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.