Medical Nutrition Therapy is a cornerstone of diabetes management. While its effectiveness to reduce A1C by 1–2% has been demonstrated when delivered by registered dietitians, all members of the medical care team need to understand the basic elements of MNT to reinforce the care plan. Although an integral part of the treatment strategy, patients with type 2 diabetes are particularly challenged by the need for weight loss. However, there are other strategies besides a calorie-restricted diet that will improve metabolic measures. Patients and providers alike may be confused by the myriad messages related to level of carbohydrate recommended, glycemic index, fiber and the diet-of-the-day in the popular press. This chapter, divided in three sections, includes 1) an overview of popular messages, separating fact from fiction, 2) a summary of the evidence based nutrition recommendations for each nutrient and 3) guidelines for weight reduction.