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Aktuelle Ernährungsmedizin 2002; 27(2): 101-107
DOI: 10.1055/s-2002-24633
Originalbeitrag
© Georg Thieme Verlag Stuttgart · New York

Ernährungstherapie bei Diabetes mellitus

Nutritional Therapy in Diabetes mellitusMonika  Toeller1
  • 1Deutsches Diabetes-Forschungsinstitut an der Heinrich-Heine-Universität, Deutsche Diabetes-Klinik, Düsseldorf
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Publication History

Publication Date:
05 April 2002 (online)

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Zusammenfassung

In diesem Beitrag ist die Ernährungstherapie bei Typ-1- und Typ-2-Diabetes unter Berücksichtigung der aktuellen Datenlage und der Empfehlungen der Fachgesellschaften dargestellt. Die Nährstoffrelationen sehen eine Spannbreite für die Kohlenhydrataufnahme zwischen 45 und 60 % der Gesamtenergie vor, wobei Lebensmittel mit reichlichem Ballaststoffanteil und niedrigem glykämischen Index bevorzugt werden sollen. Gesamtfett soll auf 25 - 35 % der Energie begrenzt werden; die Fettzufuhr soll einfach ungesättigte Fettsäuren (10 - 20 % der Energie) und n-3-Fettsäuren aus fettem Fisch und auch aus pflanzlichen Quellen umfassen. Die Proteinaufnahme soll 20 % der Gesamtenergie nicht überschreiten. Beim metabolischen Syndrom sind je nach den Befunden und Therapiezielen des einzelnen Patienten Prioritäten in den ernährungstherapeutischen Maßnahmen, die die Insulinresistenz, Fettstoffwechselstörungen, Hochdruck und Adipositas beeinflussen können, zu setzen. Besondere Aufmerksamkeit verlangt die Ernährungsberatung von Diabetikerinnen in der Schwangerschaft bzw. bei Gestationsdiabetes. Für die Feinanpassung der Insulindosis ist sowohl die Menge der Kohlenhydrate als auch die glykämische Wirkung der Lebensmittel zu berücksichtigen, wenn normnahe Blutzuckerwerte erzielt werden sollen.

Abstract

This contribution summarizes the nutritional therapy in type 1 and type 2 diabetes mellitus considering current literature and recommendations of expert groups. The proportion of macronutrients allows a range of 45 - 60 % of total energy for carbohydrate intake. Foods rich in fibre and with a low glycaemic index are particularly recommended. Total fat intake should be restricted to 25 - 35 % of energy including mono unsaturated fatty acids (10 - 20 %) as well as n-3 fatty acids from oily fish and plant sources. Protein intake should be below 20 % of total energy. Priorities have to be established according to the individual needs in the medical nutrition therapy of the metabolic syndrome to cope with insulin resistance, dyslipoproteinaemia, hypertension and obesity. Special attention must be given to the nutritional counselling of women in pregnancy or with gestational diabetes. Both, the amount of carbohydrate and the glycaemic effect of different foods have to be considered when adjusting the insulin dosis in order to achieve near-normoglycaemia.

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Dr. med. Monika Toeller

Deutsches Diabetes-Forschungsinstitut an der Heinrich-Heine-Universität · Deutsche Diabetes-Klinik

Auf'm Hennekamp 65

40225 Düsseldorf

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