Diabetologiahtps/dai.org/10.1007/s00125-023-05894-8GUIDELINESEvidence-based European recommendations for the dietarymanagement of diabetesThe Diabetes and Nutrition Study Group(DNSG)of the European Association for the Study of Diabetes(EASD)C European Association for the Study of Diabetes 2023AbstractDiabetes management relies on effective evidence-based advice that informs and empowers individuals to manage their healthAlongside other cornerstones of diabetes management,dietary advice has the potential to improve glycaemic levels,reduce riskof diabetes complications and improve health-related quality of life.We have updated the 2004 recommendations for thenutritional management of diabetes to provide health professionals with evidence-based guidelines to inform discussions withpatients on diabetes management,including type 2 diabetes prevention and remission.To provide this update we commissionednew systematic reviews and meta-analyses on key topics,and drew on the broader evidence available.We have strengthened andexpanded on the previous recommendations to include advice relating to dietary pattems,environmental sustainability,foodprocessing.patient support and remission of type 2 diabetes.We have used the Grading of Recommendations,Assessment,Development and Evaluations(GRADE)approach to determine the certainty of evidence for each recommendation based onfindings from the commissioned and identified systematic reviews.Our findings indicate that a range of foods and dietarypatterns are suitable for diabetes management,with key recommendations for people with diabetes being largely similar forthose for the general population.Important messages are to consume minimally processed plant foods,such as whole grains,vegetables,whole fruit,legumes,nuts,seeds and non-hydrogenated non-tropical vegetable oils,while minimising the consump-tion of red and processed meats,sodium,sugar-sweetened beverages and refined grains.The updated recommendations reflectthe current evidence base and,if adhered to,will improve patient outcomes.Keywords Diabetes management.Dietary guidance.Eating advice.Nutrition recommendations.Type 2 diabetes prevention.Type 2 diabetes remissionAbbreviationsMUFAMonounsaturated fatty acidsDASH Dietary Approaches to Stop HypertensionNNSNon-nutritive sweetenerDNSG Diabetes and Nutrition Study GroupIGTImpaired glucose toleranceIntroductionMembers of the Guideline Development Group for the Diabetes andDiabetes management,including the prevention and remis-Nutrition Study Group (DNSG)of the EASD are listed in alphabeticalsion of type 2 diabetes,relies on effective evidence-basedorder in the Appendix.These individuals are the authors of this article.advice that informs and empowers individuals to manage theirThese guidelines were reviewed for EASD by its Committee on Clinicalhealth.Well-designed dietary recommendations and nutritionAffairs.therapy are essential to improve both life expectancy and qual-ity.However,the flood of nutrition informa
