May 11th, 2011 
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Diabetic Medical Nutrition Therapy
In 2002 the American Diabetes Association (ADA) published its seventh set of recommendations since 1950. These new recommendations are categorized into goals of medical nutrition therapy that apply to all persons with diabetes or goals that apply to specific situations. General goals that apply to all diabetics include the following: 1. Attain and maintain optimal metabolic outcomes including the following: a. Blood glucose levels in the normal or near normal range. b. Lipid and lipoprotein profiles that reduce risk for macrovascular diseases. c. Blood pressure levels that reduce the risk for vascular disease. 2. Prevent and treat chronic complications. 3. Improve health through healthy food choices and physical activity. 4. Address individual nutritional needs taking into consideration personal and cultural preferences and lifestyle while respecting individual’s wishes and willingness to change. Goals that apply to specific situations include: 1. Youth with type 1 diabetes: a. Provide adequate energy to ensure normal growth and development. b. Integrate insulin regimens into usual eating and physical activity habits. 2. Youth with type 2 diabetes: a. Facilitate changes in eating and physical activity habits that reduce insulin resistance and improve metabolic status. 3. Pregnant and lactating women: a. Provide adequate energy and nutrients necessary for optimal pregnancy outcome. 4. Older adults: a. Provide for nutritional and psychosocial needs of an aging individual. 5. Individuals treated with insulin or insulin secretagogues: a. Provide self management education for treatment and prevention of hypoglycemia, acute illness, and exercise related blood glucose problems. 6. Individuals at risk for diabetes: a. Decrease risk by encouraging physical activity. b. Promote food choices that facilitate moderate weight loss or at least prevent weight gain. Owing to the complexity of nutrition issues, the ADA recommends that a registered dietician who is knowledgeable and skilled in implementing nutrition therapy into diabetes management and education be the medical team member responsible for providing medical nutrition therapy. It is also essential that all healthcare team members be knowledgeable about nutrition therapy and supportive of the diabetic who needs to make these important lifestyle changes
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