American Diabetes Association Guideline, Explained

American Diabetes Association (ADA)

The American Diabetes Association (ADA) is the United States leading health organization dealing with diabetes information, research, and advocacy. The ADA has completely revised its comprehensive home reference to give all the necessary information people with diabetes need to lead healthy and active lives.

The American Diabetes Association guidelines are an extensive resource that has all relevant details on the latest medical advances and the best self-care techniques. The Guidelines helps people with diabetes understand to how best to deal with the disease. The guidelines have information on gestational diabetes, type1, and type 2 diabetes. Also, they discuss the latest types of insulin and diabetes medications.

Moreover, they outline strategies on nutrition and meal planning, and advice on how to work with the health care system and insurance providers. The bottom line of the ADA recommendations is that there is no universal eating pattern that is suitable for all people with diabetes. In other words, the key to gaining optimal nutrition and health is in individualizing the meal plans.

What to eat

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According to scientific evidence, there is no standard diet plan ideal for everybody with diabetes. The ADA recommends that adults diagnosed with diabetes should eat a variety of nutrient dense foods in the right portions. This should be part of a diet plan that takes into consideration individual cultures, traditions, religious beliefs, preferences, and metabolic objectives.


The latest ADA guidelines acknowledge that there is no conclusive scientific evidence about the ideal amount of carbohydrates to be eaten by people with diabetes. There is a still a lot of research to be done in order to understand carbohydrates, and how the different types of carbohydrates may impact glycemic control and blood sugar levels. In fact, many studies on carbohydrates are short term, small, and have low retention rates. They don’t provide conclusive evidence.

The new guidelines put emphasis on the sources of the carbohydrates. They advise that the carbohydrates consumed should come from fruits, vegetables, legumes, whole grains, and dairy products. Carbohydrates sources that have added sugar, fats, and/or sodium are to be avoided.


It is also recommended that people with diabetes eat at least the same amount of whole grains and fiber recommended for the people without diabetes. People with diabetes can get enough fiber from nuts, legumes, seeds, fruits, and vegetables. However, there is some concern in regard to whole grains. Some professionals feel that they are not necessary. This is because of the link between celiac disease, gluten, and type 1 diabetes. Nonceliac gluten sensitivity must be examined as a part nutrition therapy.


The ADA guidelines further recommend that sucrose should be substituted for starch. People with diabetes are advised to limit or at best avoid consumption of sweetened beverages. These include all caloric sweeteners such as sucrose and high fructose corn syrup. In other words, people with diabetes must avoid processed foods with sucrose and all sweetened and sugary beverages.

The guidelines indicate that the use of non-nutritive sweeteners is likely to lower the total calorie and carbohydrate consumption if substituted for caloric sweeteners and there is no compensation through the intake of additional calories from food sources. Ideally, the nonnutritive sweeteners should be from natural sources. There are natural zero calorie sweeteners available, e.g. products made with stevia and monk fruit extracts. These will have no effect on your blood sugar levels.

Quality fat

The guidelines note that there is inconclusive evidence regarding the ideal amount of fat people with diabetes should consume. So the goals should depend on the needs of individual patient. However, studies indicate that the quality of the fat used is far more important than the quantity consumed.

In fact, not all saturated fat and dietary cholesterol are bad. In other words, a diet of diversity which includes high quality sources of saturated fat like grass fed animal foods, coconut, and coconut oil is acceptable. However, the amounts in the diet should be tailored to suit the individual patient. The guidelines recommend that people with diabetes use the same guidelines for cholesterol, saturated fat, and Tran’s fats as the ordinary population.

Ideally, cholesterol should account for less than 300 mg per day, the saturated fats for less than 10 percent of calories, and Tran’s fat must be limited as much as possible. The guidelines suggest that the Mediterranean monounsaturated fatty acid rich diet may be beneficial for people with type 2 diabetes.

Herbs and vitamins

The ADA position is that there is no clear evidence that vitamin and mineral supplementation is beneficial in people without underlying deficiencies. Nutritional experts believe that people should act earlier and avoid waiting till the underlying deficiencies manifest. The ADA also noted that there is no sufficient evidence to suggest that the use of micronutrients like magnesium, chromium, and vitamin D Improves glycemic control in diabetics.

Moreover, the ADA states that there is lack of clear evidence supporting the use of cinnamon and other herbs in the management of glycemic in diabetics. The challenge here is that herbal products are not standardized and the amounts of ingredients they contain vary. Besides, there is that likelihood of some herbal products interacting with other medications.


For people with diabetes and high blood pressure, the guidelines recommend an individualized reduction in sodium consumption. The ADA notes that there may be a challenge in meeting a nutritionally sufficient diet and low sodium. It suggests that the availability, palatability, and the extra cost of the special low sodium products be taken into consideration.

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The ADA guidelines note that there are many ways of achieving a healthy diet and that there is no single or standard meals plan that works for everybody with diabetes. In this regard, nutrition professionals must be open minded and tailor medical nutrition therapy to meet their patient’s individual health goals, personal, religious, and cultural preferences. Besides, the diet plan should meet the patient’s health literacy and the patient must be able to access the healthy food options. Most of all, the patient must be willing, able, and ready to make the changes.

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