Are diets such as “no concentrated sweets”, “no added sugar”, and “liberal diabetic diet” appropriate for patients with diabetes?
The notion of a “diabetic diet” is outdated and perpetuates the false notion that restricting sucrose-sweetened foods will improve glycemic control. A restricted diet may be detrimental to quality of life in the frail elderly patient for whom food is one of life’s few remaining pleasures. • Should patients with diabetes restrict fat intake? Fat restriction reduces the palatability of food and is not indicated for the majority of patients in long-term care, many of whom are at risk of undernutrition. • In which patients are oral agents generally most effective in treating diabetes? Oral agents are generally most effective in patients whose fasting plasma glucose levels are less than 300 mg/dL. These agents may be initiated if adequate glycemic control is not achieved by lifestyle and diet modifications within 3 months of diagnosis or sooner if the patient remains persistently hyperglycemic or becomes acutely ill. • Is the use of “sliding-scale” insulin recommended in long-term care pati
