Diabetes Management

Introduction to Dietary Recommendations

The American Diabetes Association (ADA) recommends prioritizing carbohydrate intake from vegetables, fruits, legumes, whole grains, and dairy products, with an emphasis on high fiber content and low glycemic index 1, 2.
A Mediterranean-style diet, rich in monounsaturated and polyunsaturated fats, may be considered to improve glucose metabolism 1, 3, 2, 4.
Individuals with diabetes should avoid sugary drinks and minimize consumption of foods with added sugars, and consider replacing sugar-sweetened beverages with water 1, 3, 2, 5.
Trans fats should be completely avoided 5, 3.

The American Diabetes Association does not recommend the use of herbal supplements, such as yupisin (algarroba), for glycemic control in individuals with diabetes, due to lack of clear evidence and potential undocumented side effects or interactions with medications 1, 2, 4, 6.
The use of herbal supplements may delay the initiation of evidence-based treatments, and close monitoring of patients who choose to use herbal supplements is necessary to ensure no toxic effects occur and treatment goals are met 1, 2.
Natural supplements can have side effects and interact with medications, and self-prescribing high doses of supplements can be toxic 2, 4.

Healthcare professionals should emphasize the importance of following evidence-based treatments and promote healthy eating patterns based on evidence 1, 2.
Patients should be educated about the lack of evidence regarding herbal supplements and the potential risks associated with their use 1, 2.
Individuals with documented nutrient deficiencies, such as pregnant women, those with highly restricted dietary intake, and older adults or strict vegetarians, may benefit from specific supplements 7.
Monitor carbohydrate intake through carbohydrate counting or experience-based estimation, and consider reducing overall carbohydrate intake, as this has demonstrated the most evidence for improving glycemia 8, 5, 9.

There is insufficient evidence to support the use of supplements, including chromium, vitamin D, cinnamon, herbs, antioxidants (Vitamins E, C, carotene), magnesium, and zinc, for blood glucose management in people with diabetes 2, 4, 6, 5, 9, 7.
Using supplements to treat hypoglycemia can worsen hypoglycemia by stimulating insulin release without raising blood glucose, and carbohydrate sources high in protein should be avoided when treating hypoglycemia 2, 4.