Diabetes Type 1 and 2

DM: Prevention and Treatment of Cardiovascular Disease (2001)

• Assessment
  Nutrition Practice Guidelines for Type 1 and 2 Diabetes: Prevention and Treatment of Cardiovascular Disease in Diabetes (2001)

  • Conclusion

    Diabetes is a major risk factor for CVD in type 2 diabetes. Early diagnosis and aggressive management of cholesterol and other serum lipids and blood pressure is recommended when LDL-cholesterol is >100 gm/dL and blood pressure is >130/80 mm Hg (by modifying food intake to 25% to 35% total fat, <7% saturated fat, < 200 mg cholesterol, 2,400 mg sodium, kcal for weight loss), physical activity and the addition of medications when lifestyle changes are not adequate. ATP III recommendations (the Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults) for treating hyperlipidemia are appropriate for individuals with diabetes and hyperlipidemia(2001).

     

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Type 1 and 2 Diabetes:Prevention and Treatment of Cardiovascular Disease in Diabetes (2001)
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • American Diabetes Association. Position Statement: Management of dyslipidemia in adults with diabetes. Diabetes Care. 2002;25 (suppl 1):S74-S77.
      • Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, Bray GA, Vogt TM, Cutler JA, Windhauser MM, Lin P, Karanja N.  A clinical trial on the effects of dietary patterns on blood pressure. N Engl J Med. 1997; 336:1117-1124.
      • The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993; 329:977-986.  
      • Delahanty LM, Sonnenberg LM, Hayden D, Nathan DM. Clinical and cost outcomes of medical nutrition therapy for hypercholesterolemia: A controlled trial. J Am Diet Assoc. 2001;101:1012-1016.
      • Grundy SM, Benjamin IJ, Burke GL, Chait A, Eckel RH, Howard BV, Mitch W, Smith SC, Sowers JR.  Diabetes and cardiovascular disease.  A statement for healthcare professionals from the American Heart Association. Circulation. 1999;100:1134-1146.
      • Mayer-Davis EJ, Levin S, Marshall JA.  Heterogeneity in associations between macronutrient intake and lipoprotein profile in individuals with type 2 diabetes. Diabetes Care 1999;22:1632-1639.
      • Mukamal KJ, Nesto RW, Cohen MC, Muller JE, Maclure M, Sherwood JB, Mittleman MA.  Impact of diabetes on long-term survival after acute myocardial infarction. Comparability of risk with prior myocardial infarction. Diabetes Care. 2001;24:1422-1427.
      • Orchard TJ, Forrest KY, Kuller LH, Becker DJ.  Lipid and blood pressure treatment goals for type 1 diabetes: 10-year incidence data from the Pittsburgh Epidemiology of Diabetes Complications Study. Diabetes Care. 2001;24:1053-1059.
      • Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, Obarzanek E, Conlin PR, Miller III ER, Simons-Morton DG, Karanja N, Lin PH. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) Diet. N Engl J Med. 2001; 344:3-10.
      • Storm H, Thomsen C, Pedersen E, Rasmussen O, Christiansen C, Hermansen K. Comparison of a carbohydrate-rich diet and diets rich in stearic or palmitic acid in NIDDM patients. Diabetes Care 1997; 20:1807-1813.
      • Turner RC, Millns H, Neil HAW, Stratton IM, Manley SE, Matthews DR, Holman RR. Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom prospective diabetes study (UKPDS: 23). BMJ. 1998; 316: 823-828.
      • Yu-Poth S, Zhao G, Etherton T, Naglak M, Jonnalagadda S, Kris-Etherton PM. Effects of the National Cholesterol Education Program’s Step I and Step II dietary intervention programs on cardiovascular disease risk factors: a meta-analysis. Am J Clin Nutr. 1999;69:632-646.