Statement of the American Diabetes Association: Nutrition Recommendations for the Treatment and Prevention of Diabetes

The following Nutrition Recommendations for Carbohydrates were published by the American Diabetes Association in January 2002 (Diabetes Care 2002;25:148-198):

• Foods containing carbohydrate from whole grains, fruits, vegetables, and low-fat milk are important components and should be included in a healthy diet.
• With regard to the glycemic effects of carbohydrates, the total amount of carbohydrate in meals or snacks is more important than the source or type.
• Because sucrose does not increase glycemia to a greater extent than isocaloric amounts of starch, sucrose and sucrose-containing foods do not need to be restricted by people with diabetes, however, they should be substituted for other carbohydrate sources or, if added, be covered with insulin or other glucose-lowering medication.
• Nonnutritive sweeteners are safe when consumed within the ADI levels established by the FDA.
• Individuals receiving intensive insulin therapy should adjust their premeal insulin dosages based on the carbohydrate content of meals.
• Although the use of low-glycemic index foods may reduce postprandial hyperglycemic, there is not sufficient evidence of long-term benefit to recommend use of low-glycemic index diets as a primary strategy in food/meal planning.
• As far the general public, consumption of dietary fiber is to be encouraged; however, there is no reason to recommend that people with diabetes consume a greater amount of fiber than other Americans.
• Individuals receiving fixed daily insulin dosages should try to be consistent in day-to-day carbohydrate intake.
• Carbohydrate and monounsaturated fat should together provide 60–70% of energy intake. However, the individual’s metabolic profile and need for weight loss should be considered when determining the monounsaturated fat content of the diet.
• Sucrose and sucrose-containing foods should be eaten in the context of a healthy diet.

References:

1. Technical Review: Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications. Diabetes Care, volume 25, number 1, page 148-198, January 2002.
2. Position Statement: Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications. Diabetes Care, volume 25, number 1, page 202-212, January 2002.