Diabetes Standards of Care and Resources for Clinicians and Educators
Nutrition
Healthy eating is an essential component of managing diabetes. All individuals with prediabetes or diabetes should receive nutrition education that considers access to nutritious foods, as well as personal and cultural preferences.
Health care team members are encouraged to provide basic nutrition education. Whenever possible, patients should be referred to a registered dietitian (RD) for individualized medical nutrition therapy (MNT).
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Clinical Practice Recommendations
Recommendations for Nutrition
- Order serum creatinine/estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) at diabetes diagnosis and then at least annually thereafter.
- Control blood pressure. For most patients with diabetes, the target is <140/90 mmHg. Consider more or less stringent targets if appropriate.
- Prescribe an ACE inhibitor or ARB for all diabetes patients who have both hypertension and albuminuria, unless contraindicated.
- Consider nephrology consultation if the etiology of the chronic kidney disease (CKD) is unclear, if CKD is progressing rapidly, if there is any difficulty managing CKD complications, or if eGFR is <30 mL/min/1.73 m2.
It is recommended that patients receive basic nutrition education that supports healthful eating patterns, focusing on a variety of foods in appropriate amounts. Consider using My Native Plate to engage discussion about eating practices such as food choices, meal preparations, and portions.
- Provide basic nutrition education to all patients with diabetes or prediabetes:
- at diagnosis
- then annually
- more often as needed
- Refer patients to an RD, whenever possible, for MNT for diabetes and other health conditions that need individualized nutrition recommendations (e.g., hypertension, dyslipidemia, kidney disease).
- at diagnosis
- then annually
- more often as needed
- Assess a patient’s access to a sufficient quantity of affordable, nutritious foods. Screen for food insecurity using the Food Insecurity Assessment Tool and Resource List [PDF – 230 KB].
Clinician and Educator Resources
Featured Nutrition Resources
Patient Education Resources
Nutrition Patient Education Resources
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Education Materials and Resources (Online Catalog) |
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DASH Eating Plan Exit Disclaimer: You Are Leaving www.ihs.gov [PDF] |
CME Training
Nutrition CME Trainings
| Session Title | Session Material | CME/CE Information |
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| New The Developmental Origins of Obesity and Diabetes Exit Disclaimer: You Are Leaving www.ihs.gov Jonathan Q. Purnell, MD Interim Director, Center for Preventive Cardiology Professor, Department of Medicine Knight Cardiovascular Institute Division of Endocrinology, Diabetes, and Clinical Nutrition Oregon Health & Science University (Originally presented on 04/13/22.) |
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| New Nutrition for Kidney Health: Preventing and Managing Kidney Disease Exit Disclaimer: You Are Leaving www.ihs.gov Maria Kofas, MSPH, RDN, LN Public Health Nutritionist Billings Area Telenutrition Program Specialist (Originally presented on 03/29/22.) |
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| New Food Sovereignty in Indigenous Communities Exit Disclaimer: You Are Leaving www.ihs.gov Tonya S. Wapskineh, MPH Center for Indigenous Health Research and Policy Oklahoma State University Center for Health Sciences (Originally presented on 03/23/22.) |
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| New Nutrition, Culture, and Indigenous Foods in Alaska Exit Disclaimer: You Are Leaving www.ihs.gov Flora Deacon Indigenous Chef, Alaska and Melissa A. Chlupach, MS, RD, LD Assistant Professor, Dietetics and Nutrition University of Alaska Anchorage (Originally presented on 03/16/22.) |
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| New What Can I Eat? Diabetes Nutrition Education Curriculum for American Indian and Alaska Native Adults with Type 2 Diabetes Exit Disclaimer: You Are Leaving www.ihs.gov Sarah Stotz, PhD, MS, RDN, CDE Research Assistant Professor Centers for American Indian and Alaska Native Health Colorado School of Public Health (Originally presented on 03/01/22.) |
