Healthy eating is essential in all people with diabetes. An individualised weight management plan with evidence-based management advice is recommended for all people with diabetes who are overweight or obese (BMI > 30 kg/m2 or BMI > 25 kg/m2 with waist circumference > 88 cm in women or > 102 cm in men.
5% sustained total body weight loss is associated with significant improvements in glycaemic control, blood pressure and lipids
Typically at least 10-15% total body weight loss is required to achieve remission of type 2 diabetes
Remission may not be possible if long duration of diabetes due to loss of pancreatic beta cells
Current dietary recommendations in non-pregnant adults with diabetes include:
Nutritional education from a registered dietitian is recommended as best practice at diagnosis and then:
Annually for ongoing assessment of nutritional education needs
Recent evidence suggests that low-energy, low GI and modified macronutrient dietary approaches can be effective in achieving weight loss and remission of type 2 diabetes.
There is no conclusive evidence to suggest one dietary strategy is more effective than any other for achieving sustained weight loss and improvements in glycaemic control. The choice of dietary strategy will depend on many factors but particularly patient preference, tolerance, nutritional needs, income, comorbidities and cultural suitability. Different dietary strategies include: