Interactive diabetes case 18: A 61-year-old patient with type 2 diabetes and a recent change in diet (medical nutrition therapy) – A5

ANSWER — 

Correct.

Medical nutrition therapy for patients with diabetes includes the following elements: limitation of caloric intake (portion control) to achieve weight loss in those who have overweight or obesity; consistency of carbohydrate intake from day to day and at each mealtime, particularly in those who are on insulin or insulin secretagogues; and healthy choices of macronutrients (carbohydrate, fat, and protein). These elements are interrelated [1] (see "Medical nutrition therapy for type 2 diabetes mellitus"). Healthy choices tend to reduce caloric intake.

The patient agrees to follow your advice. He also asks your opinion about eating fish. He loves fish, but his daughter has heard about mercury contamination in fish, and he does not know what to do. What do you advise?

●You advise him to eat fish at least twice a week and to enjoy it. (See "Interactive diabetes case 18: A 61-year-old patient with type 2 diabetes and a recent change in diet (medical nutrition therapy) – B1".)

●You advise him to avoid fish because of mercury contamination. (See "Interactive diabetes case 18: A 61-year-old patient with type 2 diabetes and a recent change in diet (medical nutrition therapy) – B2".)

Please note that answer A3 is also correct. (See "Interactive diabetes case 18: A 61-year-old patient with type 2 diabetes and a recent change in diet (medical nutrition therapy) – A3".)