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For individuals living with diabetes, dietary choices play a crucial role in managing blood sugar levels and overall health. Among the many food-related decisions people face, the choice between full-fat and reduced-fat dairy products has become increasingly complex. While conventional wisdom has long favored low-fat options, emerging research suggests the relationship between dairy fat content and diabetes management may be more nuanced than previously thought. Understanding the science behind these choices can help you make informed decisions that support your metabolic health.
Understanding the Fundamental Differences Between Full-Fat and Reduced-Fat Dairy
The primary distinction between full-fat and reduced-fat dairy products lies in their fat content and the processing methods used to achieve different fat levels. Full-fat dairy products contain all the naturally occurring fats found in milk, typically ranging from 3.25% to 4% milk fat in whole milk. These fats include saturated fatty acids, monounsaturated fats, and small amounts of polyunsaturated fats, along with naturally occurring trans fats like conjugated linoleic acid.
Reduced-fat dairy products undergo processing to remove varying amounts of this natural fat content. Low-fat milk contains approximately 1% milk fat, while skim or fat-free milk has virtually all fat removed, containing less than 0.5% milk fat. This processing affects more than just the calorie content—it fundamentally changes the nutritional profile, taste, texture, and how the body processes these foods.
The fat content in dairy products influences the absorption of fat-soluble vitamins and affects satiety signals in the body. Whole milk, with its higher fat content, slows down the digestion process and can lead to a more gradual increase in blood sugar compared to skim or low-fat milk. This slower digestion rate can be particularly relevant for individuals managing diabetes who need to avoid rapid blood sugar spikes.
Beyond the macronutrient differences, the processing required to create reduced-fat dairy products can sometimes lead manufacturers to add ingredients to improve taste and texture. These additions may include sugars, thickeners, or other additives that can impact blood sugar control—a consideration that becomes especially important for diabetes management.
The Complex Relationship Between Dairy and Blood Sugar Control
The relationship between dairy consumption and blood sugar management is remarkably complex, with research revealing several counterintuitive findings. Dairy products contain lactose, a natural sugar that can raise blood glucose levels. However, dairy also contains protein and fat, which typically help slow the absorption of sugar into the bloodstream.
One of the most interesting aspects of dairy’s metabolic effects is its insulinogenic property—dairy products stimulate insulin secretion from the pancreas to a greater degree than would be expected based solely on their carbohydrate content. This means that consuming dairy triggers a larger insulin response than other foods with similar amounts of carbohydrates. While this might seem beneficial for controlling immediate blood sugar spikes, the long-term implications are more complicated.
The fat content in dairy appears to modulate how quickly glucose enters the bloodstream. The presence of fat slows gastric emptying, meaning food moves more slowly from the stomach into the small intestine where nutrient absorption occurs. This slower transit time can result in a more gradual rise in blood glucose levels, potentially reducing the magnitude of post-meal blood sugar spikes that people with diabetes work to avoid.
However, the story doesn’t end with acute blood sugar responses. Some research suggests that while dairy’s high insulin response may blunt immediate glucose spikes, it could potentially contribute to insulin resistance over time. This creates a paradox where short-term benefits might come at the cost of long-term metabolic health—though the evidence on this point remains mixed and continues to evolve.
Recent Research on Full-Fat Dairy and Diabetes Risk
Recent scientific investigations have challenged long-held assumptions about dairy fat and diabetes. A 2024 study following pre-diabetic adults for 9 years found that the odds of returning to normal glycemia was significantly elevated by 69% per 200 g/d increased high-fat dairy intake, while the amount of total dairy or low-fat dairy was not related to the outcomes. This finding suggests that full-fat dairy may actually support better glucose regulation in certain populations.
Full-fat yogurt consumption has been linked to a lower chance of developing diabetes, and an increased likelihood of returning to normal blood sugar levels for patients who already had pre-diabetes. This protective effect appears particularly strong for fermented dairy products, which may offer additional metabolic benefits beyond their fat content.
In a large Australian cohort study, protective associations with prediabetes risk were found for high-fat dairy types, whereas neutral associations were seen for low-fat dairy types. These population-level findings add to a growing body of evidence suggesting that dairy fat may not be the metabolic villain it was once thought to be.
