A six-week community wellness programme was conducted to promote weight loss and reduce obesity. Participants’ weight, blood pressure, waist circumference, body mass index, and finger-stick glucose were measured before and after the programme which included exercise, nutrition and diabetes prevention sessions. Initially, 189 men and women enrolled; 74 participants were included in the post-intervention data collection. Statistically significant results (p <0.001) indicated that women reduced weight (mean 3.31% ± 0.02%) and decreased waist circumference by 1.91552% ± 2.14454 inches. Men reduced weight significantly (mean 6.5% ± 0.44%) and decreased waist circumference (mean 3.14063 ± 3.04118 inches) (p<.001).
Jenny Manry, DNP, FNP, APRN-BC, Assistant Professor, Fort Hays State University
Jane Peterson, PhD, APRN, FAANP, Clinical Associate Professor, University of Missouri Kansas City
Article accepted for publication: February 2013
This articles deals with the dietary advice that should be provided to people with type 2 diabetes by anyone working in the community (it does not cover advice on physical activity or prevention of type 2 diabetes). If a patient with type 2 diabetes is overweight or obese, the most important factor is to lose weight — even a 5–10% weight loss can improve insulin sensitivity and hence diabetic control. Other factors that are considered in this article are the type of carbohydrate that can be eaten, with wholegrain/high-fibre, lower glycaemic index starches being the best option (the glycaemic index measures the effect of carbohydrates on blood glucose level). Although sugar provides 'empty calories' (food that supplies energy but negligible nutrition) and can result in weight gain, it does not contribute to diabetes directly. Cholesterol levels should be reduced by eating the correct fats, and salt levels should be kept to below 6g a day.
This articles looks at the dietary advice that should be provided for people with type 1 diabetes. As well as focusing on healthy eating generally, blood sugar control can be optimised if both the type and amount of carbohydrate is considered. Low glycaemic index (GI) carbohydrates, where glucose is released slowly into the blood stream, may help to lower the individual’s glycated haemoglobin (HbA1c) levels (HbA1c is a form of haemoglobin that is measured to identify the average plasma glucose concentration over a prolonged time period). Carbohydrate (‘carb’) counting should be considered as it can improve glycaemic control and promote independence in regard to food choice and management of the condition. Gestational diabetes (that which develops during pregnancy) is also considered, as this can affect birth outcome, the baby’s future health and the health of the mother after the birth.
