Nutrition Therapy Recommendations for theManagement of Adults With Diabetes

A healthful eating pattern, regularphysical activity, and often pharma-cotherapy are key components of diabetes management. For many individ-uals with diabetes, the most challenging part of the treatment plan is determin-ing what to eat. It is the position of the American Diabetes Association (ADA) that there is not a “one-size-fits-all ” eating pattern for individuals with diabetes. The ADA also recognizes the integral role of nu-trition therapy in overall diabetes manage-ment and has historically recommended that each person with diabetes be actively engaged in self-management, education, and treatment planning with his or her health care provider, which includes the collaborative development of an individ-ualized eating plan (1,2). Therefore, it is important that all members of the health care team be knowledgeable about dia-betes nutrition therapy and support its implementation. This position statement on nutrition therapy for individuals living with diabe-tes replaces previous position statements, the last of which was published in 2008 (3). Unless otherwise noted, research re-viewed was limited to those studies con-ducted in adults diagnosed with type 1 or type 2 diabetes. Nutrition therapy for the prevention of type 2 diabetes and for the management of diabetes complications and gestational diabetes mellitus is not addressed in this review. Agrading system,developedby theADA and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations (1) (Table 1). The level of evidence that supports each recommendation is listed after the rec-ommendation using the letters A, B, C, or E. A table linking recommendations to evi-dence can be reviewed a