The effectiveness of medical nutrition therapy (MNT) in the management of diabetes has been well established (1). Previous reviews have provided comprehensive recommendations for MNT in the management of diabetes (2,3). The goals of MNT are to 1 ) attain and maintain optimal blood glucose levels, a lipid and lipoprotein profile that reduces the risk of macrovascular disease, and blood pressure levels that reduce the risk for vascular disease; 2) prevent and treat the chronic complications of diabetes by modifying nutrient intake and lifestyle; 3) address individual nutrition needs, taking into account personal and cultural preferences and willingness to change; and 4) maintain the pleasure of eating by only limiting food choices when indicated by scientific evidence (4).