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DM: Individualize Nutrition Prescription
➤ The RDN should individualize the nutrition prescription and implement
evidence-based guidelines in collaboration with the adult with
diabetes. A variety of eating patterns (combinations of different
foods or food groups) are acceptable for the management of diabetes.
Personal preferences (e.g., tradition, culture, religion, health beliefs
and goals, economics) and metabolic goals should be considered when
recommending one eating pattern over another. Treatment decisions
should be founded on evidence-based guidelines tailored to individual
patient preferences, prognoses and co-morbidities. (Fair, Imperative)
DM: Encourage Healthful Eating Plan for Appropriate-Weight
Adults with Diabetes
➤ For appropriate-weight adults with diabetes, the RDN should
encourage consumption of a healthful eating plan, with a goal of
weight maintenance and prevention of weight gain. A variety of
eating patterns (combinations of different foods or food groups) are
acceptable for the management of diabetes. (Consensus, Conditional)
DM: Encourage Reduced Energy Healthful Eating Plan for
Overweight or Obese Adults with Diabetes
➤ For overweight or obese adults with diabetes, the RDN should
encourage a reduced energy, healthful eating plan, with a goal of
weight loss, weight loss maintenance and prevention of weight gain.
Studies based on reduced energy interventions reported significant
reductions in HbA1c of 0.3%–2.0% in adults with type 2 diabetes and
of 1.0%–1.9% in adults with type 1 diabetes, as well as optimization of
medication therapy and improved quality of life. (Strong, Conditional)
DM: Individualize Macronutrient Composition
➤ The RDN, in collaboration with the adult with diabetes, should
individualize the macronutrient composition of the healthful eating
plan within the appropriate energy intake. Limited research regarding
differing amounts of carbohydrate (39%–57% of energy) and fat
(27%–40% of energy), reported no significant effects on A1C or insulin
levels in adults with diabetes, independent of weight loss. Limited
research reports mixed results regarding the effects of the amount of
protein (ranging from 0.8–2.0 g/kg/day) on fasting glucose levels and
A1C. (Fair, Imperative)
Nutrition Intervention
