Nutrition management of insulin-dependent diabetes mellitus in adults: review by the diabetes care and education dietetic practice group.

Insulin-dependent diabetes mellitus (IDDM) is a chronic disease in which insulin production from the pancreas is diminished or absent. Insulin-dependent diabetes mellitus is most often diagnosed in childhood, but it also occurs in adults. Treatment requires the use of exogenous insulin coordinated with food intake and physical activity. Management goals for IDDM are to attain metabolic control of glucose and lipid levels and to prevent or delay the onset of medical complications associated with diabetes. Because the type and amount of food consumed directly affect blood glucose levels, meal and snack planning, along with an appropriate insulin regimen and physical activity program, is necessary to achieve management goals. Nutrition assessment, initial education, implementation of a meal plan, and ongoing nutrition education and counseling are part of the process of nutrition management of diabetes. The registered dietitian who has a working knowledge of nutrition and diabetes management serves as an integral part of the diabetes health care team.

Effect of storage upon the toxicity of synfuel process waters to bacteria.

Storage of synfuel process waters at 4 degrees C for 8 years appeared to reduce the toxicity of these waters to indicator bacteria. When these waters were mixed in the amount of 10 percent process waters to 90 percent sewage, heterotrophic bacteria grew which indicate that storage or aeration may improve the treatability of these waters.

Evaluation of prenatal vitamin-mineral supplements.

Nutritional requirements of pregnancy are reviewed, and guidelines for evaluating prenatal vitamin-mineral supplements are provided. Daily antepartum supplementation of 0.4-0.8 mg of folic acid and 30-60 mg of elemental iron is currently recommended, although the lower ends of these ranges may be most appropriate. Dietary intake of these nutrients is likely to be inadequate without supplementation, and their importance is well established. Requirements for other minerals and vitamins are not well established, and there is no consensus on the need for supplementation. However, available data suggest that prenatal supplements should probably contain other nutrients; pyridoxine hydrochloride, cholecalciferol, vitamin E, pantothenic acid, calcium, magnesium, zinc, copper, and possibly selenium should be considered. Interactions among the minerals and vitamins commonly found in prenatal supplements may affect the absorption of various nutrient components. Thus, very high or low levels of certain nutrients should be avoided. The chemical form of minerals should also be considered. Products should have demonstrated bioavailability for iron, zinc, and other components that are subject to bioavailability problems. Use of low-potency product that contains a wide range of vitamins and minerals appears to be the most prudent approach to prenatal vitamin and mineral supplementation.