Special populationChildren and adolescents with diabetes mellitus1 so far, there is no effective way to prevent the onset of childhood type
Children and adolescents with diabetes mellitus
1 so far, there is no effective way to prevent the onset of childhood type 1 diabetes (D).
Patients with type 2.1 diabetes can benefit from MNT (A).
In patients with type 3.1 diabetes that MNT should be used in the first visit, regularly (at least annually) follow-up; medical staff should provide training and guidance consistent with age for type 1 diabetes in children and family; family participation is an important part of optimizing the whole childhood and adolescence diabetes management (D).
4 how should the patient be adjusted according to the carbohydrate intake and exercise to adjust the pre prandial insulin dose (D).
5 children with type 1 diabetes are at greater risk of hypoglycemia and complications (B).
Two, gestational diabetes mellitus (GDM)
1 nutrition and exercise therapy, blood glucose monitoring and insulin treatment should be carried out according to the level of blood glucose in GDM pregnancy and lactation management (A).
2 energy intake should be appropriate to ensure proper weight gain. Weight loss should not occur during pregnancy. For overweight or obese women with GDM, weight gain should be reasonably controlled (D).
3 we should strengthen monitoring to avoid the metabolism of fat mobilization caused by starvation ketosis or ketoacidosis, abnormal lipid metabolism and other metabolic complications during pregnancy (C).
4.GDM is an important risk factor for the development of type 2 diabetes in the future. It is recommended to improve the life style, to carry out the necessary physical activity and nutrition therapy (A) after delivery.
5 a small number of meals, a low GI diet, or a suitable diet with a suitable formula for diabetes may help to control the blood glucose level and perinatal outcomes of GDM, and to reduce the risk of hypoglycemia and inadequate energy intake (C).
6 pre pregnancy and early pregnancy on the basis of a balanced diet daily supplement of 400 g of folic acid, to reduce the risk of neural tube defects and congenital malformations of the risk of diabetic mother offspring (A).
7 during pregnancy and lactation should maintain good micronutrient intake, when necessary, calcium supplementation during pregnancy or for micronutrient compound (D).
Three, the elderly diabetes
1 elderly diabetic patients without excessive calorie restriction to reduce weight, to avoid fat weight loss; overweight and obesity can maintain a stable weight. Recommended total energy intake was approximately 30 kCal/kg per day (D).
2 long-term residence in the nursing home is not recommended to strictly limit the diet, should provide regular diet, quantitative timing of carbohydrate (D).
3 elderly patients with diabetes should be carbohydrate based energy, accounting for the total energy of 45% ~ 60% (B).
4 elderly diabetic patients do not need to be overly strict with sucrose (C).
5 elderly patients with diabetes should be more energy rich and rich in dietary fiber, low GI food, in order to improve glucose metabolism and reduce the risk of cardiovascular disease (B).
6 elderly patients with diabetes protein intake is recommended for the 1 ~ 1.3 g/ (kg• d), to high-quality protein based, can improve insulin secretion, reduce age-related muscle loss, etc. (A).
7 daily supplementation of inorganic salts and vitamins may be beneficial, especially for elderly patients with diabetes mellitus (D) who have a long term intake of food or nutrients.
8 increase in elderly patients with diabetes exercise is beneficial, 3 times more than aerobic exercise, each 60 min per week, in order to achieve the maximum heart rate of 60% to 75% as the standard, but should be assessed for risk assessment and exercise cardiac function (B).
9 diabetes education and dietary guidance can significantly reduce HbA1c (B) in elderly diabetic patients.
Four, pre diabetes
1 lifestyle interventions are safe and effective in reducing blood glucose and cardiovascular risk in all pre diabetic populations (A).
2 patients with prediabetes should lose weight from 5% to 10% and maintain for a long time (A).
3 recommended low fat, low saturated fat and low trans fatty acids, a diet rich in dietary fiber (A).
4 recommendations to control blood pressure, salt limit, limit alcohol (D).
5 a low energy diet supplemented with L-carnitine improves insulin sensitivity (B) in patients with abnormal glucose metabolism; Mediterranean diet can prevent type 2 diabetes mellitus (A).