Diabetes group updates guidance on medical nutrition therapy

The American Diabetes Association's new consensus report on medical nutrition therapy includes, for the first time, advice on patients with prediabetes. Among the recommendations, published in Diabetes Care:

Patients with prediabetes who are overweight or obese should be referred to an intensive lifestyle intervention with personalised goals, like the Diabetes Prevention Programme, and/or to individualised medical nutrition therapy provided by a registered dietitian nutritionist. Evidence supports losing 7%-10% of body weight.

Adults with type 1 or 2 diabetes should be referred for individualised medical nutrition therapy both at diagnosis and as health needs change throughout life. Research shows that nutrition therapy can lower haemoglobin A1c at least as well as type 2 diabetes medications.

The ideal percentages of calories from carbohydrate, protein, and fat vary in people with diabetes and prediabetes, so "macronutrient distribution should be based on individualised assessment of current eating patterns, preferences, and metabolic goals."