Medical nutrition therapy for diabetes mellitus

Background: Lifestyle modifications including medical nutrition, exercise, and behavioral psychological therapy play a pivotal role in the treatment of diabetes mellitus. In this study, we discuss the fundamental and essential aspects of medical nutrition therapy for treatment of diabetes mellitus based on the medical nutrition recommendations of the Korean Diabetes Association.Current Concepts: Patients with diabetes should receive education for individualized medical nutrition therapy from a qualified clinical dietitian. Overweight adults or those with obesity must lose at least 5% of their body weight. The percentages of carbohydrate, protein, and fat intake are individualized based on treatment goals and preferences. A Mediterranean, vegetarian, low-fat, low-carbohydrate, and Dietary Approaches to Stop Hypertension diet may be used based on individualized plans and priorities. Patients with diabetes are recommended to consume carbohydrates from fiber-rich whole grains, legumes, vegetables, raw fruits, and dairy products and to reduce intake of sweetened beverages. It is not necessary to limit protein intake. Patients with diabetes are recommended to replace foods high in saturated and trans fatty acids with foods rich in unsaturated fatty acids. Routine administration of unsaturated fatty acid supplements is not recommended. Sodium intake should not exceed 2,300 mg/day. Routine use of micronutrient supplements such as vitamins and minerals to improve blood glucose levels is not recommended. Patients using insulin or insulin secretagogues should be counseled to avoid hypoglycemia if they consume alcohol.Discussion and Conclusion: Medical nutrition therapy, which has been shown to treat diabetes and prevent a variety of cardiovascular risk factors and complications, should be utilized aggressively by all healthcare providers who treat patients with diabetes.