Skip to main content
SpringerLink
Log in

Ernährungstherapie bei Typ-2-Diabetes

  • Chapter
  • First Online:
Ernährungsempfehlungen bei Typ-2-Diabetes

  • 4759 Accesses

Zusammenfassung

Es wird darauf hingewiesen, dass in den vergangenen Jahren zahlreiche neue Erkenntnisse zur Ernährungstherapie bei T2DM gewonnen wurden und nun zusätzliche leitlinienkonforme Konzepte zur Verfügung stehen. Die Hauptrolle der Hauptnährstoffe wird kritisch hinterfragt, und anhand wissenschaftlicher Studien werden aktuelle Einsichten zu Fett (insbesondere zu Nahrungscholesterin und ges. Fettsäuren), Eiweiß und Kohlenhydraten belegt. Des Weiteren beschäftigt sich dieses Kapitel intensiv mit dem glykämischen Index sowie der glykämischen Last, stellt einen Low-Carb-Diäten-Vergleich auf, informiert mit praktischen Beispielen zur Umsetzung einer kohlenhydratreduzierten Ernährung und beschreibt den Unterschied zwischen metabolischer Ketose zur diabetischen Ketoazidose. Ferner wird die Handhabung der Fett-Protein-Einheiten-Berechnung erklärt und der Frage auf den Grund gegangen, ob mehr Eiweiß bei T2DM die Nieren schädigt. Zudem werden die Vorteile einer mediterranen Kost bei T2DM aufgezeigt.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 49.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    Diese Erkenntnisse decken sich mit den Empfehlungen der Adipositasleitlinie der Bundesärztekammer 2014.

  2. 2.

    ► https://www.gastrojournal.org/article/S0016-5085(16)35229-5/abstract

Literatur

  • ADA American Diabetes Association (2014) Nutrition Therapy Recommendations for the Management of Adults with Diabetes. Diabetes Care 37(Supplement 1):120–143. https://doi.org/10.2337/dc14-S120

    Article  Google Scholar 

  • ADA American Diabetes Association (2018) Standards of Medical Care in Diabetes. Clinical Diabetes 36(1): 14–37.doi.org/10.2337/cd17–0119

  • Ajala O, English P, Pinkney J (2013) Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes. Am J Clin Nutr 97(3):505–516. https://doi.org/10.3945/ajcn.112.042457

    Article  CAS  PubMed  Google Scholar 

  • American Diabetes Association (ADA) und European Association for the Study of Diabetes (EASD) (2012) Positionspapier Hyperglykämie-Management bei Typ-2-Diabetes: ein patientenzentrierter Ansatz. Springer, Berlin Heidelberg

    Google Scholar 

  • Astrup A, Raben A, Geiker N (2015) The role of higher protein diets in weight control and obesity-related comorbidities. Int J Obes (Lond) 39(5):721–726. https://doi.org/10.1038/ijo.2014.216

    Article  CAS  Google Scholar 

  • Barrera F, George J (2014) The role of diet and nutritional intervention for the management of patients with NAFLD. Clin Liver Dis 18(1):91–112. https://doi.org/10.1016/j.cld.2013.09.009

    Article  PubMed  Google Scholar 

  • Bell KJ, Smart CE, Steil GM, Brand-Miller JC, King B, Wolpert HA (2015) Impact of fat, protein, and glycemic index on postprandial glucose control in type 1 diabetes: implications for intensive diabetes management in the continuous glucose monitoring era. Diabetes Care 38(6):1008–1015. https://doi.org/10.2337/dc15–0100

  • Bosy-Westphal A, Fieres-Keller F, Müller MJ (2017) Ernährungstherapie bei Diabetes. Diabetologie 12:187–205

    Article  Google Scholar 

  • Bundesärztekammer (BÄK), Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) (2014) Nationale VersorgungsLeitlinie Therapie des Typ-2-Diabetes – Langfassung, 1. Aufl. Version 3. 2013, zuletzt geändert: April 2014. http://www.versorgungsleitlinien.de/themen/diabetes2/dm2_therapie. https://doi.org/10.6101/AZQ/000203

  • Danne T, Battelino T, Jarosz-Chobot P et al. (2008) Establishing glycaemic control with continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes: experience of the PedPump Study in 17 countries. Diabetologia 51(9):1594–1601. https://doi.org/10.1007/s00125–008–1072–2. Epub 2008 Jul 1

  • Gesellschaft DA (2014) Interdisziplinäre Leitlinie S 3Prävention, Therapie der Adipositas, Version 2. DAG, Martinsried

