Type 1 Diabetes Through the Life Span: A Position Statement of the American Diabetes Association

Jane L. Chiang; M. Sue Kirkman; Lori M.B. Laffel; Anne L. Peters

Disclosures

Diabetes Care. 2014;37(7):2034-2054. 

In This Article

Nutrition Therapy

Nutrition therapy is an important component of the treatment plan for all individuals with type 1 diabetes. Each patient should have an individualized food plan based on food preferences, schedule, and physical activity. Nutrition therapy aims to ensure that the patient and family understand the impact food has on blood glucose, how food interacts with exercise and insulin to prevent hypo- and hyperglycemia and to achieve glucose goals, and how to implement the food plan in a variety of situations. The food plan takes into consideration the patient's numeracy, literacy, engagement, and ability to adjust insulin.

General diabetes nutrition principles, as defined in the ADA Standards of Care, apply to people with type 1 diabetes, particularly in reference to normal growth and development in youth and the maintenance of a healthy body weight at all ages. Specifically, with regards to individuals with type 1 diabetes, topics such as carbohydrate counting and meal composition should be addressed. For selected individuals who have mastered carbohydrate counting, education on the impact of protein and fat on glycemic excursions should be incorporated into diabetes management.[32] Those who are overweight or obese may benefit from weight reduction counseling.

Recommendations.

  • Individualized medical nutrition therapy is recommended for all people with type 1 diabetes as an effective component of the overall treatment plan. (A)

  • Monitoring carbohydrate intake, whether by carbohydrate counting or experience-based estimation, remains a key strategy in achieving glycemic control. (B)

  • If adults with type 1 diabetes choose to drink alcohol, they should be advised to do so in moderation (one drink per day or less for adult women and two drinks per day or less for adult men). Discussion with a health care provider is advised to explore potential interactions with medications. Adults should be advised that alcohol can lower blood glucose levels and that driving after drinking alcohol is contraindicated. (E)

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