Nutrient quality in dietary therapy for diabetes and diabetic kidney disease

ABSTRACT Dietary therapy is crucial for diabetes care with the aim of preventing the onset and progression of diabetes and its complications. The traditional approach to dietary therapy for diabetes has primarily focused on restricting the intake of the three major nutrients and rigorously controlling blood glucose levels. However, advancements in nutritional science have shown that within the three major nutrients – carbohydrates, proteins and lipids – there exist multiple types, each with distinct impacts on type 2 diabetes and its complications, sometimes even showing conflicting effects. In light of this, the present review shifts its focus from the quantity to the quality of the three major nutrients. It aims to provide an overview of how the differences in nutrient quality can influence onset and progression of type 2 diabetes and diabetic kidney disease, highlighting the diverse effects and, at times, contradictory impacts associated with each nutrient type. Diet therapy is crucial for treatment of diabetes and its complications, including diabetic kidney disease. Considering the diversification of the pathophysiology and comorbidities of diabetes, it might become crucial in the future to focus on the quality of nutrients in the diet rather than just the quantity. This suggests that individualized dietary therapy could be increasingly important.