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This document is a clinical practice guideline on dietary recommendations for individuals with type 2 diabetes mellitus (T2DM). The guideline emphasizes the importance of individualized therapy, counseling, and self-management for T2DM patients. It discusses the different types of T2DM and the need for personalized diets based on individual preferences and protein requirements. The guideline recommends weight loss as a goal for individuals with excess weight and highlights the benefits of telehealth applications in supporting behavioral modifications and increasing adherence to weight loss programs. Additionally, it provides strategies for weight reduction and maintenance, emphasizing the need for close follow-up and coordination with patients. The text also discusses the impact of various dietary factors on blood glucose response, specifically focusing on the glycemic index (GI) and dietary fiber. It states that a low GI/GL diet is associated with a reduced risk of type 2 diabetes and improved glycemic control. The text emphasizes the importance of dietary fiber, particularly from whole grain products, in reducing the risk of type 2 diabetes, cardiovascular disease, and other diseases. It suggests a target of 30 grams of dietary fiber per day. The text also provides recommendations for specific populations, such as geriatric patients and migrants, and discusses the impact of beverages, particularly sugar-sweetened beverages, on blood glucose control and overall health. It concludes that routine micronutrient supplementation is not recommended for individuals with type 2 diabetes, but vitamin D supplementation may improve insulin resistance in those with established deficiency. The text also explores [Extracted from the article]

However, the intake of naturally-occurring sugars (within the normal range of the diet) was associated with improved parameters of glycemic control, and Nansel et al. conclude that foods containing this source of sugar do not have negative effects on blood glucose control in adolescents with T1Dm [59]. The increased consumption of high-fiber foods seems to have a positive effect on the trend of postprandial glycemia, but the recommendations for fiber intake are based on those for the general population (30 g per day). Meal frequency and meal timing Recommendation If people with T1Dm are overweight, they should avoid irregular eating times, eating late and a time window for daily food intake>12 h. With regard to the consumption of individual foods/meals (according to the "acute food/meal studies" and clinical experience), special consideration of foods containing carbohydrate with a very low GI (below approx. 30) or a very high GI (above approx. 90) seems advisable. However, this is not justified, since the study did not intend to compare a low-GI diet with a high-GI diet, but primarily compared a diet with a fixed carbohydrate distribution ("carbohydrate framework") vs. a diet with flexible carbohydrate intake. [Extracted from the article]

Nearly half of the overweight and obese patients with T2Dm who initially received only a formula diet of 825 to 853 kcal per day for 3-5 months achieved diabetes remission in contrast to only 4% of patients who received only standard therapy from their primary care physician [13]. They sometimes prefer different foods, often eat more carbohydrates, have different meal concepts, a different understanding of portions, and different food preparation methods and food combinations. For people with T2Dm, the recommendations are differentiated for the different treatment situations and forms: For overweight patients with T2Dm: a meta-analysis on fiber and whole grain consumption in diabetes management included 42 intervention studies. In patients with T2Dm, a high consumption of low GI foods such as legumes and oats can improve glycemic control, increase insulin sensitivity, and thus reduce insulin requirements [165]. Etiologic effects and optimal intakes of foods and nutrients for risk of cardiovascular diseases and diabetes: Systematic reviews and meta-analyses from the Nutrition and Chronic Diseases Expert Group (NutriCoDE). [Extracted from the article]

The risk of potential malnutrition is present if the reduced food intake continues (approximately<50% of the requirement for more than 3 days) or if several risk factors are present at the same time, which either reduce the amount of food or significantly increase the energy and nutrient requirements. With regard to the consumption of individual foods/meals (according to the "acute food/meal studies" and clinical experience), special consideration of foods containing carbohydrate with a very low GI (below approx. 30) or a very high GI (above approx. 90) seems advisable. The increased consumption of high-fiber foods seems to have a positive effect on the trend of postprandial glycemia, but the recommendations for fiber intake are based on those for the general population (30 g per day). However, the intake of naturally-occurring sugars (within the normal range of the diet) was associated with improved parameters of glycemic control, and Nansel et al. conclude that foods containing this source of sugar do not have negative effects on blood glucose control in adolescents with T1Dm [59]. Meal Frequency and Meal Timing Recommendation If people with T1Dm are overweight, they should avoid irregular eating times, eating late and a time window for daily food intake>12 h. [Extracted from the article]