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h.txt
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It is critical to integrate medical nutrition therapy (MNT) provided by a
registered dietician (RD) into primary care of type 2 diabetes mellitus (T2DM).
This is necessary to achieve the goals of improving overall metabolic measures
beyond calorie restriction and weight loss. Misconceptions about nutrition in
T2DM add to the challenges of executing MNT in a culturally sensitive
population. The current review provides insights into MNT for the prevention and
management of T2DM in India, based on both evidence and experience. It revisits
historical Indian studies and provides information on appropriate dietary intake
of carbohydrates (60-70%), proteins (~ 20%) and fats (10%) that will be
acceptable and beneficial in an Indian T2DM population. It discusses nuances of
types of carbohydrates and fats and explains associations of increased dietary
fiber intake, balanced intake of low and high glycemic index foods and
substitution of saturated fats with plant-based polyunsaturated fats in
improving outcomes of T2DM and attenuating risk factors. The article also
deliberates upon special patient populations with comorbid conditions and
diseases and the necessary adjustments needed in their nutritional care. It
outlines a step-wise approach to MNT involving a careful interplay of nutrition
assessment, diagnosis, individualization and patient counseling. Overall, the
success of MNT relies on providing accurate, acceptable and appropriate dietary
choices for continued patient adherence. Collaborative efforts from
diabetologists, endocrinologists, internists and RDs are required to prioritize
and implement MNT in diabetes practice in India.Funding: Signutra Inc.