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Diabetes Prevention

PDM: Introduction (2014)

Guideline Overview

Guideline Title

Prevention of Type 2 Diabetes (2014) Evidence-Based Nutrition Practice Guideline


The focus of this guideline is on medical nutrition therapy (MNT) for individuals who are at high risk for type 2 diabetes, such as individuals with prediabetes and adults with metabolic syndrome.

The primary goals of MNT are to improve glycemic control and minimize the impact of other comorbidities, such as obesity, hypertension and disorders of lipid metabolism, in order to prevent progression to type 2 diabetes.

Guideline Development

This guideline is intended for use by registered dietitian nutritionists (RDNs) involved in providing medical nutrition therapy (MNT) for individuals who are at high risk for type 2 diabetes. The application of the guideline must be individualized to assist the RDN to successfully integrate MNT into the overall medical management of persons at high risk for type 2 diabetes. The recommendations in the guideline are based on a systematic review of the literature and the work performed by the Academy of Nutrition and Dietetics Expert Working Group on Prevention of Type 2 Diabetes, and/or recommendations from the evidence-based guidelines developed by the American Diabetes Association and Project IMAGE, A European Evidence-Based Guideline for the Prevention of Type 2 Diabetes.
Recommendations include:
  • Screen for Type 2 Diabetes Risk
  • MNT for Prevention of Type 2 Diabetes in High Risk Groups
  • Assessment in High Risk Groups
  • Weight Loss and Prevention of Type 2 Diabetes
  • Nutrition Prescription for Macronutrients
  • Fiber and Prevention of Type 2 Diabetes
  • Whole Grains and Prevention of Type 2 Diabetes
  • Vegetable-based Protein and Prevention of Type 2 Diabetes
  • Type of Fat and Prevention of Type 2 Diabetes
  • Fruits and Vegetables and Prevention of Type 2 Diabetes
  • Sugar and Prevention of Type 2 Diabetes
  • Glycemic Index/Glycemic Load and Prevention of Type 2 Diabetes
  • Physical Activity and Prevention of Type 2 Diabetes
  • Nutrition-related Effects of Medications
  • Nutrition Counseling
  • Coordination of Care
  • Monitoring and Evaluation in High Risk Groups
The number of supporting documents for these topics is below:
  • Recommendations: 17
  • Conclusion Statements: 108
  • Evidence Summaries:  108
  • Article Worksheets: 300


All Academy guidelines are revised every five years. The literature search will begin for each guideline topic three years after publication to identify new research that has been published since the previous search was completed. An expert workgroup will convene to determine the need for new and revised recommendations. See Revision under Guideline Development for more information. The updated guideline will be developed using the Academy of Nutrition and Dietetics Evidence Analysis Process (see EAL Policy and Process tab).

New research may warrant a revision to a specific question or recommendation prior to the full project or guideline revision. Once identified, information is gathered and the Evidence-Based Practice Committee will make a decision on the appropriate action.


  • Clinical judgment is crucial in the application of these guidelines. People planning interventions should consider what adaptations may be needed for different ethnic groups (particularly with regard to culturally-specific dietary advice), people with physical limitations and people with mental health problems.
  • Careful consideration should be given to the application of these guidelines for patients with significant medical co-morbidities.

Go to Scope of Guideline