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Current nutrition recommendations for people with diabetes largely ignore the glycemic index (GI) differences between carbohydrate foods and use older classifications that do not reflect physiologic effects on glycemia or insulinemia. We need to guide people in the best choices and encourage industry to develop new low-GI foods. Foods containing sugar, whether naturally occurring or refined, have low to intermediate GI values, and their inclusion can help to reduce the overall GI of the diet. In practice, the GI in diabetes management involves a “this for that” approach that is not complex and expands, rather than limits, food choices. Nutrition recommendations need to recognize major developments in science, and the GI of foods is one of these.