Relevance of Nutrition Intervention in Diabetes Management: A Perspective from Indian Clinical Experts

Abstract

Poor glycemic control in diabetes patients is a major hurdle in the management of disease and its associated comorbidities. Pharmacotherapy alone is not sufficient to curb the risk of associated complications. The role of nutrition along with physical exercise in achieving optimal glycemic con-trol is overlooked for many years in India. Nowadays, medical nutrition therapy (MNT) has evolved as an integral therapy in achieving better glycemic control. However, there is a lack of uniformity in health care practitioner’s perception and lack of recommendations in a structured manner regard-ing its use. Through a series of regional advisory board meeting, insights were gained into current practices in diabetes management to uncover the gaps in nutrition for better patient outcomes, and understand patient knowledge, attitude and perceptions towards nutrition in general and diabetes-specific formulas (DSF) in particular. The key viewpoints were as follows: i) Good self-care practice and creating awareness inpatients about glycemic variations is important. ii) Experts highlighted the importance of referring patients to a clinical nutritionist or dietician. Patients should be introduced to diabetic educators and education through charts regarding different foods with low glycemic index is advised. iii) Portion control, healthy eating patterns and avoiding a high carbohydrate diet is beneficial. iv) MNT should be included in patients diet plan as a partial if not full meal replacement. Diabetes-specific formulas should be palatable and affordable to ensure patients compliance. These formulas can be taken in combination with meals in proportionate amounts. v) Diabetes-specific nutrition improves multiple health outcomes and the mindset of Indian patients towards nutritious food needs to be changed.