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Diabetes aktuell 2015; 13(1): 27-30
DOI: 10.1055/s-0035-1549232
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© Georg Thieme Verlag Stuttgart · New York

Ernährungsmedizin bei Typ-2-Diabetes – die aktuelle Studienlage – Weit mehr als eine Versorgung des Körpers mit Nährstoffen

Medical nutrition therapy in patients with type 2 diabetes mellitus – much more than providing energy and essential nutrients
Gesine Weser
1   Medizinische Klinik III, Universitätsklinikum Carl Gustav Carus, Dresden
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Publication Date:
16 March 2015 (online)

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Die nutritive Therapie bei Menschen mit Typ-2-Diabetes reicht weit über die Versorgung des Körpers mit Nährstoffen hinaus. Vor dem Hintergrund einer komplexen Dysregulation des Glukosemetabolismus ist sie – neben der medikamentösen Therapie – eine wertvolle Strategie, um einer Stoffwechselentgleisung vorzubeugen. Vor allem die Zufuhr von Ballaststoffen scheint nach wie vor einer der wichtigsten Ansatzpunkte zu sein, um den Blutglukoseverlauf zu glätten und die Magenentleerung zu verzögern. Zudem stellt sich die Frage, ob die bisherigen verhaltenen Empfehlungen zum Verzehr von Obst für Patienten mit Typ-2-Diabetes (noch) gerechtfertigt erscheinen oder ob sich hier nicht bisher wenig genutzte Chancen für eine erhöhte Aufnahme von Ballaststoffen, Vitaminen und sekundären Pflanzeninhaltsstoffen ergeben. Auch Mikronährstoffdefizite sind bei Patienten mit Typ-2-Diabetes beschrieben. Ein Vergleich aktueller Studien zur Supplementierung mit Chrom zeigt jedoch, wie differenziert die Frage nach einer Supplementierung betrachtet werden muss.

The „medical nutrition therapy“ in patients with type 2 diabetes mellitus is much more than providing energy and all essential nutrients. Considering the complex dysregulation of the glucose metabolism in patients with type 2 diabetes mellitus it rather is a valuable strategy to avoid uncontrolled blood glucose – besides the pharmacological treatment. Above all fiber intake may still be one of the most important approaches to smooth blood glucose curves and to delay gastric emptying. Additionally it is arguable, whether current recommendations on restricted fruit intake for patients with type 2 diabetes mellitus are still justified and whether this area may present a underutilised source for an increased intake of fibers, vitamins and phytochemicals. Micronutrient deficiencies are common in people with diabetes type 2 mellitus as well, which often is associated with the discussion about the benefits and risks of supplementation. Current studies related to the supplementation of chromium show how differentially the evaluation needs to be done in that case.

Key words

medical nutrition therapy - fibers - fruit intake - chromium supplementation
 

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