Currently, the low-energy diet is the only recognized nutrition therapy for type 2 diabetes in Japan. However, in recent decades, many foreign scientific organizations have accepted various nutritional approaches to manage diabetes, such as the low-carbohydrate diet, the Mediterranean diet, diet approaches to stop hypertension (DASH), and the vegetarian diet. Moreover, growing evidence has called into question classical nutritional approaches such as the low-fat diet for the prevention of cardiovascular disease and the low-protein diet for the prevention of diabetic kidney disease. Similarly, the recommended nutrition therapy for diabetes may change in near future. Such changes in nutrition therapy must be dynamic and based on not only scientific evidence but also each patient's narrative.