    Google Scholar 

  • Gesellschaft DD (2018) S3-Leitlinie Therapie des Typ-1-Diabetes, 2. Aufl. DDG, Berlin

    Google Scholar 

  • Ebert T, Halbritter J (2018) Epidemiologie und Pathogenese der diabetischen Nierenerkrankung. Diabetologe 14:78–85 doi.org/10.1007/s11428–018–0307–1

    Article  Google Scholar 

  • Esposito K, Kastorini CM, Panagiotakos DB, Giugliano D (2011) Mediterranean diet and weight loss: meta-analysis of randomized controlled trials. Metab Syndr Relat Disord. 2011 Feb 9(1):1–12. https://doi.org/10.1089/met.2010.0031 Epub 2010 Oct 25

    Article  PubMed  Google Scholar 

  • European Association for the Study of Diabetes (EASD), European Association for the Study of Obesity (EASO), European Association for the Study of the Liver (EASL) (2016) EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol 64(6):1388–1402. https://doi.org/10.1016/j.jhep.2015.11.004 Epub 2016 Apr 7

    Article  Google Scholar 

  • Foster-Powell K, Holt SHA, Brand-Miller JC (2002) International table of glycemic index and glycemic load values: 20021,2. Am J Clin Nutr 76:5–56

    Article  CAS  PubMed  Google Scholar 

  • Fung TT, van Dam RM, Hankinson SE, Stampfer M, Willett WC, Hu FB (2010) Low-carbohydrate diets and all-cause and cause-specific mortality: two cohort studies. Ann Intern Med 153(5):289–298. https://doi.org/10.7326/0003–4819–153–5-201009070–00003

  • Govers, Ellen, Slof EM, Verkoelen H, Ten Hoor-Aukema NM (2015) Guideline for the Management of Insulin Resistance. International Journal of Endocrinology and Metabolic Disorders 1(4). https://doi.org/10.16966/2380–548X.115

  • Hamdy O, Horton ES (2011) Protein content in diabetes nutrition plan. Curr Diab Rep 11(2):111–119. https://doi.org/10.1007/s11892–010–0171-x

  • Harcombe Z, Baker J, Cooper S, Davies SM, Sculthorpe B, DiNicolantonio N, James J, Grace F (2015) Evidence from randomised controlled trials did not support the introduction of dietary fat guidelines in 1977 and 1983: a systematic review and meta-analysis. Open heart 2(1) e000196. https://doi.org/10.1136/openhrt-2014–000196

  • Heart, Stroke Foundation Canada (2015) Position Statement SATURATED FAT HEART DISEASE AND STROKE. Heart, Stroke, Ottawa

    Google Scholar 

  • Hu T, Mills KT, Yao L, Demanelis K, Eloustaz M, Yancy WS Jr, Kelly TN, He J, Bazzano LA (2012) Effects of low-carbohydrate diets versus low-fat diets on metabolic risk factors: a meta-analysis of randomized controlled clinical trials. Am J Epidemiol 176(Suppl 7):S44–S54. https://doi.org/10.1093/aje/kws264

    Article  PubMed  PubMed Central  Google Scholar 

  • Jakubowicz D, Froy O (2013) Biochemical and metabolic mechanisms by which dietary whey protein may combat obesity and Type 2 diabetes. The Journal of nutritional biochemistry 24(1):1–5. https://doi.org/10.1016/j.jnutbio.2012.07.008

    Article  CAS  PubMed  Google Scholar 

  • Jenkins DJ et al (1981) Glycemic index of foods: a physiological basis for carbohydrate exchange. Am J Clin Nutr 34(3):362–366

    Article  CAS  PubMed  Google Scholar 

  • Kasper H, Burghardt W (2014) Ernährungsmedizin und Diätetik. Urban, Fischer, München

    Google Scholar 

  • Keller U (2011) Nahrungsproteine bei Adipositas und Diabetes. Schweizer Zeitschrift für Ernährungsmedizin 3(11):29

    Google Scholar 

  • Koloverou E, Panagiotakos DB (2016) Macronutrient Composition and Management of Non-Insulin-Dependent Diabetes Mellitus(NIDDM): A New Paradigm for Individualized Nutritional Therapy in Diabetes Patients. Rev Diabet Stud 13(1):6–16. https://doi.org/10.1900/RDS.2016.13.6. PLoS One 12(12):e 0188892. https://doi.org/10.1371/journal.pone.0188892

  • Lankinen, MA, Stancakova A, Uusitupa MA, Agren J, Pihlajamaki J, Kuusisto J, Schwab U, Laakso M (2015) Plasma fatty acids as predictors of glycaemia and type 2 diabetes. Diabetologia, 58 (11), S. 2533–2544. https://doi.org/10.1007/s00125–015–3730–5