More recent research from 2025 has provided additional nuance to this picture. High intake of non-fermented milk can significantly increase type 2 diabetes risk among Swedish men and women, and a similar positive association between very high cheese intake and diabetes risk has also been observed. However, higher intakes of fermented milk, cream, and butter have modest protective effects on the risk of type 2 diabetes among both Swedish men and women.
These findings highlight an important point: not all dairy products affect diabetes risk equally, and the type of dairy product may matter as much as or more than its fat content. Fermentation, processing methods, and the food matrix in which dairy fats exist all appear to influence metabolic outcomes.
The Evidence on Reduced-Fat Dairy and Metabolic Health
While full-fat dairy has gained attention for potential benefits, reduced-fat dairy products have their own body of supporting research. A study found that consumption of 4 servings per day of low-fat dairy milk and yogurt products under free-living conditions for 6 months reduced fasting plasma insulin by 9% and improved insulin resistance by 11% in overweight and obese adults.
A systematic review and meta-analysis of randomized clinical trials found a mean difference in HOMA-IR (a measure of insulin resistance) of −1.21 when comparing dairy dietary interventions to control, with findings suggesting that dairy intake, especially low-fat dairy products, has a beneficial effect on HOMA-IR, waist circumference, and body weight.
The mechanisms behind low-fat dairy’s potential benefits may relate to several bioactive components. Dairy proteins, including casein and whey, have demonstrated effects in reducing insulin resistance in both human and animal studies. These proteins may work independently of the fat content, suggesting that removing fat doesn’t necessarily eliminate dairy’s metabolic benefits.
Calcium, another key component of dairy products, remains present in reduced-fat versions and may contribute to improved metabolic health. Some research suggests calcium plays a role in regulating insulin sensitivity and glucose metabolism, though the exact mechanisms remain under investigation.
However, not all studies have shown benefits from reduced-fat dairy. A randomized controlled trial found that both low-fat and full-fat dairy diets decreased the Matsuda insulin sensitivity index compared with a limited dairy group, and contrary to the hypothesis, neither dairy diet improved glucose tolerance in individuals with metabolic syndrome, with both dairy diets decreasing insulin sensitivity.
The Insulin Sensitivity Paradox
One of the most puzzling aspects of dairy research involves its effects on insulin sensitivity—the body’s ability to respond effectively to insulin. The evidence presents a complex and sometimes contradictory picture that challenges simple recommendations.
Research on 272 middle-aged, nondiabetic women found that those in the highest quartile of dairy consumption had significantly greater insulin resistance values than those in the middle-two quartiles or the lowest quartile, and the association remained significant after controlling for potential confounders.
This finding suggests that higher dairy consumption might be associated with increased insulin resistance, at least in some populations. However, the duration of dairy consumption appears to matter significantly. Studies that showed a reduction in insulin sensitivity were 12 weeks in duration or shorter, whereas almost all studies that showed an improvement in insulin sensitivity were 12 weeks in duration or longer.
This temporal pattern suggests that dairy’s effects on insulin sensitivity may change over time. Short-term consumption might temporarily reduce insulin sensitivity, while longer-term consumption could potentially improve it. This possibility highlights the importance of considering study duration when interpreting research findings and making dietary recommendations.
The population studied also appears to influence outcomes. Studies showing reduced insulin sensitivity were often conducted in individuals with metabolic syndrome, whereas most previous studies showing benefits used comparatively healthier participants. This suggests that baseline metabolic health may determine how an individual responds to dairy consumption.
Nutritional Considerations Beyond Blood Sugar
When evaluating full-fat versus reduced-fat dairy for diabetes management, blood sugar control represents just one piece of a larger nutritional puzzle. The complete nutritional profile of these products affects overall health in ways that can indirectly influence diabetes management.
Full-fat dairy products provide fat-soluble vitamins—A, D, E, and K—in their natural form. These vitamins require dietary fat for optimal absorption, and the fat naturally present in whole dairy products facilitates this process. Vitamin D, in particular, plays a crucial role in insulin sensitivity and glucose metabolism, making its bioavailability especially relevant for people with diabetes.
The fatty acid profile of dairy fat includes several potentially beneficial compounds. Conjugated linoleic acid (CLA), a naturally occurring trans fat found in dairy products, has been studied for potential metabolic benefits. Odd-chain fatty acids like pentadecanoic acid (15:0) and heptadecanoic acid (17:0), which are found primarily in dairy fat, have been associated with lower diabetes risk in some observational studies.
