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Coaching patients to use food for better blood sugar: new article

Updated: Jan 9

Recently, an important new article about how to help patients change their diets to achieve better blood sugar results, and even put type 2 diabetes into remission, was distributed to the extensive network of diabetes health professionals across Canada.

The article, entitled "Helping Individuals Adopt Therapeutic Nutrition Along the Dysglycemia Continuum" was published December 20 by The Diabetes Communicator, the quarterly professional publication of Diabetes Canada. (Dysglycemia is the medical name for unhealthy blood sugar levels.)

The authors are three Canadian lifestyle physicians, Dr. Leanne Reimche, Dr. Brendan Byrne, and Dr. Jasdeep Saluja, and health writer Anne Mullens, BSc, BJ , (three of whom are closely associated with the Institute for Personalized Therapeutic Nutrition (IPTN), which co-sponsors this remission site.)

In the article, the authors share research evidence about the effectiveness of dietary change in improving blood sugar and metabolic health. Then they illustrate their approach and coaching styles for helping patients make easy but effective changes to reduce insulin resistance, improve their blood sugar levels, and potentially put type 2 diabetes into remission.

The authors note that while research shows diet and exercise are the first line treatment for prediabetes and type 2 diabetes, during busy medical appointments providers' advice "can amount to vague and unhelpful platitudes such as 'try to eat less and move more.' ”

Instead, they share how they aim to engage more effectively with patients at "key motivational moments" to provide personalized dietary advice.

They note: " Unlike other physician encounters, which are more directive, therapeutic nutrition interventions involve tapping into patients’ own strengths, goals, and desires. Then the care provider must act as a coach to help patients prioritize their changes, to decide what they are willing and able to change, and to anticipate and plan for the challenges of any change."

In the article, the doctors illustrate this personalized coaching process using three patient case studies, each with different levels of insulin resistance and stages of blood sugar dysfunction.

The authors note that there is no single therapeutic nutrition diet that works. Rather, finding the best dietary intervention involves working with patients to discuss their current patterns of eating and providing options for new food choices that would best fit their health needs, goals, lifestyle, and food preferences.

However, there are clear "dietary commonalities" among all the dietary approaches. They all:

  • focus on whole foods and minimally processed foods

  • eliminate ultra-processed foods

  • reduce or eliminate added sugars, and foods (carbohydrates) that rapidly digest to sugar

  • eliminate all sweet beverages, including pop, fruit juice, sports drinks, specialty coffees

  • ensure adequate protein and other essential nutrients

  • contain plenty of vegetables for fibre and nutrients

  • include healthy fat sources such as olive oil or nut oils

The authors note: "Following these dietary commonalities, patients can eat in the style of their choosing, including whole-foods plant-forward, low-carb, ketogenic, vegetarian, vegan, Mediterranean, and more. Ethnic or cultural diets can be adjusted using these commonalities."

Sean McKelvey, the CEO of the IPTN, says the article is a major milestone in spreading the word about the power of therapeutic nutrition to improve type 2 diabetes and metabolic health. It will be incredibly helpful for both healthcare providers and patients to better understand what is involved in personalizing nutritional approaches. "Describing the dietary commonalities is an especially valuable contribution that will reduce the arguments over the pros and cons of specific dietary patterns and have everyone focus on the common ground," McKelvey said. "It will enable professionals to focus on coaching the evidence-based approach that aligns best with individual patients' preferences and values."

The paper is now provided in the links of research evidence in the Resources for Healthcare Providers section of this website. Be sure to read it and share it widely to get the word out to more people about how to adopt therapeutic nutrition to improve metabolic health and put type 2 diabetes into remission.


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