Nutrition Principle for the Patient with Diabetes Mellitus :

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 (1) 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.Basic principles of diabetes meal planning :

1. Eat three meals throughout the day. Do not skip meals.

2. Because of the effect that medications and carbohydrates have on blood glucose (blood sugar) it is
important to have carbohydrates at each meal. Carbohydrates are found in grains, starchy
vegetables, beans, milk and fruit.
Examples of carbohydrate foods and their serving sizes are:

1/3 cup pasta or rice, potatoes, beans, casserole, corn or peas

1 cup of cereal or soup
1 slice bread, 1 small muffin, ½ hamburger bun, 1 dinner roll, or 1 small flour or corn tortilla
a handful of pretzels or low fat chips
1 piece or 1 cup of fresh fruit
½ cup fruit juice (limit to ½ cup per day) and light canned fruit
1 cup of skim or 1% milk, or lite yogurt
Women should have 2 to 4 carbohydrate foods at each meal.
Men should have 3 to 5 carbohydrate foods at each meal.

3. Eat snacks containing carbohydrates between meals if:

your meals are 5 or more hours apart
you are hungry
your activity level is higher than usual

4. Examples of carbohydrate snacks are: (if needed, choose 1 or 2)

a piece of fruit
a handful of crackers or pretzels
 ½ sandwich
a cup of lite yogurt, or skim or 1% milk
3 cups of popcorn

5. Just because a food is labeled “sugar-free”, does not mean that it is good for you. Some sugar-free
foods have the same amount of carbohydrate as regular, sweetened items. The following foods
are high in sugar and should be limited. A dietitian can teach you how to work these types of foods
into your diabetes meal plan.

6. Protein and fat do not have an immediate effect on blood glucose, but can have an effect on your
heart and your weight. A dietitian can teach you about heart-healthy eating.

Dafpus : https://care.diabetesjournals.org/content/27/suppl_1/s36

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