Current recommendations regarding the dietary treatment of diabetes mellitus

Diet is often the most difficult aspect of any diabetes treatment program. A primary dietary goal for patients with type I diabetes receiving conventional treatment is consistent day-to-day caloric and carbohydrate intake. The best way to achieve this consistency is with the Exchange Lists for Meal Planning. Dietary consistency is less important for type I diabetic patients receiving intensive therapy as such patients can be taught to adjust premeal insulin doses to compensate for departures from their meal plan. A primary dietary goal for most patients with type II diabetes is weight loss, but no effective dietary method to accomplish this objective has been established. Secondary issues pertaining to the dietary treatment of diabetes include: (1) the possibility that diets relatively high in monounsaturated fat have beneficial metabolic effects when compared with high carbohydrate diets; (2) the potential benefit of low protein diets in patients with nephropathy; (3) the lack of evidence that dietary sucrose aggravates hyperglycemia; (4) the potential utility of glycemic indexing of foods; and (5) the beneficial effects of soluble fiber on serum cholesterol levels.