Ernährung und Diabetes mellitus Typ 1 Gibt es eine gute Evidenz und welche Empfehlungen lassen sich formulieren?

A look at historical recommendations regarding nutrition for people with type 1 diabetes reveals phases of very strict regimens with low-carbohydrate and low-calory daily intake. Following commencement of the insulin era, increasing liberalization of nutritional recommendations with a clear focus on carbohydrate counting was the result of modern insulins, evidence from the Diabetes Control and Complications Trial (DCCT), and improvements in diabetes technology. One of the consequences of this development is that more and more persons with type 1 diabetes are overweight or even obese. This higher bodyweight represents an additional cardiovascular risk factor, and other risk factors such as hypertension or hyperlipidemia also worsen consecutively. There are almost no specific nutritional recommendations exclusively for persons with type 1 diabetes. This article provides an overview of the current evidence. The recommendations for healthy nutrition as prescribed for the general population should be underscored for persons with type 1 diabetes: plant-based nutrition, Mediterranean diet, wholegrain products, seeds, nuts, and only small amounts of meat and sweets.