Diet in non-insulin dependent diabetes

Diet is the firstline treatment in non-insulin dependent diabetes (NIDDM). Patients with NIDDM are often overweight.

Weight reduction is beneficial in:

• lowering insulin resistance
• lowering hepatic glucose production
• lowering cardiovascular morbidity in part by producing a more favourable lipoprotein profile - decreased LDL and VLDL levels and increased HDL levels

Weight loss is achieved by:

• reducing total daily energy intake
• reducing total fat intake (fat is the most calorie rich macronutrient) by replacing foods rich in saturated fatty acids (dairy and animal products) with either foods rich in carbohydrate and fibre or with foods containing polyunsaturated fatty acids (oils and margarines)
• increasing complex carbohydrates with low glycaemic indices (pasta, rice, lentils, potatoes and wholemeal bread) and reducing simple carbohydrates (refined sugars)

It should be remembered that sugar substitutes such as sorbitol and fructose contain similar numbers of calories to ordinary sugar and so are of no particular advantage in weight control.