Toeller M
Klinische Abteilung des Diabetes-Forschungsinstituts, Heinrich-Heine-Universität Düsseldorf.
Z Gesamte Inn Med. 1993 Mar;48(3):120-6.
Most aspects of the nutritional therapy of diabetes mellitus apply equally to IDDM and NIDDM patients and are also appropriate for people with high risk of cardiovascular diseases. A restriction of energy, a reduction of saturated fatty acids as well as of alcoholic drinks and simple sugars are the most important measures. This modification of nutritional intake together with increased fibre consumption is not only appropriate to avoid hyperglycaemia in diabetic patients but has also its benefits in patients presenting with the metabolic syndrome (possible reduction of hyperinsulinaemia, hypertension and hyperlipoproteinaemia). Diabetic patients should have regular screening for microalbuminuria. At first signs of an early stage of nephropathy patients should be advised to restrict their protein intake. About 50% of daily energy intake should be derived from carbohydrates and fat intake should be no more than 35% of total energy (saturated fatty acids less than 10% of energy). Carbohydrate exchange units are usually not necessary in NIDDM patients. In addition diabetes specialty foods are not an essential part of the nutritional therapy. The success of the nutritional therapy in diabetic patients is substantially dependent upon qualified counselling and education of the patients by the physician (as far as possible with the assistance of a dietitian).
糖尿病营养治疗的大多数方面同样适用于胰岛素依赖型糖尿病（IDDM）和非胰岛素依赖型糖尿病（NIDDM）患者，也适用于心血管疾病高危人群。限制能量摄入、减少饱和脂肪酸以及酒精饮料和单糖的摄入是最重要的措施。这种营养摄入的调整以及增加膳食纤维的摄入，不仅有助于避免糖尿病患者出现高血糖，对患有代谢综合征的患者也有益处（可能降低高胰岛素血症、高血压和高脂蛋白血症）。糖尿病患者应定期筛查微量白蛋白尿。在肾病早期出现最初症状时，应建议患者限制蛋白质摄入。每日能量摄入的约50%应来自碳水化合物，脂肪摄入量不应超过总能量的35%（饱和脂肪酸占能量的比例应小于10%）。非胰岛素依赖型糖尿病患者通常无需碳水化合物交换单位。此外，糖尿病专用食品并非营养治疗的必要组成部分。糖尿病患者营养治疗的成功在很大程度上取决于医生对患者进行的专业咨询和教育（尽可能在营养师的协助下）。
