Background Type 1 diabetes is primarily an autoimmune disease and type 2 diabetes is primarily
a metabolic condition. However, medical nutrition therapy is an integral part of
management for both types of diabetes to improve glycaemic control and reduce the
risk of complications.
Objective To outline the principles of dietary management in type 1 and type 2 diabetes and
provide strategies to assist in overcoming common difficulties related to diet.
Discussion All people with diabetes should be provided with quality professional education on
medical nutrition therapy upon diagnosis, and at regular intervals thereafter. For
children and adolescent patients with type 1 diabetes, the challenge is to maintain
good glycaemic control while providing adequate energy for growth and development.
Modification in dietary advice is required, depending on developmental stage. In
type 2 diabetes, the initial challenge is to achieve weight loss of 5–10% body weight,
normalise blood glucose and reduce cardiovascular risk factors. Specific strategies
include a kilojoule controlled diet with reduced saturated fat, trans fat and sodium;
moderate protein; and high in dietary fibre and low glycaemic index carbohydrates.
Carbohydrates should be spread evenly throughout the day and matched to medication.
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