Diabetes UK evidence-based nutrition guidelines for the prevention and management of diabetes (2018)

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Autor(es): Dyson, P. A., Twenefour, D., Breen, C., Duncan, A., Elvin, E., Goff, L., Hill, A., Kalsi, P., Marsland, N., McCardle, P., Mellor, D., Oliver, L. and W
Nome da Publicação : Diabetic Medicine 2018; 35: 541-547
Ano de publicação : 2018

Abstract

A summary of the latest evidence-based nutrition guidelines for the prevention and management of diabetes is presented. These guidelines are based on existing recommendations last published in 2011, and were formulated by an expert panel of specialist dietitians after a literature review of recent evidence. Recommendations have been made in terms of foods rather than nutrients wherever possible. Guidelines for education and care delivery, prevention of Type 2 diabetes, glycaemic control for Type 1 and Type 2 diabetes, cardiovascular disease risk management, management of diabetes-related complications, other considerations including comorbidities, nutrition support, pregnancy and lactation, eating disorders, micronutrients, food supplements, functional foods, commercial diabetic foods and nutritive and non-nutritive sweeteners are included. The sections on pregnancy and prevention of Type 2 diabetes have been enlarged and the weight management section modified to include considerations of remission of Type 2 diabetes. A section evaluating detailed considerations in ethnic minorities has been included as a new topic. The guidelines were graded using adapted ‘GRADE’ methodology and, where strong evidence was lacking, grading was not allocated. These 2018 guidelines emphasize a flexible, individualized approach to diabetes management and weight loss and highlight the emerging evidence for remission of Type 2 diabetes. The full guideline document is available at: https://www.diabetes.org.uk/professionals/position-statements-reports/food-nutrition-lifestyle/evide…

Summary

The new Diabetes UK evidence-based nutrition guidelines support that nutrition management should be an integral part of the clinical care for all people with diabetes and those at risk of developing Type 2 diabetes. Key features of the new guidelines were to try to move from recommendations for individual nutrients to foods that meet the needs of people with diabetes, and to make the new guidelines more usable by individuals.

Regarding recommendations about the use of low calorie sweeteners, and foods and drinks containing them, in the 2018 nutrition guidelines Diabetes UK states: “Non-nutritive (artificial) sweeteners are safe and may be recommended”, which is in line with the conclusions in the previous recommendations in 2011: “Non-nutritive sweeteners are safe when consumed within the daily intake levels and may reduce HbA1c [glycated haemoglobin – an index of longer-term glucose control] when used as part of a low-calorie diet”. In the full guideline report, the expert panel of specialist dietitians describes low calorie sweeteners as “sweetening agents that provide little or no calories (energy) and have no effect on glycaemia”. It is also stated that for people who are accustomed to sugar sweetened products, low calorie sweeteners have the potential to reduce overall energy and carbohydrate intake and may be preferred to sugar when consumed in moderation and can be a useful strategy for those individuals seeking to control their calorie intake and manage their weight.

The full guideline document is available for download at: https://www.diabetes.org.uk/professionals/position-statements-reports/food-nutrition-lifestyle/evide…

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