Nutrition Recommendations
Table 1. Nutrition Therapy Recommendations
Topic Recommendation
Effectiveness of
nutrition therapy
Nutrition therapy is recommended for all people with type 1 and type 2
diabetes as an effective component of the overall treatment plan. (A)
Individuals who have diabetes should receive individualized MNT as
needed to achieve treatment goals, preferably provided by an RD familiar
with the components of diabetes MNT. (A)
• For individuals with type 1 diabetes, participation in an intensive
flexible insulin therapy education program using the carbohydrate
counting meal planning approach can result in improved glycemic
control. (A)
• For individuals using fixed daily insulin doses, consistent
carbohydrate intake with respect to time and amount can result in
improved glycemic control and reduce risk for hypoglycemia. (B)
• A simple diabetes meal planning approach such as portion control
or healthful food choices may be better suited to individuals
with type 2 diabetes identified with health and numeracy literacy
concerns. is may also be an effective meal planning strateg y for
older adults. (C)
People with diabetes should receive DSME according to national
standards and diabetes self-management support when their diabetes is
diagnosed and as needed thereaer. (B)
Because diabetes nutrition therapy can result in cost savings (B) and im-
proved outcomes such as reduction in A1C(A), nutrition therapy should
be adequately reimbursed by insurance and other payers. (E)
Energ y balance For overweight or obese adults with type 2 diabetes, reducing energ y
intake while maintaining a healthful eating pattern is recommended to
promote weight loss. (A)
Modest weight loss may provide clinical benefits (improved glycemia,
blood pressure, and/or lipids) in some individuals with diabetes,
especially those early in the disease process. To achieve modest weight
loss, intensive lifestyle interventions (counseling about nutrition
therapy, physical activity, and behavior change) with ongoing support
are recommended. (A)