| Abstract: |
This article considers the nutritional implications of oral medication use in type 2 diabetes. The scope of practice for registered dietitians working in diabetes care and education has changed dramatically in the past few years. To implement an effective plan of medical nutrition therapy for the person who has diabetes, the dietitian must have a good knowledge of the effects of diabetes medications in relation to food, exercise, weight, and blood glucose and lipid levels. The development of new oral agents to treat type 2 diabetes has been unprecedented in the past 5 years, with four new classes of agents being introduced. Before discussing these oral agents, the article explains the pathophysiology of type 2 diabetes and examines the goals for glycemic control, lipid levels, blood pressure, weight, and exercise. The review of oral agents focuses on sulfonylureas, meglitinide, biguanides, alpha glucosidase inhibitors, and thiazolidinediones. Each agent is discussed in terms of its mode of action and nutritional implications. In addition, the article comments on the practice of combination therapy. 6 tables. 33 references. (AA-M). |