Is nutrition therapy for diabetes still part of the ‘first Step’ of treatment?

Pharmacological treatments, once considered ‘second step’ treatments for type 2 diabetes (T2D) after the ‘first step’ of diet therapy and physical activity, have increasingly become part of the first step of treatments.1 Clinical guidelines for diabetes treatment outline the important role that lifestyle plays even after pharmacological treatments have been initiated. However, patients find adherence to appropriate dietary patterns to be one of the most difficult aspects of treatment to implement consistently, and evidence suggests that the recommended dietary patterns are not well followed. Do we really need dietary/nutrition therapy after drug therapy has been initiated?

Coppell and colleagues add to the literature that begins to answer this …