Salt Restriction in Diabetes

There are no long-term interventions examining the effects of salt reduction in people with diabetes, and these are urgently required. Sodium reduction is controversial as it appears that an intake below 2.5 g and above 6 g/day of salt is associated with increased cardiovascular disease risk. However, pre-existing illness leading to a lower salt intake may confound the findings. Only a few studies have prospectively collected data on the sodium intake and excretion of people with diabetes and examined hard end points. In addition, future studies need to collect more data on food intake as well as coexistent illnesses to address potential confounding. The World Health Organization recommends a reduction to less than 5 g/day salt in adults. Given that the available evidence suggests that the salt intake of people with type 2 diabetes is generally well above 6 g/day it seems reasonable to ensure individuals with diabetes have an intake below 6 g/day. However, such recommendations need to be individualized.