The implementation of effective dietary strategies is important for diabetes management. Dietary carbohydrate is the main factor determining blood sugar level, especially in the postprandial period. Carbohydrate-rich diets can have deleterious effects on glycemic control in diabetic patients and may play an important role in the development of cardiovascular diseases. Low glycemic diets have been reported to have beneficial effects for diabetes control and cardiovascular risk factors. However, according to the American Diabetes Association recommendations for medical nutrition therapy, monitoring carbohydrate intake, whether by carbohydrate counting, exchange, or experience-based estimation, remains a key strategy for achieving glycemic control, with the use of the glycemic index and glycemic load recommended only as an auxiliary method that may provide a modest additional benefit for glycemic control over the effects observed when total carbohydrate is considered alone. Recently, an increasing amount of clinical evidence supports the efficacy of low glycemic diets for the management of diabetes. The development of practical methods to apply the glycemic index and glycemic load to the management of diabetes in clinical settings is warranted.