 Type 2 diabetes involves problems getting enough glucose into the cells.

When the
sugar can't get where it is supposed to be, it leads to elevated blood sugar levels in the
bloodstream, which can lead to complications such as kidney, nerve, and eye
damage, and cardiovascular disease.: the aim of medical nutritional therapy is to
optimize metabolic control and decrease the risk factors for diabetic complications
through management of A1C and blood sugar as near as possible to normal value and
within safe levels; also to reduce blood pressure and lipid, considering the quality of life
and therapeutic needs of [Link] .Also the health care team should document
any step of Medical Nutritional Therapy (MNT) in patient’s record forms & evaluate
the outcome using body weight, waist circumference,well being, Blood Pressure (BP)
fasting & post-prandial blood glucose, A1C, serum lipids and albumin in urine.

-The regulation of body weight :

requires longterm regulation of energy balance. In order to prevent obesity, the two main
management methods are to: 1) Reduce
energy density of the everyday diet
2)Stimulate fat oxidation by promoting a sufficient level of physical activity.

complication in a type 2 diabetic,a diet with a variety of nutrients, like the Mediterranean diet
is an ideal [Link] is rich in whole grain and vegetables, fruits, legumes, a moderately high
intake of fish, minimal red meat, nuts, and high MUFA/olive oil2
For patients with diabetes and symptomatic heart failure, dietary sodium in-take of <2,000
mg/day .In those with kidney involvement <2000mg/day or even lesser is advised. To
prevent high blood pressure a diabetic along with his regular meal plan, should contain low
[Link] good option to reduce kidney diseases and CVD is vegetarian food
Partial meal replacement (PMR) or full meal replacements (FMR) are other strategies led by RDs
for body weight control and reducing body fat and can be used effectively in T2DM .These
approaches include replacement of one or two daily meals (PMR) or all meals (FMR) with a
healthful single food or a combination of foods such as fortified bars, powders, shakes, frozen
foods, dietary supplements, etc. These meal plans help maintain dietary adequacy by providing
acceptable macronutrient distribution and improving the intake of vitamins, minerals and
proteins, thereby reducing the risk of deficiencies that are common in patients on restricted
diets. Combining low GI, high fiber foods such as leafy vegetables (amaranth, fenugreek,
spinach, radish leaves, etc.) or non-starchy vegetables such as tomatoes, gourds, brinjal,
cauliflower, etc., is an efficient approach to replacing carbohydrates with fibers and lowering
the GI and GL of regular meals.
Step 1:Initial Nutrition Workup and Assessment
Step 2:Diagnosis of Nutrition Needs
This step involves a careful assessment of the patient’s clinical profile to identify potential risk
factors (e.g., presence of infections, celiac diseases, comorbid conditions, etc.), the
environmental and behavioral profile, and food intake to determine the nutritional quality.
Physiologic classification of food items based on their carbohydrate quality is a reliable method
of determining their postprandial glycemic effect
Step 3: Initiating Medical Nutrition Therapy

Step 4:Monitoring and Evaluation

• Determine Energy requirements:

Calculate Energy value of diet and its Proportionate distribution for each patient Individually.
. For Type 1 DM: Kcals are based on needs for normal growth, development, physical
activity and maintenance of desirable body weight.
.For Type 2 DM: as majority cases are obese, The Kcals adjustments are made to achieve
Weight [Link] Management and Requirements in Diabetes Mellitus.
This can be done in following way:
.Calculate the ideal body wt. (IBW) on the Basis of weight and height.
.Determine energy intake on basis of kcals For different activity levels and whether the
Individual is normal wt., obese or Underweight
. Diabetics should consume :
– 45-65% energy from carbohydrate
– 20-30% energy from fats
– 10-30% energy from proteinsNutrition for Diabetes mellitus.
Diet and Feeding pattern
•Amount and time of food intake particularly the Carbohydrates, should be controlled to
prevent Fluctuations of blood glucose beyond the normal range.
•Intake of refined sugar and refined cereals should be low as blood glucose levels rise sharply
shortly after Consumption.
•Avoid “Fasting” and “Feasting” in diabetics – to Avoid fluctuations – not miss a meal or
overeat.
Small and frequent meals with in between meal
 • Adjustment should be made for exercise and Appetite.
Foods not allowed: Glucose, sugar, jaggery, honey, sweets of different Types, chocolates,
candies.
Foods to be avoided: Potatoes, yam, arbi, sweet potatoes,
Mangoes, grapes, bananas, alcohol, fried Foods- paranthas, pooris, pakoras,
Namkeens, mathris, cakes, pastries etc.
Foods to be used freely: Green leafy vegetables, tomatoes, Cucumber, raddish, lemon, black
coffee And tea without sugar

