Nutrition therapy for diabetes: effectiveness, carbohydrates and alcohol

Studies documenting the effectiveness of medical nutrition therapy for Type 1 and Type 2 diabetes report improvements in hemoglobin A_1C (A1C), as well as in other outcomes. A variety of nutrition therapy interventions are effective. Under debate is the role of carbohydrate intake on glycemic control and weight loss in individuals with Type 2 diabetes. Some studies have reported improvements in glycemic control from reducing carbohydrate intake; however, other trials have reported no significant changes in A1C with a lower carbohydrate eating pattern. Studies comparing low-carbohydrate or low-fat diets for weight loss at 12 months report similar amounts of weight loss. Evidence for the usefulness of the glycemic index concept is debatable. For the majority of people with diabetes moderate alcohol consumption with food will have minimal, if any, acute or long-term effects on glycemic control, and may have beneficial effects on insulin sensitivity and decreased risk for coronary heart disease.