Malnutrition in the Diabetic Patient
Malnutrition – Diabetic Patient
According to the PREDYCES study (a project that evaluates the prevalence and costs of hospital malnutrition in Spain), the presence of diabetes is associated with a risk of over 40% of developing malnutrition. In the subgroup of hospitalised diabetic patients over 65 years of age, 39.1% are at nutritional risk and 21.2% are malnourished.
Nutritional education in patients with diabetes or at risk of developing it is of great importance, as it forms part of the therapeutic and/or preventive strategy not only for Diabetes Mellitus (DM) itself, but also for the frequently associated risk factors, as well as the complications classically linked to DM.
In the comprehensive management of DM, nutrition is a fundamental pillar, as an effective nutritional strategy greatly contributes to preventing and improving the clinical course of the disease, to the primary and secondary prevention of cardiovascular risk factors and chronic complications associated with DM, and to improving quality of life.
The nutritional model to aim for can be summarised in the following points:
Carbohydrates are the fundamental pillar and should be consumed in the form of legumes, cereals and fruit. Similarly, frequent consumption of vegetables is recommended. Nuts are also part of this diet, although their intake should be moderate due to their caloric value.
With regard to proteins, a moderate intake of meat products is recommended, with preference given to fish, including oily fish, and poultry. A moderate consumption of dairy products is also advised, particularly cheese and yoghurt.
Olive oil is preferred as the main source of fat.
In the hospital setting, the presence of malnutrition is quite significant, as is the presence of diabetes or alterations in glycaemic status. Likewise, in the outpatient setting, situations often arise in which there is a need to use enteral nutrition in patients with hyperglycaemia, which is often difficult to control.
When dietary measures are not sufficient, the diet should be supplemented with enteral nutrition products. These are rich in protein and energy, with a very healthy composition. Their liquid consistency allows older adults with chewing difficulties who cannot consume adequate amounts of solid foods to meet their nutritional requirements.