Healthy eating guidelines:

•Use whole grain cereals, grams and pulses •Avoid refined and simple CHOs like
sugar, juices,Jams, confectionary, sweets etc. Avoid fast foods and ready-to-eat food items that
are processed and Deep fried
•Cooking oil to be restricted to 3-4 ex and use more Of MUFA and PUFA rich oils.
•Avoid deep fried foods and whole milk and its pdts.
• Aim to include at least 4-5 portions (3 veg, 2 fruits) of fruit and vegetables each day to Increase
dietary fibre.
• Take more of Green leafy vegetables, Whole grains, salads with every meal
• Avoid baked items, red meats, egg yolks,Salted nuts, namkeens etc.
• Regulate and reduce salt and sodium Intake.

. For type 2 diabetics, the focus of a vegetarian or vegan diet should be

maintaining a level of caloric intake that results in fat loss, adequate protein
consumption, adequate consumption of compounds that are most bio-available in
animal products (i.e. vitamin B-12, iron, creatine), and whole food carbohydrate
sources that are lower in glycemic index.
Nutrition and physical activity are important parts of a healthy lifestyle when you
have diabetes. Along with other benefits, following a healthy meal plan and being
active can help you keep your blood glucose level, also called blood sugar, in your
target range. To manage your blood glucose, you need to balance what you eat
and drink with physical activity and diabetes medicine, if you take any. What you
choose to eat, how much you eat, and when you eat are all important in keeping
your blood glucose level in the range that your health care team recommends.
Physical activity:
Lowers blood glucose levels -Lowers blood pressure -Improves blood flow- Burns extra calories
so you can keep your weight down if needed
Improves your mood Can prevent falls
and improve memory in older adults ,May help you sleep better
If you are overweight, combining physical activity with a reduced-calorie eating plan can lead to
even more benefits. In the Look AHEAD: Action for Health in Diabetes study,1 overweight adults
with type 2 diabetes who ate less and moved more had greater long-term health benefits
compared to those who didn’t make these changes. These benefits included improved
cholesterol levels, less sleep apnea, and being able to move around more easily.

With type 2 diabetes, be sure to pick a diet rich in nutrient-dense foods, which can help provide
the fiber, vitamins, and minerals that your body needs.
You should also be sure to enjoy a variety of heart-healthy fats, including monounsaturated and
polyunsaturated fatty acids. These can help reduce your cholesterol levels to support heart
health .
Similarly, eating plenty of foods high in fiber can enhance blood sugar management and help
keep you feeling fuller for longer to help prevent eating when you’re not hungry.
Here are some examples of nutritious foods that your diet should include:

 Fruits (apples, oranges, berries, melons, pears, peaches)

 Vegetables (like broccoli, cauliflower, spinach, cucumbers, zucchini)
 Whole grains (quinoa, couscous, oats, brown rice, farro)
 Legumes (beans, lentils, chickpeas)
 Nuts (almonds, walnuts, pistachios, macadamia nuts, cashews)
 Seeds (chia seeds, pumpkin seeds, flax seeds, hemp seeds)
 Protein-rich foods (skinless poultry, seafood, lean cuts of red meat, tofu, tempeh)
 Heart-healthy fats (olive oil, avocados, canola oil, sesame oil)
 Beverages (water, black coffee, unsweetened tea, vegetable juice).
Foods to avoid with type 2 diabetes
Limiting your consumption of foods high in saturated fat, trans fat, and added sugar can help
support better blood sugar management and prevent health complications related to diabetes.
Here are some of the foods you should limit with type 2 diabetes:

 High fat meat (fatty cuts of pork, beef, and lamb, poultry skin, dark meat chicken)
 Full-fat dairy (whole milk, butter, cheese, sour cream)
 Sweets (candy, cookies, baked goods, ice cream, desserts)
 Sugar-sweetened beverages (juice, soda, sweet tea, sports drinks)
 Sweeteners (table sugar, brown sugar, honey, maple syrup, molasses)
 Processed foods (chips, microwave popcorn, processed meat, convenience meals)
 Trans fats (vegetable shortening, fried foods, dairy-free coffee creamers, partially
hydrogenated oil).

