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- November 20, 2008 |
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CME on Diabetes is a website built to transmit top-level CME conferences given by international experts in endocrinology, insulin resistance, prediabetes, metabolic syndrome and type 2 diabetes. More than 2.6 million slides have been viewed since the website launch. Thank you for your continued support and commitment!
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"The Importance of Carbohydrate Counting in the Management of Diabetes" Dana Whitham (biography)
English - 2002-01-19 - 20 minutes
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Summary :
Eating habits based on a carbohydrate breakdown. How to help patients in their everyday dilemma of healthy eating. Proper eating does not mean that one must eat differently than non-diabetics persons.
Learning objectives :
Upon completion of this presentation, participants should be able to:
1.Define carbohydrate counting.
2.Identify the benefits of carbohydrate counting compared to traditional meal planning approaches.
3.Describe characteristics of a patient who would do well with carbohydrate counting.
Bibliographic references :
Insulin resistance: concepts, controversies, and the role of nutrition.
Sievenpiper JL, Jenkins AL, Whitham DL, Vuksan V.
Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON.
Insulin resistance is a prevalent condition, in which insulin loses its normal physiological action. Since people were first classified as insulin resistant over 60 years ago, one of the main discoveries has been that insulin resistance clusters with other risk factors such as obesity, elevated triglycerides, and low high-density lipoprotein cholesterol, increasing cardiovascular disease risk. Although insulin resistance appears to manifest first in the periphery and then in the liver, other sites, such as the brain and the pancreatic &b.beta-cell, may play pathogenic roles. Factors contributing to insulin resistance at these sites include perturbations in free fatty acids, glucose, and hormone-signalling, some of which may be linked to various genetic polymorphisms. Appropriate nutritional treatment for insulin resistance is controversial. Two main approaches are drawn from diabetes recommendations: i) a high-carbohydrate, low-fat, high-fibre diet emphasizing low glycemic-index foods and ii) sharing calories between monounsaturated fat and complex carbohydrate at the expense of saturated fat. Recent interest in insulin resistance has prompted the development of new guidelines. Promising data have also emerged, showing that a high-carbohydrate, high-fibre, low-fat diet plus exercise programs maintained through intensive counselling can decrease diabetes risk by over 40%. Additional research is required to confirm the sustainability of this approach and sort out the determinants of insulin resistance so that more effective nutritional interventions will result.
Can J Diet Pract Res 2002 Spring;63(1):20-32
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