Since the 1970s, the success or failure of diet in diabetes care has been based on compliance. The most important consideration being whether or not a patient was deemed to have modified their dietary intake and achieved a particular dietary prescription. Evaluation needs to consider the impact of diet on clinical outcomes like body weight, lipid levels and HbA1C. Application of the nutritional guidelines is not about achieving the gold standard but about the modification of an individual’s dietary intake to shift the balance in the direction of the gold standard and at the same time, maximise health benefits and quality of life for that individual.
Findings of the Diabetes UK survey in 1997 show that a quantitative method of dietary prescription is no longer applied in practice. The survey also shows that most dietitians reported, at the time, following the 1992 nutritional guidelines. The nutritional recommendations in the UK are under review and the more up-to-date guidelines from Europe and America should be applied until updated recommendations are published in the UK.