 Foods to eat for a type 2 diabetic diet meal plan include complex
carbohydrates such as brown rice, whole wheat, quinoa, oatmeal, fruits,
vegetables, beans, and lentils. Foods to avoid include simple carbohydrates,
which are processed, such as sugar, pasta, white bread, flour, and cookies,
pastries.
 Foods with a low glycemic load (index) only cause a modest rise in blood
sugar and are better choices for people with diabetes. Good glycemic
control can help in preventing long-term complications of type 2 diabetes
 Fats don’t have much of a direct effect on blood sugar but they can be
useful in slowing the absorption of carbohydrates.
 Protein provides steady energy with little effect on blood sugar. It keeps
blood sugar stable, and can help with sugar cravings and feeling full after
eating
 Healthy diabetes meal plans include plenty of vegetables, and limited
processed sugars and red meat.
 Diet recommendations for people with type 2 diabetes include a vegetarian
or vegan diet, the American Diabetes Association diet (which also
emphasizes exercise), the Paleo Diet, and the Mediterranean diet.
 Guidelines on what to eat for people with type 2 diabetes include eating
low glycemic load carbohydrates, primarily from vegetables, and
consuming fats and proteins mostly from plant sources.
 What to not to eat if you have type 2 diabetes: sodas (regular and diet),
refined sugars, processed carbohydrates, trans fats, high-fat animal
products, high-fat dairy products, high fructose corn syrup, artificial
sweeteners, and any highly processed foods.

(low glycemic load foods, or foods that are a part of a type 2 diabetes low-carb diet plan)
are in their whole food form and include additional nutrients such as: Fiber -Vitamins

 Smaller amounts of proteins and fats

 These additional nutrients slow down the absorption of the glucose and keep blood
sugar levels more stable.
  Examples of complex carbohydrates, or low glycemic load :
 Brown rice
 Whole wheat
 Quinoa
 Steel-cut oatmeal
 Vegetables
 Fruits
 Beans
 Lentils

(high glycemic load foods, or foods that are not part of a type 2 diabetes diet plan because
they raise blood sugar levels) are processed foods, and don’t contain other nutrients to slow
down sugar absorption and thus these foods can raise blood sugar dangerously fast. Many
simple carbohydrates that are off-limits are easily recognized as “white foods.”

Simple carbohydrates or high glycemic index for example::

 Sugar
 White pasta
 White bread
 Flour
 Cookies
 Pastries
 White potatoes
 Pastries and sweets

Protein provides slow steady energy with relatively little effect on blood sugar. Protein,
especially plant-based protein, should always be part of a meal or snack. Protein not only keeps
blood sugar stable, but it also helps with sugar cravings and feeling full after eating (satiety).
Protein can come from both animal or plant sources; however, animal sources are also often
sources of unhealthy saturated fats.

Good protein choices include:

 Beans
 Legumes
 Eggs
 Fish and seafood
 Organic dairy products
 Peas
 Lean meats such as chicken and turkey

All healthy diabetes meal plans include:

1-A lot of vegetables

2-Limit processed sugars and red meat.

1-Chia seeds
Chia is a type of seed that provides fiber, protein, and omega-3 fatty acids. Chia is a superfood
because it brings down the glycemic load of any meal, increases hunger satisfaction (satiety),
and stabilizes bloods sugar.
2-Wild salmon
Salmon is a type 2 diabetes superfood because salmon is a great source of anti-inflammatory
omega-3 fatty acids. There are differences in the fatty acids in wild vs. farmed salmon
3-White balsamic vinegar
The superfood vinegar is best consumed as vinaigrette dressing on your salad, but it has
beneficial effects no matter how you enjoy it. Vinegar slows gastric emptying, which has several
beneficial effects for people with type 2 diabetes. This slows the glucose release into the
bloodstream, allowing for a small, steady insulin response instead of a large insulin surge.
4-Cinnamon
Cinnamon lowers the blood glucose level in people with type 2 diabetes, and it has been well
researched and found to be beneficial at doses of about 1 teaspoon/day Cinnamon lowers both
fasting and postprandial (after meals) blood sugar levels
5-Lentils
Lentils are a superfood because they contain important vitamins, have great protein, and have
lots of fiber. Lentils are rich in:

 Iron,
 Other minerals, and
 B vitamins such as folate.