What dietary modifications do you recommend for the management of type 2 diabetes, considering the benefits of Mediterranean, plant-based, low-carbohydrate, and ketogenic diets?

In general, the most important consideration for diet modifications for patients with type 2 diabetes is an individualized diet plan to which the patient can adhere and which will help the patient lose weight. Lower carb/keto diets might be associated with better weight loss in the short term, but there is no clear winner in terms of low-fat vs low-carb when it comes to long-term outcomes such as weight loss and glycemic control. The best success is tied to adherence. For example, the LOOK Ahead study in people with type 2 diabetes promoted a lower fat diet (not low carb) and those who lost at least 10% of their body weight had a reduction in CVD outcomes. I do think it is also important to consider an overall healthy dietary plan for cardi...