Diabetes Mellitus: Dietary Management of Diabetes-Related Complications

This set of vocabulary flashcards covers the etiology, diagnosis of acute complications like DKA, classification of chronic complications, and dietary management strategies for diabetes-related issues including gastroparesis and nephropathy.

Diabetic Gastroparesis (DGP)

A complication of diabetes characterized by the slow emptying of the stomach, typically occurring in individuals with long-standing type 1 and type 2 diabetes mellitus.

Post-prandial hyperglycaemia

The largest contributing factor to HbA1c, accounting for $70\%$ of daytime hyperglycaemia, with its contribution increasing towards the evening.

DKA Triad

The clinical diagnosis for Diabetic Ketoacidosis consisting of Hyperglycemia (blood glucose $> 11\,mmol/L$), Venous pH $< 7.3$ or serum bicarbonate $< 15\,mmol/L$, and Ketonemia (blood $\beta$-hydroxybutyrate $\geq 3\,mmol/L$).

Kussmaul’s breathing

A clinical feature of Diabetic ketoacidosis characterized by rapid and deep breathing patterns.

Macrovascular complications

Chronic complications of diabetes that include coronary artery disease, cerebrovascular disease, and peripheral vascular disease.

Microvascular complications

Chronic complications of diabetes that include retinopathy, nephropathy, and neuropathy.

UKPDS study

A prospective observational study determining that each $1\%$ reduction in HbA1c significantly reduces the incidence rates of diabetes complications, with HbA1c $< 6\%$ being the lowest risk group.

Typical lipid profile in DM

Characterized by raised triglycerides (TG) and decreased high-density lipoprotein (HDL) cholesterol.

Ideal Fatty acid profile for insulin sensitivity

Total fat intake should be $< 37\%$ of total energy (TE); higher intakes reduce insulin sensitivity regardless of the fatty acid profile.

Diabetic retinopathy

A microvascular complication caused by free radical damage from oxidative stress, affecting $70-80\%$ of Type 1 and $60\%$ of Type 2 patients within 20 years of diagnosis.

Diabetic Nephropathy

A kidney-related complication with a prevalence of up to $40\%$ in DM patients, marked by risk factors such as hyperglycaemia, hypertension, and dyslipidaemia.

KDOQI 2020 Protein Recommendation

A guideline for dietary protein intake in nephropathy management suggested at $0.6-0.8\,g/kg/day$.

Gastroparesis treatment (Dietary)

Management consisting of 6 small meals per day, low fat intake ($< 40\,g$), low fiber intake, and a focus on liquid or modified food consistencies.

Metoclopramide

A drug used to regulate intestinal motility in gastropathy, typically dosed at $5-20\,mg$ four times per day.

Bezoar formation

The formation of undigested material in the stomach; patients at risk should avoid high-fiber foods such as oranges, berries, coconut, and legumes.

SEMDSA HbA1c Recommendation

A recommendation to maintain an HbA1c value of $< 7\%$ to reduce the risk of vascular diabetic complications.