Evidence for nutritional therapy in diabetes mellitus

Nutritional therapy is a central component of any management strategy for people with diabetes. During recent years, a variety of novel dietary concepts have been introduced to broaden the spectrum of treatment options. In addition to the established low-fat diet, low carbohydrate, vegetarian/vegan diets and, in particular, the Mediterranean diet are equally effective to improve metabolic disturbances. The quality of carbohydrates and fat are more relevant than their relative proportions. In view of the obesity problem of many patients, the time-restricted use of very-low-calorie diets, including a meal replacement strategy, is more frequently applied and facilitates both greater weight loss and stronger metabolic improvements. Subjects with diabetes should make their own decision after counselling which dietary treatment they prefer and should be continuously supported.