Nutrition Therapy Recommendations for the Management of Adults With Diabetes

  1. William S. Yancy Jr., MD, MHSC10
  1. 1University of Washington Medical Center, Seattle, WA
  2. 2Minneapolis Heart Institute Foundation, Minneapolis, MN
  3. 3Department of Endocrinology, ABQ Health Partners, Albuquerque, NM
  4. 4American Diabetes Association, Alexandria, VA
  5. 5Nutrition Concepts by Franz, Minneapolis, MN
  6. 6Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
  7. 7Department of Pharmacotherapy, Washington State University, Spokane, WA
  8. 8University of Michigan Medical School and the Center for Preventive Medicine, Ann Arbor, MI
  9. 9pbu consulting, llc., Cloquet, MN
  10. 10Duke University School of Medicine, Durhum, NC
  1. Corresponding authors: Alison B. Evert, atevert{at}, and Jackie L. Boucher, jboucher{at}

A healthful eating pattern, regular physical activity, and often pharmacotherapy are key components of diabetes management. For many individuals with diabetes, the most challenging part of the treatment plan is determining 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 nutrition therapy in overall diabetes management 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 individualized eating plan (1,2). Therefore, it is important that all members of the health care team be knowledgeable about diabetes nutrition therapy and support its implementation.

This position statement on nutrition therapy for individuals living with diabetes replaces previous position statements, the last of which was published in 2008 (3). Unless otherwise noted, research reviewed was limited to those studies conducted 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.

A grading system, developed by the ADA 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 recommendation using the letters A, B, C, or E. A table linking recommendations to evidence can be reviewed at Members of the Nutrition Recommendations Writing Group Committee disclosed all potential financial conflicts of interest with industry. These disclosures were discussed at the onset of the position statement development process. Members of …

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