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| Why Breastfeeding Support is a Shared Responsibility Exit Disclaimer: You Are Leaving www.ihs.gov Jessica Quinlan, MPH, RD, CLC Pueblo of Zuni WIC Program Nutrition Coordinator Zuni Youth Enrichment Project Food Sovereignty Coordinator (Originally presented on 08/25/21.) |
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| Telenutrition for Diabetes Prevention and Management Exit Disclaimer: You Are Leaving www.ihs.gov Maria Kofas, MSPH, RDN, LN Public Health Nutritionist Billings Area Telenutrition Program Specialist (Originally presented on 7/13/21.) |
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| Make Every Bite Count with the Dietary Guidelines: Supporting Healthy Eating Across the Lifespan Exit Disclaimer: You Are Leaving www.ihs.gov Janet de Jesus, MS, RD - HHS Nutrition Advisor Dennis Anderson-Villaluz, MBA, RD, LDN, FAND - HHS Nutrition Advisor Dana DeSilva, PhD, RD - HHS ORISE Health Policy Fellow Jessica Larson, MS, RD - USDA Public Affairs Specialist (Originally presented on 5/12/21.) |
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| FDA Update on the Nutrition Facts Label and Education Campaign Exit Disclaimer: You Are Leaving www.ihs.gov Blakeley Fitzpatrick, MPH, RD Director, Division of Nutrition Programs and Maya Maroto, EdD, MPH, RD Public Health Educator FDA/Center for Food Safety and Applied Nutrition (Originally presented on 3/30/21.) |
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| Native American Food Culture, Traditions, and Nutrition Counseling: a look into Chippewa/Cree and Navajo Traditions Exit Disclaimer: You Are Leaving www.ihs.gov Terrie Stump Diabetes Prevention Coordinator Rocky Boy Diabetes Program and Dakotah Bronec, RD Dietitan Benefis Health System (Originally presented on 3/24/21.) |
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| Simplified Carbohydrate Education Approaches Exit Disclaimer: You Are Leaving www.ihs.gov Jenna Cope, MPH, RD, LD, CHES® Senior Public Health Analyst Office for the Advancement of Telehealth HRSA Federal Office of Rural Health Policy and Kibbe Brown, MS, RDN Nutrition Consultant IHS Division of Diabetes Treatment and Prevention (Originally presented on 3/16/21.) |
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| Traditional Foods Are a Way to Talk About Health: The CDC Traditional Foods Project Exit Disclaimer: You Are Leaving www.ihs.gov Dawn Satterfield, PhD, MSN, RN CDC National Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation and Lemyra DeBruyn, PhD (retired) (Originally presented on 3/9/21.) |
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| Indigenous Foods Movement in Alaska: Holistic Approaches for Nutrition and Culture Exit Disclaimer: You Are Leaving www.ihs.gov Seth N. Anderson, MS, RD, LD Dietitian, Primary Care Clinics Southcentral Foundation Luz Smeenk, MS, RD, LD Community Educator, Diabetes Program and Amy Foote, CDM Executive Chef Alaska Native Tribal Health Consortium (Originally presented on 3/2/21.) |
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| Native Centered Nutrition Education Exit Disclaimer: You Are Leaving www.ihs.gov Kibbe Conti, MS, RD Diabetes Program Dietitian Zuni Service Unit Zuni, NM (Originally presented on 3/11/20.) |
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| Mindful Eating Basics Exit Disclaimer: You Are Leaving www.ihs.gov Erica Dean , MS, RDN, LD, CDE Diabetes Education Program Claremore Indian Hospital Claremore, OK (Originally presented on 3/4/20.) |
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| The Updated Nutrition Facts Label: Information for Diabetes Educators Exit Disclaimer: You Are Leaving www.ihs.gov Robin McKinnon, PhD, MPA Blakely Fitzpatrick, MPH, RD (Originally presented on 9/24/19.) |
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| Conference Indigenous Food Systems: Seeds of our Ancestors, Seeds of Life Exit Disclaimer: You Are Leaving www.ihs.gov Winona LaDuke, BA, MA (Originally presented on 8/8/19.) |
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| Conference Promoting Food Security and Food Sovereignty in Indigenous Communities: Lessons from Tribally-Driven Research Exit Disclaimer: You Are Leaving www.ihs.gov Valarie Blue Bird Jernigan, Professor of Rural Health and Director of the Center for Indigenous Health Research and Policy (Originally presented on 8/8/19.) |
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