Reduced-fat dairy products often undergo fortification to replace nutrients lost during fat removal. Many low-fat and skim milk products are fortified with vitamins A and D to levels comparable to or exceeding those in whole milk. However, the bioavailability of these added fat-soluble vitamins in the absence of dietary fat remains a consideration.
One concern with some reduced-fat dairy products involves added sugars or sweeteners used to improve palatability after fat removal. Flavored yogurts, in particular, can contain substantial amounts of added sugar—sometimes as much as a dessert. For individuals managing diabetes, these added sugars can significantly impact blood glucose control and should be carefully considered when reading nutrition labels.
The protein content remains relatively consistent across full-fat and reduced-fat dairy options, providing high-quality complete protein with all essential amino acids. This protein contributes to satiety, helps maintain muscle mass, and plays a role in blood sugar regulation by slowing carbohydrate absorption.
The Role of Fermentation in Dairy Products
The fermentation process used to create products like yogurt, kefir, and some cheeses appears to confer unique metabolic benefits that may be independent of fat content. Understanding these effects can help inform choices about which dairy products to include in a diabetes management plan.
Higher intakes of yogurt were associated with an increased odds of returning to normal glycemia in pre-diabetic individuals. This protective effect appears consistent across multiple studies and populations, suggesting that fermented dairy products may offer particular advantages for glucose regulation.
The fermentation process transforms lactose into lactic acid, reducing the sugar content of the final product compared to the milk from which it was made. This reduction in lactose means fermented dairy products typically have a lower glycemic impact than fresh milk, potentially making them better choices for blood sugar management.
Fermented dairy products also contain probiotics—beneficial bacteria that can influence gut health and metabolism. Emerging research suggests that the gut microbiome plays a significant role in glucose metabolism and insulin sensitivity. The probiotics in fermented dairy may help optimize the gut bacterial composition in ways that support better metabolic health.
The protein structure in fermented dairy products differs from that in fresh milk due to the fermentation process. This altered protein structure may affect how the body digests and absorbs these products, potentially influencing their metabolic effects. Some research suggests that the proteins in fermented dairy may have enhanced bioactivity compared to those in non-fermented products.
When choosing fermented dairy products, the distinction between plain and sweetened varieties becomes crucial. Plain yogurt and kefir contain only naturally occurring sugars from milk, while flavored versions often contain substantial added sugars that can undermine blood sugar control. Reading labels carefully and choosing unsweetened options provides the benefits of fermentation without the metabolic drawbacks of added sugars.
Practical Considerations for Dairy Selection
Translating research findings into practical dietary choices requires considering individual circumstances, preferences, and health goals. No single approach to dairy consumption works optimally for everyone with diabetes.
Portion control remains important regardless of which type of dairy you choose. A standard serving of milk is 8 ounces (1 cup), yogurt is typically 6-8 ounces, and cheese is 1-1.5 ounces. These portions provide meaningful amounts of nutrients while keeping carbohydrate and calorie intake manageable.
Reading nutrition labels becomes essential when selecting dairy products. Pay attention to total carbohydrates, added sugars, protein content, and serving sizes. Two products that appear similar may have vastly different nutritional profiles depending on processing and added ingredients.
For individuals concerned about calorie intake, the energy density difference between full-fat and reduced-fat dairy can be significant. Whole milk contains about 150 calories per cup, while skim milk contains about 80 calories. Over time, these differences can impact weight management, which in turn affects diabetes control.
Consider your overall dietary pattern when making dairy choices. If your diet includes other sources of saturated fat, choosing reduced-fat dairy might help keep total saturated fat intake within recommended ranges. Conversely, if you consume a diet low in fat overall, full-fat dairy might provide beneficial fatty acids without excessive total fat intake.
Individual glucose response varies considerably from person to person. If you have access to blood glucose monitoring, testing your response to different dairy products can provide personalized information about which options work best for your body. Some people may find that full-fat dairy produces more stable blood sugar levels, while others may respond better to reduced-fat options.
Timing of dairy consumption may also matter. Consuming dairy with meals rather than alone can help moderate its impact on blood sugar by combining it with other macronutrients. The protein and fat in dairy can also help slow the absorption of carbohydrates from other foods eaten at the same meal.
