People with type 2 diabetes require dietetic
advice at diagnosis (preferably within 1 month),
a follow up visit 3 months after initial dietary
intervention, and should receive ongoing MNT
every 6–12 months.15 Due to the high prevalence
of overweight and obesity in this group, and its
primary role in the aetiology of the condition,
weight loss of 5–10% of initial body weight
at diagnosis is a primary objective, along with
management of hyperglycaemia, hyperlipidaemia
and/or hypertension. This can be achieved
through a diet in which energy intake is balanced
with regular physical activity, and one that is
low in saturated fat and sodium and high in fibre
and low GI carbohydrates. It is worth noting that
reducing energy intake, regardless of dietary
composition, and regular dietary counselling
and support are the most likely predictors of
successful weight loss.16,17
I t is important to limit the intake of saturated
fat and avoid trans fats to assist with weight
management, improve insulin sensitivity,
and reduce blood lipids to decrease overall
cardiovascular disease risk.
Carbohydrate intake should be spread out
evenly over the day to assist with blood glucose
management. For patients taking insulin and
some types of oral medications, carbohydrate
intake should be matched with the action of their
medication. Carbohydrate should come mainly
from fibre rich fruits, vegetables, wholegrains
and legumes, as well as low fat dairy products
(milk and yoghurt), preferably with a low GI .11
I t is generally advisable for people with
diabetes to avoid high protein diets due to
possible negative effects on kidney function and
a lack of evidence for long term benefits.
Alcohol should be limited to no more than
two standard drinks per day.18
Regular physical activity should also
accompany dietary changes and ideally
should include at least 150 minutes per week
of moderate intensity aerobic exercise and
resistance training three times per week unless
there are contraindications.