Individuals with type 2 diabetes must change their eating patterns and meal plan according to nutrition recommendations. Along with carbohydrates, the amount of protein and fat consumed is important for maintaining good metabolic control, weight management, and preventing long-term complications. The ADA recommends that individuals with type 2 diabetes consume 15-20% of calories from protein and limit saturated and trans fats. Recent research shows that regularly snacking on high-protein foods as part of a habitual diet can help with fat loss without significantly impacting health biomarkers.

1. Group Activity-Protein and fat recommendation for type 2 diabetes
Newly diagnosed type-2 diabetes requires alter previous patterns of eating and implementing new
eating behaviours and adherence to meal planning principles to learn specific nutrition
recommendations. Next to carbohydrate the amount of protein and fat in meal planning according
to individual need having a significant importance to maintain good metabolic control, wt.
management as well as prevention long term complications of diabetes such as nephropathy,
hypertension and cardiovascular diseases.
ADA recommendations for protein in type-2 diabetes
• Individual with type-2 diabetes and normal renal function the usual protein intake should be
15-20% of energy. (1,2)
• Protein ingested by individual with type 2 diabetes can increase insulin response without
increasing plasma glucose concentrations. Therefore, protein should not be used to treat
acute or prevent night time hyperglycaemia.(1,2)
• As a method of weight loss high protein diets are not recommended as they may produce
short term weight loss and improved glycaemia. The long term effects of protein intake >
20%, of calories on diabetes management and its complications such as nephropathy are still
not been established.(1,2)
Recent research in type-2 diabetes patients have shown that chronologically scheduled snacking
with high protein products within the habitual diet leads to loss of fat mass (4).
Table 1 Changes in biochemical determinations between the beginning and the end of the study. Baseline
Final p
Glucose (mg/dL) 159.2 ± 62.2 156.7 ± 59.4 ns
Insulin (mU/L) 10.2 ± 5.1 10.0 ± 4.9 ns
HOMA-IR 3.65 ± 2.00 3.43 ± 1.84 ns
Glycosylated He m o globin (%) 7.0 ± 1.3 7.2 ± 1.5 ns
Total cholesterol (mg/dL) 177.0 ± 37.4 176.9 ± 32.8 ns
HDL- cholesterol (mg/dL) 42.7 ± 9.0 42.5 ± 8.1 ns
LDL- cholesterol (mg/dL) 92.0 ± 37.2 102.9 ± 25.7 ns
Tryglycerides (mg/dL) 178.5 ± 103.6 157.7 ± 92.8 ns
AST (UI/L) 31.8 ± 22.2 26.9 ± 16. 1 ns
ALT (UI/L) 36.6 ± 23.5 31.6 ± 19.5 ns
Uric acid (mg/dL) 5.8 ± 1.3 6.1 ± 1.5 ns
Ho m ocysteineμmol/L)
( 22.7 ± 4.4 23.3 ± 4.4 ns
C-reactive protein (mg/L) 13.6 ± 15. 1 9.8 ± 10.7 ns
A small change in habitual dietary recommendations by include of specific low glycaemia,
moderately high protein product in breakfast and morning and afternoon snacks can promote body
weight and fat mass loss without significant changes in biochemical parameters and cardio vascular
risk factors. Also important for regulating meal frequency and timing, (4)
Dietary fat and cholesterol
ADA recommendations for people with type 2 diabetes
• Saturated for should be > 7% of total calories. (1,2)

2. • Intake of trans fat should be minimised. (1,2)
• Individual with diabetes should limit dietary cholesterol to < 200 mg / day (1,2)
• Two or more servings of fish / week (expert commercially fried fish filets) provide n -3
polyunsaturated fatty acids (1,2)
The primary goal for above recommendations is to reduce risk of CVD as saturated and trans
fatty acids are the major determinants of plasma LDL cholesterol.
Diet high in polyunsaturated fatty acid or mono unsaturated fatty acid appears to have similar
effect on plasma lipid concentration. In a study motility rate reduce by 7% in elderly Europeans
who took Mediterranean diet where poly unsaturated FA were substitute for monounsaturated
fatty acids, (1)
References:
1. American Diabetes Association: Nutrition Recommendations and interventions for
Diabetes (Position Statement); Diabetes Care, Vol 31, Supp-1,S 61-S 74,2008.
2. Monika Toeller: Lifestyle Issues: Diet; Text book of Diabetes; Chapter-22,4th edition.
3. Madelyn L.Wheeler et al; Macronutrient, food groups and eating patterns in the
management of Diabetes (A systemic literature review, 2010); Diabetes Care-35, S 434-
S445, February 2012.
4. Santiago Navas-Carretero et al; Chronogically scheduled snacking with high-protein
products within the habitual diet in type 2 diabetes leads to a fat mass loss; A
longitudinal study: Nutrition Journal 2011,10:74
5. Natalie D.Luscombe-Marsh et al;Carbohydrate restricted diets high in either monoun-
saturated fat or protein are equally effective at promoting fat loss and improving blood
lipids; Am J Clin Nutr 2005;81: S 762-S 772.