Special Considerations for Different Types of Diabetes
The optimal approach to dairy consumption may differ depending on the type of diabetes and individual metabolic characteristics. Understanding these nuances can help tailor dietary choices to specific needs.
For individuals with type 2 diabetes, the relationship between dairy fat content and metabolic health appears particularly complex. Some research suggests that full-fat dairy may offer protective effects against diabetes progression, while other studies show neutral or negative effects. The presence of insulin resistance, which characterizes type 2 diabetes, may influence how the body responds to different types of dairy.
People with type 1 diabetes face different considerations. Since type 1 diabetes results from autoimmune destruction of insulin-producing cells rather than insulin resistance, the metabolic effects of dairy fat may differ. However, the insulinogenic properties of dairy still require attention when calculating insulin doses for meals containing dairy products.
Individuals with prediabetes represent a particularly important group for dairy research. Evidence suggests that high-fat dairy intake may help some people with prediabetes return to normal glucose levels, potentially preventing or delaying progression to type 2 diabetes. This finding suggests that dairy choices during the prediabetic stage might influence long-term metabolic trajectory.
Gestational diabetes, which occurs during pregnancy, requires careful attention to all dietary choices. The nutritional needs of pregnancy, combined with the need for blood sugar control, make dairy selection particularly important. The calcium and protein in dairy products support fetal development, while the choice between full-fat and reduced-fat options should be made in consultation with healthcare providers based on individual circumstances.
The Impact of Dairy on Cardiovascular Health in Diabetes
People with diabetes face elevated cardiovascular disease risk, making heart health a crucial consideration when evaluating dietary choices. The relationship between dairy fat, particularly saturated fat, and cardiovascular health has been extensively debated and researched.
Traditional dietary guidelines have recommended limiting saturated fat intake to reduce cardiovascular disease risk, which led to recommendations for reduced-fat dairy products. However, recent research has challenged the assumption that all saturated fats affect cardiovascular health equally. The saturated fats in dairy products may have different metabolic effects than saturated fats from other sources.
Some studies have found that dairy fat consumption is not associated with increased cardiovascular disease risk, and may even be associated with reduced risk in some populations. The food matrix—the complex structure in which nutrients exist within whole foods—appears to influence how the body processes dairy fats. Fats consumed as part of whole dairy products may have different effects than isolated dairy fats or saturated fats from other sources.
The relationship between dairy consumption and blood pressure, an important cardiovascular risk factor, has shown generally favorable results. Dairy products contain several nutrients that may support healthy blood pressure, including calcium, potassium, and magnesium. These benefits appear to exist regardless of fat content, though some research suggests low-fat dairy may have particularly beneficial effects on blood pressure.
Inflammation, another key factor in cardiovascular disease, may be influenced by dairy consumption. Some research suggests that dairy products, particularly fermented varieties, may have anti-inflammatory effects. However, individual responses vary, and some people may experience increased inflammation with dairy consumption.
Understanding Individual Variation in Dairy Response
One of the most important insights from dairy research is the significant individual variation in how people respond to dairy consumption. Genetic factors, gut microbiome composition, baseline metabolic health, and other individual characteristics all influence dairy’s metabolic effects.
Lactose intolerance affects a substantial portion of the global population, with prevalence varying significantly across ethnic groups. People with lactose intolerance lack sufficient lactase enzyme to digest lactose, leading to digestive symptoms when consuming dairy products. For these individuals, fermented dairy products like yogurt and aged cheeses, which contain less lactose, may be better tolerated than fresh milk.
Genetic variations in genes related to fat metabolism, insulin signaling, and vitamin D metabolism may influence how individuals respond to different types of dairy. While genetic testing for these variations is not yet standard practice for dietary recommendations, understanding that genetic factors play a role helps explain why research findings sometimes appear contradictory.
The gut microbiome—the community of bacteria living in the digestive tract—varies considerably between individuals and influences how the body processes dairy products. Some bacterial species are particularly efficient at fermenting dairy components, potentially producing beneficial metabolites. The composition of an individual’s gut microbiome may determine whether dairy consumption has positive, neutral, or negative metabolic effects.
Baseline metabolic health appears to significantly influence dairy’s effects. Research suggests that for normal-weight individuals, higher dairy consumption doesn’t affect glucose metabolism, while in those overweight and obese who would be insulin resistant, the results have been mixed. This suggests that recommendations should be tailored based on current metabolic status.
