issued recommendations for three types of MNT:

  1. Primary prevention measures of MNT are directed at preventing or delaying the onset of type 2 Diabetes in high-risk individuals (obese or with pre-diabetes) by promoting weight reduction.
  2. Secondary prevention measures of MNT are directed at preventing or delaying-related complications in diabetic individuals by improving glycemic control.
  3. Tertiary prevention measures of MNT are directed at managing diabetes-related complications (cardiovascular disease, neuropathy) in diabetic individuals.

  • Despite the popular notion, there is not any " Diabetic diet". MNT is considered an integral component of diabetes management and diabetes is a self-management education. . 
  • People with DM should receive individualized MNT, preferably by a registered dietitian.
  • As part of the diabetes management plan, MNT should not be a single education session but rather an ongoing dialog.
  • MNT should be customized to take into account cultural, lifestyle, and financial considerations. 
  • MNT plans should integrate a variety of foods that the patient enjoys and allows for flexibility to encourage patient empowerment and improve patient adherence. During these sessions of education, patients receive instructions on appropriate food selection, preparation, and proper portion control.

The primary focus of MNT for patients with T1DM is matching optimal insulin dosing for carbohydrate consumption.

In T2DM, the primary focus is portion control, and controlling blood glucose, blood pressure and lipids through individualizing limits of carbohydrates saturated fats, sodium, and calories.

In general, for the general population, a diet that includes fruits, vegetables, fiber-containing foods, and low-fat milk is advised.

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