Recent research shows that up to one quarter of aged care residents have diabetes. Diabetes is characterised by the body’s reduced ability to control blood glucose levels (BGL) with poorly controlled diabetes having the potential to result in side effects such as poor would healing, pressure ulcers, weight loss, chronic infections, cognitive decline and increased risk of falls. Glucose is however, an essential energy source for the body and therefore needs to be included in the diet in moderation. Carbohydrate foods such as breads and cereals, rice, pasta, potato, dairy, fruit, cakes, biscuits, soft drinks, juices, etc all breakdown to form glucose/sugar.
Aged care residents with diabetes were previously treated with a diet that restricted energy and carbohydrate and had limited or no added sugar. Thankfully for residents, the management of diabetes in RACF’s has become less prescriptive with evidence showing that a strict ‘diabetic diet’ provides no real long term benefits for BGL control. It is recommended that sugar be included in the diet in moderate amounts as with all other non-diabetic residents. Evidence suggests that the unnecessary restriction of carbohydrate foods can place residents at increased risk of malnutrition and associated consequences such as infections and pressure sores. In terms of meals offered to residents with diabetes, it is recommended they are provided with the standard menu choices.
It has become widely recognised that it is most beneficial to promote healthy eating through regular meals and snacks. Sugar does not need to be avoided and low fat diets are not recommended aside from situations when it is advised to do so by a medical professional.
While the above is generalised advice for those residents with diabetes, there will be instances where a residents BGL’s are difficult to control and the resident may require a more individualised dietary plan with a regulated amount of carbohydrate/sugars at each meal. Please consult the resident’s dietitian and doctor in these situations.
It is also well recognised that being overweight can have a negative effect on blood sugar control. In these situations it is recommended the options are discussed with the resident and with the resident’s permission, they are referred to a dietitian who can help create an individualised eating plan. In most situations it is more appropriate to aim for weight maintenance rather than weight reduction.
In summary, it is recommended that residents with controlled diabetes are offered the standard diet to promote their optimal health and well-being.