Dairy Alternatives and Blood Sugar Management
For individuals who cannot or choose not to consume traditional dairy products, numerous plant-based alternatives have become available. Understanding how these alternatives compare to dairy in terms of blood sugar impact can help inform choices.
Plant-based milk alternatives vary widely in their nutritional profiles and effects on blood sugar. Unsweetened almond milk, cashew milk, and other nut-based milks typically contain minimal carbohydrates and have little impact on blood glucose. However, they also provide less protein than cow’s milk unless fortified.
Soy milk offers a protein content comparable to cow’s milk and contains all essential amino acids, making it nutritionally similar to dairy milk in some respects. Unsweetened soy milk typically has a modest impact on blood sugar, though individual responses vary.
Oat milk has gained popularity but presents challenges for blood sugar management. Even unsweetened oat milk contains significant carbohydrates from the oats themselves, and the processing used to create oat milk can result in a product with a relatively high glycemic impact. For individuals focused on blood sugar control, oat milk may not be the optimal choice.
Coconut milk provides fat but little protein or carbohydrate, creating a different nutritional profile than dairy milk. The fats in coconut milk are primarily medium-chain triglycerides, which are metabolized differently than the fats in dairy products.
When choosing dairy alternatives, reading labels becomes even more critical than with traditional dairy. Many plant-based milk alternatives contain added sugars, thickeners, and other ingredients that can affect blood sugar. Choosing unsweetened varieties and checking the carbohydrate content helps ensure these products align with blood sugar management goals.
Integrating Dairy Choices into a Comprehensive Diabetes Management Plan
Dairy consumption represents just one component of a comprehensive approach to diabetes management. Integrating dairy choices with other dietary strategies, physical activity, medication management, and lifestyle factors creates the most effective approach to blood sugar control.
The overall dietary pattern matters more than any single food or food group. Whether you choose full-fat or reduced-fat dairy, these products should fit within a balanced diet rich in vegetables, fruits, whole grains, lean proteins, and healthy fats. The Mediterranean diet and DASH (Dietary Approaches to Stop Hypertension) diet, both of which include moderate amounts of dairy, have shown benefits for diabetes management and cardiovascular health.
Meal composition influences how the body responds to dairy products. Combining dairy with fiber-rich foods, lean proteins, and healthy fats creates meals that promote stable blood sugar levels. For example, Greek yogurt with berries and nuts provides protein, healthy fats, fiber, and antioxidants in addition to the dairy.
Physical activity significantly affects insulin sensitivity and glucose metabolism, potentially influencing how the body responds to dairy consumption. Regular exercise may enhance the body’s ability to process dairy products effectively and maintain stable blood sugar levels.
Medication management must account for dietary choices, including dairy consumption. The insulinogenic properties of dairy mean that people using insulin or certain diabetes medications may need to account for dairy’s effects when calculating doses or timing medication.
Stress management, sleep quality, and other lifestyle factors also influence blood sugar control and may interact with dietary choices. A holistic approach that addresses all aspects of health provides the best foundation for effective diabetes management.
Emerging Research and Future Directions
The science of dairy and diabetes continues to evolve, with new research methodologies and technologies providing increasingly sophisticated insights into these complex relationships.
Metabolomics research, which examines the small molecules produced during metabolism, is revealing new insights into how dairy consumption affects metabolic pathways. These studies have identified specific metabolites associated with dairy consumption that may influence diabetes risk, providing clues about mechanisms underlying dairy’s metabolic effects.
Personalized nutrition approaches, which tailor dietary recommendations based on individual characteristics including genetics, microbiome composition, and metabolic responses, represent an exciting frontier. As these approaches become more accessible, they may enable more precise recommendations about dairy consumption for individual diabetes management.
Long-term intervention studies with extended follow-up periods will help clarify whether the effects of dairy consumption on insulin sensitivity and glucose metabolism change over time. Understanding the temporal dynamics of dairy’s metabolic effects will improve dietary guidance.
Research examining specific dairy components—such as particular fatty acids, proteins, or bioactive peptides—may identify which elements of dairy products drive metabolic effects. This knowledge could inform the development of dairy products optimized for diabetes management.
