Perspectives of Nutrition Therapy for Type 2 Diabetes: Individualization Based on Dietary Reference Intake for Japanese, 2020

Abstract

Summary ： Modification of lifestyle including nutrition therapy plays a fundamental role in the treatment of type 2 diabetes. Because of the wide diversity in the pathogenesis of diabetes and lifestyle, nutrition therapy needs to be tailored to individual patients. Management of obesity by reduction of body weight is a critical issue for amelioration of insulin resistance. So far, a BMI of 22 has been considered the standard for Japanese, and total energy intake is calculated in order to achieve this. However, energy requirement differs among individuals according to age and physical activity, and a BMI of 22 is not an achievable target for those with an existing BMI of over 30 . On the other hand, nutrition therapy should aim to prevent frailty and sarcopenia in elderly patients by ensuring that energy and protein intakes are sufficient. On the basis on these considerations, the Japanese Diabetes Society has proposed new guidelines for nutrition therapy focusing on individualization of energy and macronutrient intakes.