THE APPROACHES OF MEDICAL NUTRITIONAL THERAPY FOR DIABETIC ELDERLY

摘要

It has been recognised that life style and nutritional habits may result in increased insulin resistance and risk of diabetes. There is a significant tendency for type 2 diabetes and impaired glucose tolerance in the elderly. The diagnosis of diabetes mellitus at the early stage before chronic complications can improve the quality of life and nutritional status and, decreases mortality. Aged-related changes must be taken into account to introduce the medical nutritional theraphy (MNT) for the person with diabetes. The nutritional status of the elderly may well be under attacked by a number of determinants including the difficulties in chewing and swallowing, loss of vision, taste, smell and appetite, and nutrients absorption. Furthermore some diseases such as osteoarthritis, hypertension, and cardiovascular diseases in addition to the multiple drug theraphy, may be consistently associated with the changes in the nutritional status of the elderly. Periodical nutritional assesment may be one of the important tool for preventing vitamin and mineral deficiencies, and may also help to restore the MNT. MNT, for older people with diabetes should be individualized with consideration given to the individual's usual food and eating habits, metabolic profile, treatments goals. A daily multivitamin supplement and oral enteral nutrition support may be appropriate for older adults, especially those with reduced energy intake. Exercise increses fat free mass and decreases fatty mass, and improve glucose tolerance. Education of older people with diabetes and caregiver is an important part of therapy. It makes one by one because of differences clinical problems and personality. Self-monitoring is needed for metabolic control of patients.