Article Summary Dietary Carbohydratre (Amount and Type) in the Prevention and Management of Diabetes: A Sstatement by the American Diabetes Association. Sheard NF, Clark NG, Brand-Miller JC, Franz MJ, Pi-Sunyder FX, Mayer-Davis E, Kulkarni K, Geil P. Diabetes Care. 2004;27:2266-2271. Objective: To clarify the position of the American Diabetes Association regarding the effects of carbohydrate intake on prevention and management of diabetes through a review of the scientific data. The statement is in a Q & A format not reflected in this abstract. Observation: Carbohydrate intake, both type and amount, is the dietary component with the greatest influence on postprandial glucose (PPG) and insulin-response levels. Although there is continuing debate, 2 methods that have been investigated as potential tools for risk assessment as well as meal planning are the glycemic index and the glycemic load. Glycemic index is a ranking of carbohydrate exchanges according to their effect on PPG and the observed increase in blood glucose (over the fasting level) 2 hours following the consumption of a set amount of carbohydrate in a specific food compared with the measured increase in a reference food (glucose or white bread), containing an equal amount of carbohydrate. The glycemic index for any food item is highly variable; therefore, the glycemic response to a particular food is also variable. Glycemic load is the product of the glycemic index and the amount of carbohydrates in a serving of a particular food. Epidemiological studies suggest that a diet with high glycemic index or load may lead to type 2 diabetes, although other factors play an important role as well. Data do not support the hypothesis that total carbohydrate intake is associated with increased risk for type 2 diabetes; there is a stronger association between total fat and saturated fat intake and type 2 diabetes. Summary: Regulating blood glucose (BG) to achieve normoglycemia is the primary goal in managing patients with diabetes. While carbohydrates do contribute to PPG concentrations, they are an important source of energy, water-soluble vitamins, minerals, and fiber; therefore, the recommended range of carbohydrate intake is between 45% and 65% of total calories. Although the relationship between glycemic index and glycemic load and the development of type 2 diabetes is still unclear, recent trials examining the efficacy of the glycemic index on BG control suggest that the use of this technique can provide benefit over that observed when total carbohydrate intake measured in grams is considered alone.