Diabetes Nutrition Therapy: Effectiveness, Macronutrients, Eating Patterns and Weight Management

• Published in: The American journal of the medical sciences Vol. 351; no. 4; p. 374
• Main Author: Franz, Marion J
• Format: Journal Article
• Language: English
• Published: United States 01.04.2016
• Subjects: Blood Glucose - metabolism; Clinical Trials as Topic - methods; Diabetes Mellitus - blood; Diabetes Mellitus - diagnosis; Diabetes Mellitus - diet therapy; Disease Management; Feeding Behavior - physiology; Glycemic Index - physiology; Humans; Nutrition Therapy - methods; Treatment Outcome; Weight Loss - physiology; Diabetes macronutrients; Weight loss interventions for diabetes; Effectiveness of diabetes nutrition therapy
• ISSN: 1538-2990
• DOI: 10.1016/j.amjms.2016.02.001

Diabetes nutrition therapy provided for individuals with diabetes must be based on research documenting effectiveness. The roles of differing macronutrient percentages, eating patterns and weight loss interventions are controversial. A review of research related to these topics is summarized. Clinical trials as well as systematic reviews and Cochrane reviews report an approximately 1-2% lowering of hemoglobin A1c as well as other beneficial outcomes from nutrition therapy interventions, depending on the type and duration of diabetes and level of glycemic control. There are no ideal percentages of macronutrients or eating patterns or both that apply to all persons with diabetes. Clinical trials demonstrate the effectiveness of modest weight loss and physical activity for the prevention or delay of type 2 diabetes. However, as the disease progresses, weight loss interventions may or may not result in beneficial glycemic and other metabolic outcomes. To be effective, diabetes nutrition therapy must be individualized. Treatment goals, personal preferences (eg, tradition, culture, religion, health beliefs and economics) and the individual׳s ability and willingness to make lifestyle changes all must be considered when educating or counseling individuals with diabetes. A healthy eating pattern emphasizing nutrient-dense foods in appropriate portion sizes, regular physical activity and support are important. A reduced energy intake for persons with prediabetes or type 2 diabetes and matching insulin to planned carbohydrate intake for insulin users is nutrition therapy interventions shown to be effective in achieving glycemic and other metabolic outcomes.