A food exchange list is a tool developed to help diabetic patients control their energy intake and plan balanced meals. Korean food exchange lists were first developed in 1988, revised in 1995, and updated again in 2010. With rapidly changing dietary habits and increasing demand for diverse food cultures, the Korean Diabetes Association in cooperation with 4 related organizations established a Task Force Team (TFT) to revise food exchange lists in March 2022. Starting with a workshop, TFT held 11 official revision meetings, culminating in a public hearing in May 2023. The final revised version of Korean food exchange lists was published in December 2023. Key outcomes of the revision are summarized as follows: 1. Based on the National Standard Food Composition Table 10.0 database, the existing classification system and nutrient standards for each food group remain unchanged this time. 2. Based on a survey conducted among diabetes educators, the number of items on the food exchange lists has increased from 339 in 2010 to 435 this time. 3. Considering patients’ usual eating habits, meal planning examples were developed distributing food group exchange units by energy level based on 3 types of proportions of carbohydrate energy (40%–45%, 50%–55%, 60%–65%). 4. Due to limitations in real-time updates for rapidly changing information, detailed guidance on how to access and interpret the data is provided. These revisions will help people with diabetes manage their blood sugar levels and facilitate the implementation of healthy meal planning in various other conditions, including obesity.
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As a result of a nutrition transition, chronic diseases, including diabetes, have increased in Iran. Nutrition education is a cost-effective method for modifying diet and controlling diabetes. This study aimed to examine the effect of nutrition education using MyPlate recommendations on glycemic and lipid profiles and inflammatory markers in Iranian adults diagnosed with type 2 diabetes. A 12-week randomized clinical trial was conducted on 44 adults aged 30–50 years from Ahvaz, Iran. The participants were divided into education and control groups. The education participants were taught the MyPlate recommendations. Serum levels of fasting blood sugar (FBS), hemoglobin A1c (HbA1c), lipid profiles, and inflammatory markers, including high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α, and adiponectin, were measured at the baseline and the end of the study. The results showed that serum levels of FBS (p = 0.014) and HbA1c (p < 0.001) decreased significantly in the education group at the end of the study. The serum level of low-density lipoprotein in the education group declined significantly at the end of the study (p = 0.043). Furthermore, the serum level of hs-CRP (p = 0.005) declined significantly while the level of adiponectin (p = 0.035) increased in the education group at the end of the study. The evidence of this study showed that nutrition education using MyPlate recommendations is an effective method for controlling diabetes complications. A longitudinal analysis with a larger sample size is recommended to confirm the evidence of this study.
Iranian Registry of Clinical Trials Identifier: IRCT2015031921443N2
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This study was conducted to evaluate applicability of job standards for diabetes nutrition management by hospital clinical dietitians. In order to promote the clinical nutrition services, it is necessary to present job standards of clinical dietitian and to actively apply these standardized tasks to the medical institution sites. The job standard of clinical dietitians for diabetic nutrition management was distributed to hospitals over 300 beds. Questionnaire was collected from 96 clinical dietitians of 40 tertiary hospitals, 47 general hospitals, and 9 hospitals. Based on each 5-point scale, the importance of overall duty was 4.4 ± 0.5, performance was 3.6 ± 0.8, and difficulty was 3.1 ± 0.7. ‘Nutrition intervention’ was 4.5 ± 0.5 for task importance, ‘nutrition assessment’ was 4.0 ± 0.7 for performance, and ‘nutrition diagnosis’ was 3.4 ± 0.9 for difficulty. These 3 items were high in each category. Based on the grid diagram, the tasks of both high importance and high performance were ‘checking basic information,’ ‘checking medical history and therapy plan,’ ‘decision of nutritional needs,’ ‘supply of foods and nutrients,’ and ‘education of nutrition and self-management.’ The tasks with high importance but low performance were ‘derivation of nutrition diagnosis,’ ‘planning of nutrition intervention,’ ‘monitoring of nutrition intervention process.’ The tasks of both high importance and high difficulty were ‘derivation of nutrition diagnosis,’ ‘planning of nutrition intervention,’ ‘supply of foods and nutrients,’ ‘education of nutrition and self-management,’ and ‘monitoring of nutrition intervention process.’ The tasks of both high performance and high difficulty were ‘documentation of nutrition assessment,’ ‘supply of foods and nutrients,’ and ‘education of nutrition and self-management.’
In recent years, several studies have reported that the prevalence of diabetes mellitus is increasing every year, and also the acute and chronic complications accompanying this disease are increasing. Diabetic nephropathy is one of chronic complications of diabetes mellitus, and food intake which is burden to kidney function should be limited. At the same time, diet restriction could deteriorate quality of life of patient with diabetic nephropathy. According to the results of previous studies, the aggressive management is important for delaying of the progression to diabetic nephropathy. Also, the implementation of a personalized diet customized to individuals is an effective tool for preservation of kidney function. This is a case report of a patient with diabetic nephropathy who was introduced to a proper diet through nutrition education to prevent malnutrition, uremia and to maintain blood glucose levels.
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