Diverse dietary practices and nutritional counseling strategies are followed in the
management of diabetes and its comorbidities. The dietary approaches practiced in
India make use of calorie and nutrient counting to ensure patient-centered nutrition
therapy in diabetes management. Macronutrient modulation is a central pillar of patient-centered
medical nutrition therapy (MNT). Carbohydrates (CHO) are considered as the predominant
macronutrient affecting postprandial blood glucose levels. The insulin-to-CHO ratio
is used for calculating mealtime insulin doses among patients on insulin regimen.
The aim of this article is to highlight challenges faced in planning MNT, modifying
recommended dietary allowances for persons with diabetes, and suggesting solutions
to overcome these. It also aims to understand the requirement of individual macronutrients
and their impact on glycemia as well as insulin dose adjustment.
Keywords
nutritional recommendations - medical nutrition therapy - macronutrients - carbohydrates
- fats - proteins - nutritional requirements - blood glucose concentrations - insulin
dose adjustments - glycemic control