Nutrition Therapy Effectiveness for the Treatment of Type 1 and Type 2 Diabetes: Prioritizing Recommendations Based on Evidence

Abstract

Based on 2012 data, approximately 29 million people in the United States have diabetes, an increase of 5 million from 2007 (http://www.cdc.gov/diabetes/data/statistics/2014statisticsreport.html). The estimated prevalence of total diabetes was 12–14% in total US population. Up to 25–36% of people with diabetes are undiagnosed, a rate that has fluctuated between 25 and 30% over the last few years (JAMA 314:1021–1029, 2015). Worldwide, it is estimated that 415 million people have diabetes with projections of huge increases into the foreseeable future (http://www.diabetesatlas.org). Diabetes prevalence increases with age, affecting approximately 25% of those 65 years and older. In North America, the disease is particularly prevalent in ethnic populations, such as African-Americans, Hispanic populations (Latinos and Mexican Americans), Native Americans and Alaska Natives, Asian-Americans, and Pacific Islanders. While much of the rise in the prevalence of type 2 diabetes is seen in the middle-aged and elderly, there is a trend to an earlier age of onset. Evidence shows a rise in type 2 diabetes among younger North Americans; in 10–19-year-olds, type 2 diabetes now accounts for around 9% of recent diagnoses in non-Hispanic whites and 50% or more in ethnic minority groups (http://www.cdc.gov/diabetes/statistics/incidence/fig2.htm). Studies have shown that medical nutrition therapy (MNT) can play an important role in assisting persons with diabetes to meet their glucose, lipid, and blood pressure goals and, therefore, should be a major component in the medical management of the disease (J Am Diet Assoc 108:S52–S58, 2008; J Am Diet Assoc 103:827–831, 2003).