  • Lawrence GD (2013) Dietary fats and health: dietary recommendations in the context of scientific evidence. Advances in nutrition (Bethesda, Md.) 4(3):294–302. https://doi.org/10.3945/an.113.003657

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Lechner K, Erickson N, Lechner B, Horn F (2018) Ernährungsempfehlungen beim metabolisch-vaskulären Syndrom. Dietary Recommendations in Metabolic Vascular Syndrome. Aktuel Ernahrungsmed 43:113–127

    Article  Google Scholar 

  • Leicht C, Hauner H (2015) Was Diabetiker essen sollen. Info Diabetologie 9(6):44

    Article  Google Scholar 

  • Ma C, Avenell A, Bolland M, Hudson J, Stewart F, Robertson C, Sharma P, Fraser C, MacLennan G (2017) Effects of weight loss interventions for adults who are obese on mortality, cardiovascular disease, and cancer: systematic review and meta-analysis. BMJ 359:j4849. https://doi.org/10.1136/bmj.j4849

    Article  PubMed  PubMed Central  Google Scholar 

  • Mansoor N, Vinknes KJ, Veierød MB, Retterstøl K (2016) Effects of low-carbohydrate diets v. low-fat diets on body weight and cardiovascular risk factors: a meta-analysis of randomised controlled trials. Br J Nutr 115(3):466–479. https://doi.org/10.1017/S0007114515004699

    Article  CAS  PubMed  Google Scholar 

  • Markova M, Pivovarova O, Hornemann S, Sucher S, Frahnow T, Wegner K, Machann J, Petzke KJ, Hierholzer J, Lichtinghagen R, Herder C, Carstensen-Kirberg M, Roden M, Rudovich N, Klaus S, Thomann R, Schneeweiss R, Rohn S, Pfeiffer AF (2017) Isocaloric Diets High in Animal or Plant Protein Reduce Liver Fat and Inflammation in Individuals with Type 2 Diabetes. Gastroenterology 152(3):571–585.e8. https://doi.org/10.1053/j.gastro.2016.10.007

    Article  PubMed  Google Scholar 

  • Marsh K, Barclay A, Colagiuri S, Brand-Miller J (2011) Glycemic Index and Glycemic Load of Carbohydrates in the Diabetes Diet. Curr Diab Rep. https://doi.org/10.1007/s11892–010–0173–8

  • Morio B, Fardet A, Legrand P, Lecerf JM (2016) Involvement of dietary saturated fats, from all sources or of dairy origin only, in insulin resistance and type 2 diabetes. Nutrition Reviews 74(1):33–47. https://doi.org/10.1093/nutrit/nuv043

    Article  PubMed  Google Scholar 

  • Mozaffarian D (2016) Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity. Circulation 133(2):187–225. https://doi.org/10.1161/CIRCULATIONAHA.115.018585

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Noakes TD, Windt J (2017) Evidence that supports the prescription of low-carbohydrate high-fat diets: a narrative review. Br J Sports Med 51(2):133–139. https://doi.org/10.1136/bjsports-2016–096491

  • Österreichische Diabetes Gesellschaft (2016) Diabetes mellitus – Anleitungen für die Praxis Überarbeitete und erweiterte Fassung 2016 Wien. Klin Wochenschr 128 [Suppl 2]. Springer, Wien

    Google Scholar 

  • Pańkowska E, Błazik M, Groele L (2012) Does the fat-protein meal increase postprandial glucose level in type 1 diabetes patients on insulin pump: the conclusion of a randomized study. Diabetes Technol Ther 14(1):16–22. https://doi.org/10.1089/dia.2011.0083 Epub 2011 Oct 20

    Article  CAS  PubMed  Google Scholar 

  • Prospective Urban Rural Epidemiology (PURE) study investigators. Dehghan M, Mente A, Zhang X, Swaminathan S et al. (2017) Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. Lancet 390(10107):2050–2062. https://doi.org/10.1016/S0140–6736(17)32252–3

  • Rabol R et al (2011) Reversal of muscle insulin resistance with exercise reduces postprandial hepatic de novo lipogenesis in insulin resistant individuals. Proc Natl Acad Sci U S A.16 108(33):13705–9. https://doi.org/10.1073/pnas.1110105108

