Diabetes and Nutrition
Medical nutrition
therapy is an integral component of diabetes management and of diabetes
self-management education. Yet many misconceptions exist concerning nutrition
and diabetes. Moreover, in clinical practice, nutrition recommendations that
have little or no supporting evidence have been and are still being given to
persons with diabetes. Accordingly, this position statement provides
evidence-based principles and recommendations for diabetes medical nutrition
therapy. The rationale for this position statement is discussed in the American
Diabetes Association technical review “Evidence-Based Nutrition Principles and
Recommendations for the Treatment and Prevention of Diabetes and Related Complications,”
which discusses in detail the published research for each principle and
recommendation.
Historically,
nutrition recommendations for diabetes and related complications were based on
scientific knowledge, clinical experience, and expert consensus; however, it
was often difficult to discern the level of evidence used to construct the
recommendations. To address this problem, the 2002 technical review and this
position statement provide principles and recommendations classified according
to the level of evidence available using the American Diabetes Association
evidence grading system. However, the best available evidence must still take
into account individual circumstances, preferences, and cultural and ethnic
preferences, and the person with diabetes should be involved in the
decision-making process. The goal of evidence-based recommendations is to
improve diabetes care by increasing the awareness of clinicians and persons
with diabetes about beneficial nutrition therapies.
Because of the
complexity of nutrition issues, it is recommended that a registered dietitian,
knowledgeable and skilled in implementing nutrition therapy into diabetes
management and education, be the team member providing medical nutrition
therapy. However, it is essential that all team members be knowledgeable about
nutrition therapy and supportive of the person with diabetes who needs to make
lifestyle changes.
Franz MJ, Bantle JP, Beebe CA,
Brunzell JD, Chiasson J-L, Garg A, Holzmeister LA,
Hoogwerf B,
Mayer-Davis E, Mooradian AD, Purnell JQ, Wheeler M: Evidence-based nutrition
principles and recommendations for the treatment and prevention of diabetes and
related complications (Technical Review). Diabetes
Care 25: 148–198, 2002
American Diabetes Association: Type 2 diabetes in
children and adolescents (Consensus
Statement). Diabetes Care 23:381–389, 2000
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