After reviewing the available evidence, it is the ADA’s position that there is no standard meal plan or eating pattern that is effective universally for all people with diabetes.1
In order to be effective, nutrition therapy should be individualized for each person based on his or her individual health goals; personal and cultural preferences; health literacy and numeracy; access to healthful choices; and readiness, willingness, and ability to change.
Nutrition interventions should emphasize a variety of minimally processed nutrient-dense foods in appropriate portion sizes as part of a healthful eating pattern.
Marion J. Franz, MS, RD, LD, CDE, is a nutrition/health consultant with Nutrition Concepts by Franz, Inc. For over 20 years she was the Director of Nutrition and Health Professional Education at the International Diabetes Center, Minneapolis.
- Evert AB, Boucher JL, Cypress M, Dunbar SA, Franz MJ, Mayer-Davis EJ, Neumiller JJ, Nwankwo R, Verdi CL, Urbanski P, Yancy Jr, WS. Nutrition therapy recommendations for the management of adults with diabetes. Diabetes Care 2013;36:3821-3842.
- Institute of Medicine. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, DC: National Academies Press, 2002.
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- Delahanty LM, Nathan DM, Lachin JM, et al for the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications. Association of diet with glycated hemoglobin during intensive treatment of type 1 diabetes in the Diabetes Control and Complications Trial. Am J Clin Nutr 2009;89:518-524.
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- Xu J, Eilat-Adar S, Loria CM et al. Macronutrient intake and glycemic control in a population-based sample of American Indians with diabetes: The Strong Heart study. Am J Clin Nutr 2009;89:518-524.
- Wheeler ML, Dunbar SA, Jaacks LM, et al. Macronutrients, food groups, and eating patterns in the management of diabetes: a systematic review of the literature, 2010. Diabetes Care 2012;35:434-445.
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- Rosenfalck AM, Almdal T, Viggers L, Madsbad S, Hilssted J. A low-fat diet improves peripheral sensitivity in patients with type 1 diabetes. Diabetes Med 2006;23:384-392.
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- Howard BV, Van Horn L, Hsia J, et al. Low fat dietary patterns and risk of cardiovascular disease. The Women’s Health Initiative Randomized Controlled Dietary Modification Trial. JAMA 2006;295:656-666.
- Bessesen DH. The role of carbohydrate in insulin resistance. J Nutr 2001;131:2782S-2786S.
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- American Diabetes Association. Standards for medical care in diabetes—2014. Diabetes Care 2014;37(Suppl 1):S14-S80.
- Brunzell C. Nutrition therapy for diabetes and celiac disease. In: American Diabetes Association Guide to Nutrition Therapy for Diabetes, Second Edition. Franz MJ, Evert AB, eds. Alexandria, VA: American Diabetes Association; 2012, pp 319-339