Table 4. Summary of Priority Topics
1. Strategies for all people with diabetes:
Portion control should be recommended for weight loss and maintenance.
Carbohydrate-containing foods and beverages and endogenous insulin production are the
greatest determinant of the postmeal blood glucose level. erefore, it is important to know
what foods contain carbohydrates—starchy vegetables, whole grains, fruit, milk and milk
products, vegetables, and sugar.
When choosing carbohydrate-containing foods, choose nutrient-dense, high-fiber foods
whenever possible instead of processed foods with added sodium, fat, and sugars. Nutrient-
dense foods and beverages provide vitamins, minerals, and other healthful substances with
relatively few calories. Calories have not been added to them from solid fats, sugars, or
refined starches.
Avoid sugar-sweetened beverages (SSBs).
For most people, it is not necessary to subtract the amount of dietary fiber or sugar alcohols
from total carbohydrates when carbohydrate counting.
Substitute foods higher in unsaturated fat (liquid oils) for foods higher in trans or saturated
fat.
Select leaner protein sources and meat alternatives.
Vitamin and mineral supplements, herbal products, or cinnamon to manage diabetes are not
recommended due to lack of evidence.
Moderate alcohol consumption (one drink/day or less for adult women and two drinks
or less for adult men) has minimal acute or long-term effects on blood glucose in people
with diabetes. To reduce risk of hypoglycemia for individuals using insulin or insulin
secretagogues, alcohol should be consumed with food.
Limit sodium intake to 2,300 mg/day.
2. Priority should be given to coordinating food with type of diabetes medicine for those
individuals on medicine.
For individuals who take insulin secretagogues:
• Moderate amounts of carbohydrate at each meal and snacks.
• To reduce risk of hypoglycemia
a
:
:
▶ Eat a source of carbohydrates at meals.
▶ Moderate amounts of carbohydrates at each meal and snack.
▶ Do not skip meals.
▶ Physical activity may result in low blood glucose depending on when it is performed.
Always carry a source of carbohydrates to reduce risk of hypoglycemia.
a
For individuals who take biguanides (metformin):
• Gradually titrate to minimize gastrointestinal side effects when initiating use:
▶ Take medication with food or 15 min after a meal if symptoms persist.
▶ If side effects do not resolve over time (a few weeks), follow up with health care
provider.
▶ If taking along with an insulin secretagogue or insulin, may experience hypoglycemia.
a
