Î People with diabetes and those at risk for diabetes should limit
or avoid intake of sugar-sweetened beverages (from any caloric
sweetener including high-fructose corn syrup and sucrose) to reduce
risk for weight gain and worsening of cardiometabolic risk profile. (B)
Dietary Fat Quantity and Quality
Î Evidence is inconclusive for an ideal amount of total fat intake for
people with diabetes; therefore, goals should be individualized. (C)
Fat quality appears to be far more important than quantity. (B)
Î In people with type 2 diabetes, a Mediterranean-style, MUFA-rich
eating pattern may benefit glycemic control and CVD risk factors and
can therefore be recommended as an effective alternative to a lower-
fat, higher-carbohydrate eating pattern. (B)
Î As recommended for the general public, an increase in foods
containing long-chain n-3 fatty acids (EPA and DHA) (from fatty fish)
and n-3 linolenic acid (ALA) is recommended for individuals with
diabetes because of their beneficial effects on lipoproteins, prevention
of heart disease, and associations with positive health outcomes in
observational studies. (B)
Î The amount of dietary saturated fat, cholesterol, and fat recommended
for people with diabetes is the same as that recommended for the
general population. (C)
Supplements for Diabetes Management
Î There is no clear evidence of benefit from vitamin or mineral
supplementation in people with diabetes who do not have underlying
deficiencies. (C)
Î Routine supplementation with antioxidants, such as vitamins E and C
and carotene, is not advised because of lack of evidence of efficacy
and concern related to long-term safety. (A)
Î Evidence does not support recommending n-3 (EPA and DHA)
supplements for people with diabetes for the prevention or treatment
of CV events. (A)
Î There is insufficient evidence to support the routine use of
micronutrients such as chromium, magnesium, and vitamin D to
improve glycemic control in people with diabetes. (C)
Î There is insufficient evidence to support the use of cinnamon or other
herbs/supplements for the treatment of diabetes. (C)
Î It is reasonable for individualized meal planning to include
optimization of food choices to meet recommended daily allowance/
dietary reference intake for all micronutrients. (E)
Standards of Medical Care
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