Studies investigating interactions between dairy consumption and other dietary factors, medications, and lifestyle variables will provide a more complete picture of how dairy fits into comprehensive diabetes management strategies.
Making Informed Decisions About Dairy Consumption
Given the complexity of the research and individual variation in responses, making informed decisions about dairy consumption requires considering multiple factors and potentially working with healthcare providers to develop personalized approaches.
Start by assessing your current dairy consumption patterns. How much dairy do you currently consume? What types of dairy products do you eat most frequently? Are these products full-fat, reduced-fat, or a mixture? Understanding your baseline helps identify potential areas for modification.
Consider your individual health status and goals. Are you primarily focused on blood sugar control, weight management, cardiovascular health, or a combination of factors? Your priorities should guide dairy choices. Someone focused primarily on weight management might prioritize reduced-fat options, while someone with stable weight but concerns about blood sugar stability might experiment with full-fat dairy.
Monitor your individual responses to different dairy products. If you have access to blood glucose monitoring, testing your blood sugar before and after consuming different types of dairy can provide personalized information about how your body responds. Keep notes about how different dairy products affect your energy levels, satiety, and overall well-being.
Consult with healthcare providers, including physicians, registered dietitians, and certified diabetes educators. These professionals can help interpret research findings in the context of your individual circumstances and develop personalized recommendations that account for your complete health profile.
Stay informed about emerging research while recognizing that nutritional science evolves gradually. Be cautious about making dramatic dietary changes based on single studies, and look for consistent patterns across multiple high-quality research studies.
Remember that dietary changes work best when they’re sustainable. Choose dairy products that you enjoy and that fit realistically into your lifestyle. The best dietary pattern is one you can maintain long-term, not one that feels restrictive or unsatisfying.
Key Takeaways for Dairy Selection in Diabetes Management
- The relationship between dairy fat content and diabetes management is complex, with research showing both potential benefits and concerns for both full-fat and reduced-fat options
- Full-fat dairy may slow glucose absorption and has been associated with reduced diabetes risk in some studies, particularly for fermented products like yogurt
- Reduced-fat dairy has shown benefits for insulin resistance and weight management in some research, though results vary across studies
- Fermented dairy products like yogurt and kefir appear to offer particular metabolic benefits regardless of fat content
- Individual responses to dairy vary significantly based on genetics, gut microbiome, baseline metabolic health, and other factors
- Added sugars in flavored dairy products can significantly impact blood sugar control and should be carefully considered
- The overall dietary pattern and lifestyle factors matter more than any single food choice
- Monitoring individual blood glucose responses to different dairy products can provide personalized guidance
- Portion control remains important regardless of which type of dairy you choose
- Consulting with healthcare providers helps develop personalized recommendations based on your complete health profile
Conclusion
The question of whether full-fat or reduced-fat dairy is better for managing diabetes doesn’t have a simple, universal answer. The research reveals a nuanced picture where both types of dairy can potentially fit into a diabetes management plan, depending on individual circumstances, overall dietary patterns, and personal health goals.
Recent research has challenged traditional assumptions about dairy fat, with some studies suggesting that full-fat dairy, particularly fermented varieties, may offer metabolic benefits. At the same time, reduced-fat dairy has demonstrated advantages in some research, particularly for weight management and insulin resistance. The type of dairy product, the presence of fermentation, added sugars, and individual metabolic characteristics all influence outcomes.
Rather than adhering to rigid rules about dairy fat content, focus on choosing high-quality dairy products without added sugars, paying attention to portion sizes, and monitoring your individual responses. Consider incorporating fermented dairy products like plain yogurt and kefir, which appear to offer consistent benefits across research studies. Most importantly, view dairy choices as one component of a comprehensive approach to diabetes management that includes overall dietary quality, physical activity, stress management, and appropriate medical care.
As research continues to evolve, remain open to adjusting your approach based on new evidence and your own experiences. Work with healthcare providers to develop personalized strategies that account for your unique circumstances, preferences, and health goals. By taking an informed, individualized approach to dairy consumption, you can make choices that support optimal blood sugar control and overall health.
For more information on diabetes nutrition and management strategies, visit the American Diabetes Association’s nutrition resources or consult with a registered dietitian specializing in diabetes care. The National Institute of Diabetes and Digestive and Kidney Diseases also provides evidence-based information on diabetes management and nutrition.