Optimum dietary therapy for patients with non-insulin-dependent diabetes mellitus

The recent dietary recommendations of the American Diabetes Association for patients with diabetes mellitus include an individualized approach based upon the diabetes management goals of each patient that takes into consideration preference of the patient and control of hyperglycemia and dyslipidemia. Weight loss and reduction of adiposity is an important goal of diet therapy for patients with non-insulin-dependent diabetes mellitus (NIDDM), many of whom are obese and insulin-resistant. A gradual sustained weight loss achieved by moderate reduction in total daily energy intake (~250-500 kcal) and a simultaneous increase in energy expenditure by augmenting physical activity is recommended. As far as diet composition is concerned, besides a low saturated fat, high carbohydrate diet, a high monounsaturated fat diet may also be recommended. Intake of trans fatty acids and cholesterol should be restricted and alcohol should be completely avoided. Protein intake should be between 10-20% of the total energy intake. Fiber-rich sources of complex carbohydrates are preferred over refined sugars. The diet should be wholesome and provide the recommended dietary allowances of all vitamins and minerals. Beyond this, vitamin supplements are not justified.