    Article  CAS  Google Scholar 

  • Rehner G, Daniel H (1999) Biochemie der Ernährung. Spektrum, Heidelberg/Berlin

    Google Scholar 

  • Reynolds A et al (2016) Advice to walk after meals is more effective for lowering postprandial glycaemia in type 2 diabetes mellitus than advice that does not specify timing: a randomised crossover study. Diabetologia 59(12):2572–2578 Epub 2016 Oct 17

    Article  CAS  PubMed  Google Scholar 

  • Ruiz-Canela M, Estruch R, Corella D, Salas-Salvadó J, Martínez-González MA (2014) Association of Mediterranean Diet With Peripheral Artery Disease. JAMA. 2014. Jan 22–29 311(4):415–417. https://doi.org/10.1001/jama.2013.280618

    Article  CAS  Google Scholar 

  • Sato J, Kanazawa A, Hatae C, Makita S, Komiya K, Shimizu T, Ikeda F, Tamura Y, Ogihara T, Mita T, Goto H, Uchida T, Miyatsuka T, Ohmura C, Watanabe T, Kobayashi K, Miura Y, Iwaoka M, Hirashima N, Watada H (2017) One year follow-up after a randomized controlled trial of a 130 g/day low-carbohydrate diet in patients with type 2 diabetes mellitus and poor glycemic control. Clin Nutr 36(4):992–1000. https://doi.org/10.1016/j.clnu.2016.07.003

    Article  CAS  PubMed  Google Scholar 

  • Schwingshackl L, Chaimani A, Hoffmann G, Schwedhelm C, Boeing H (2018) A network meta-analysis on the comparative efficacy of different dietary approaches on glycaemic control in patients with type 2 diabetes mellitus. European Journal of Epidemiology. doi.org/10.1007/s10654–017–0352-x

  • Snorgaard O, Poulsen GM, Andersen HK, Astrup A (2017) Systematic review and meta-analysis of dietary carbohydrate restriction in patients with type 2 diabetes. BMJ Open Diabetes Res Care 5(e):000354

    Google Scholar 

  • Souza RJ, de Mente A, Maroleanu AC, Ha AI, Kishibe V, Uleryk T, Budylowski E, Schunemann P, Beyene HJ, Anand SS (2015) Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies. BMJ (Clinical research ed.) 351:h3978. https://doi.org/10.1136/bmj.h3978

    Article  CAS  Google Scholar 

  • Tay J, Thompson CH, Luscombe-Marsh ND, Noakes M, Buckley JD, Wittert GA, Brinkworth GD (2015) Long-Term Effects of a Very Low Carbohydrate Compared With a High Carbohydrate Diet on Renal Function in Individuals With Type 2 Diabetes: A Randomized Trial. Medicine (Baltimore) 94(47):e2181. https://doi.org/10.1097/MD.0000000000002181

    Article  CAS  Google Scholar 

  • Toeller M (2005) Evidenz der Ernährung in der Therapie und Prävention des Diabetes mellitus. Aktuelle Ernährungsmedizin 30(4):197–203. https://doi.org/10.1055/s-2005–866929

  • U.S. Department of Health and Human Services and U.S. Department of Agriculture (2015) Dietary Guidelines for Americans, 8th Ed. USDA, HHS, Washington, DC

    Google Scholar 

  • van Tilburg WAP, Igou ER (2013) On the meaningfulness of behavior: An expectancy x value approach. Motivation and Emotion 37(3):373–388. doi.org/10.1007/s11031–012–9316–3

  • Worm X, Lemberger X, Mamngiameli X (2015) Flexi-Carb – Das Kochbuch. Riva, München

    Google Scholar 

  • Wu H, Flint AJ, Qi Q, van Dam RM, Sampson LA, Rimm EB, Holmes MD, Willett WC, Hu FB, Sun Q (2015) Association between dietary whole grain intake and risk of mortality: two large prospective studies in US men and women. JAMA internal medicine 175(3):373–384. https://doi.org/10.1001/jamainternmed.2014.6283

    Article  PubMed  PubMed Central  Google Scholar 

  • Zelber-Sagi S, Salomone F, Mlynarsky L (2017) The Mediterranean dietary pattern as the diet of choice for non-alcoholic fatty liver disease: Evidence and plausible mechanisms. Liver Int 37(7):936–949. https://doi.org/10.1111/liv.13435

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Tittmoning, Deutschland

    Helmut Nussbaumer

Authors
  1. Helmut Nussbaumer
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Nussbaumer, H. (2019). Ernährungstherapie bei Typ-2-Diabetes. In: Ernährungsempfehlungen bei Typ-2-Diabetes. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-57808-7_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-57808-7_4

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-57807-0

  • Online ISBN: 978-3-662-57808-7

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics

Search

Navigation