Managing Diabetes—a Growing Concern


Proper care and meal preparation is vital as more and more Canadians are diagnosed with diabetes.

Every three minutes, another Canadian is diagnosed with diabetes. Preventing and managing the condition is covered by a recent guideline update by Diabetes Canada. The update assembles the latest clinical data to help healthcare providers who care for those at risk or living with diabetes.

Diabetes is a chronic condition in which insulin is either not being produced (Type 1) or the body cannot properly use the insulin it produces (Type 2). The result of each type leaves the body with abnormally high blood sugars incapable of being used as energy.

In 2016, about 7% of Canadians were diagnosed as having Type 2 diabetes. This form of the disease is more common—an estimated 90% of diabetes cases among Canadians are Type 2—and happens more often in adults over 40. The impact is very prevalent in long-term care, where almost 28% of residents in Ontario homes have diabetes. As a healthcare foodservice operator, it is crucial to know and understand best practices when it comes to diabetes and resident care.

Five-year update key points

Diabetes Canada, formerly the Canadian Diabetes Association, has released its 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. The guidelines represent the most relevant and current evidence-based clinical data. The guidelines, reviewed and updated every five years, includes key messages for people living with diabetes.

A chapter on how to manage diabetes among older people is especially relevant for healthcare foodservice. Here are three key messages from this section:

  • Diabetes in older people is distinct from diabetes in younger people and the approach to therapy should be different. This is especially true in those who have functional dependence, frailty, dementia or who are at the end of life. Personalized strategies are needed to avoid overtreatment of the frail or elderly.
  • For an older person with diabetes and multiple comorbidities and/or frailty, strategies should be used strictly to prevent hypoglycemia, which include a less-stringent glycemic target.
  • No two older people are alike and every older person with diabetes needs a customized diabetes-care plan. What works for one individual may not be the best course of treatment for another.

An emphasis on individualized care

Whether you are a director or administrator of a home, a foodservice manager or a chef, it’s important to customize diabetes care for each resident. The guidelines stress how crucial it is to avoid over-treating people with diabetes by restricting their diet. This can lead to other complications.

Historically, therapeutic diabetic diets have been prescribed for older adults in long-term care settings. Now, growing evidence shows therapeutic diets may inadvertently lead to decreased food intake, unintentional weight loss and undernutrition, none of which are desired outcomes.

Dietitians of Canada confirms this, noting decreased intakes and unintentional weight loss may lead to an increased risk of morbidity and mortality. Based on the 2018 guidelines, liberalized diets or simply serving the regular menu, balanced according to Canada’s Food Guide, may be adequate to prevent weight loss and manage blood glucose levels for older adults with diabetes.

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