Nutritional management

Energy balance

• Energy intake varies greatly with the availability of food and according to age, appetite, growth rate, puberty, energy expenditure and environmental influences such as ambient temperature
• Although energy intake may be regulated by appetite, when food is in abundance excess energy intake causes obesity which, when accompanied by diabetes, increases cardiovascular risk
• At diagnosis, appetite and energy intake are high to restore the preceding catabolic weight loss, but should be reduced when weight is restored
• In puberty, energy intake and nutritional demands increase substantially along with significant increases in insulin dosage