3.0.0.0 NU­TRI­TION THER­A­PY

3.1.0.0 Overview

For many in­di­vid­u­als with di­a­betes, the most chal­leng­ing part of the treat­ment plan is de­ter­min­ing what to eat and fol­lowing a meal plan. There is not a one-‍size-‍fits-‍all eat­ing pat­tern for in­di­vid­u­als with di­a­betes, and meal plan­ning should be in­di­vid­u­alized. Nu­tri­tion ther­a­py has an in­te­gral role in over­all di­a­betes man­age­ment, and each per­son with di­a­betes should be ac­tively en­gaged in ed­u­ca­tion, self-‍man­age­ment, and treat­ment plan­ning with his or her health care team, in­clud­ing the col­lab­o­ra­tive de­vel­opment of an in­di­vid­u­alized eat­ing plan (35,48). All in­di­vid­u­als with di­a­betes should be of­fered a re­fer­ral for in­di­vid­u­alized MNT pro­vided by a reg­is­tered di­eti­tian (RD) who is knowl­edgeable and skilled in pro­vid­ing di­a­betes-‍specific MNT (49). MNT de­liv­ered by an RD is as­so­ci­at­ed with A1C de­creas­es of 1.0–1.9% for peo­ple with type 1 di­a­betes (50) and 0.3–2% for peo­ple with type 2 di­a­betes (50). See Table 5.1 for specific nu­tri­tion rec­om­men­da­tions. Be­cause of the pro­gres­sive na­ture of type 2 di­a­betes, lifestyle changes alone may not be ad­e­quate to main­tain eu­g­lycemia over time. How­ev­er, after med­i­ca­tion is ini­ti­at­ed, nu­tri­tion ther­a­py con­tin­ues to be an im­por­tant com­po­nent and should be in­te­grat­ed with the over­all treat­ment plan (48).

Table 5.1—Med­i­cal nu­tri­tion ther­a­py rec­om­men­da­tions