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Recommendations Summary

PDM: Coordination of Care 2014

Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.


  • Recommendation(s)

    PDM: Coordination of Care

    For individuals who are at high risk for type 2 diabetes, the registered dietitian nutritionist (RDN) should implement medical nutrition therapy (MNT) and coordinate care with a multi-disciplinary team and important others (e.g., family, friends and colleagues) in a wide variety of settings. This approach is necessary to effectively integrate MNT into overall management for individuals who are at high risk for type 2 diabetes.

    Rating: Strong
    Imperative

    • Risks/Harms of Implementing This Recommendation

      None.

    • Conditions of Application

      A multi-disciplinary team may consist of, but not be limited to, the following:

      • Community health workers
      • Doctors
      • Exercise specialists
      • Nurses
      • Pharmacists
      • Psychiatrists
      • Psychologists
      • Social service professionals
      • Social workers.

    • Potential Costs Associated with Application

      The costs of medical nutrition therapy (MNT).

    • Recommendation Narrative

      From Project IMAGE European Evidence-Based Guideline for the Prevention of Type 2 Diabetes, 2010:

      • Interventions to prevent T2DM may be delivered by a wide range of people and professions, subject to appropriate training (including the use of established behavior change techniques). There are examples of successful physical activity and dietary interventions delivered by doctors, nurses, dietician and nutritionists, exercise specialists and lay people, often working within a multi-disciplinary team (Grade A).
      • Interventions to prevent T2DM may be delivered in a wide range of settings. There are examples of successful physical activity and dietary interventions delivered in health care settings, the workplace, the home and in the community (Grade A)
      • Work with participants to engage social support for the planned behavior change (engage important others such as family, friends and colleagues, for example) (Grade A)
      • Maximize the frequency or number of contacts with participants (within the resources available) (Grade B).

    • Recommendation Strength Rationale

      • The Academy of Nutrition and Dietetics Prevention of Type 2 Diabetes Work Group concurs with the references cited
      • Evidence in support of the recommendation was grades A and B.

    • Minority Opinions

      Consensus reached.

  • Supporting Evidence

    The recommendations were created from the evidence analysis on the following questions. To see detail of the evidence analysis, click the blue hyperlinks below (recommendations rated consensus will not have supporting evidence linked).

    • References
    • References not graded in Academy of Nutrition and Dietetics Evidence Analysis Process

      Lindström J, Neumann A, Sheppard KE, Gilis-Januszewska A, Greaves CJ, Handke U, Pajunen P, Puhl S, Pölönen A, Rissanen A, Roden M, Stemper T, Telle-Hjellset V, Tuomilehto J, Velickiene D, Schwarz PE, Acosta T, Adler M, AlKerwi A, Barengo N, Barengo R, Boavida JM, Charlesworth K, Christov V, Claussen B, Cos X, Cosson E, Deceukelier S, Dimitrijevic-Sreckovic V, Djordjevic P, Evans P, Felton AM, Fischer M, Gabriel-Sanchez R, Gilis-Januszewska A, Goldfracht M, Gomez JL, Greaves CJ, Hall M, Handke U, Hauner H, Herbst J, Hermanns N, Herrebrugh L, Huber C, Hühmer U, Huttunen J, Jotic A, Kamenov Z, Karadeniz S, Katsilambros N, Khalangot M, Kissimova-Skarbek K, Köhler D, Kopp V, Kronsbein P, Kulzer B, Kyne-Grzebalski D, Lalic K, Lalic N, Landgraf R, Lee-Barkey YH, Liatis S, Lindström J, Makrilakis K, McIntosh C, McKee M, Mesquita AC, Misina D, Muylle F, Neumann A, Paiva AC, Pajunen P, Paulweber B, Peltonen M, Perrenoud L, Pfeiffer A, Pölönen A, Puhl S, Raposo F, Reinehr T, Rissanen A, Robinson C, Roden M, Rothe U, Saaristo T, Scholl J, Schwarz PE, Sheppard KE, Spiers S, Stemper T, Stratmann B, Szendroedi J, Szybinski Z, Tankova T, Telle-Hjellset V, Terry G, Tolks D, Toti F, Tuomilehto J, Undeutsch A, Valadas C, Valensi P, Velickiene D, Vermunt P, Weiss R, Wens J, Yilmaz T. Take action to prevent diabetes: The IMAGE toolkit for the prevention of type 2 diabetes in Europe. Horm Metab Res. 2010 Apr; 42 Suppl 1: S37-S55.

      Pajunen P, Landgraf R, Muylle F, Neumann A, Lindström J, Schwarz PE, Peltonen M, Acosta T, Adler M, AlKerwi A, Barengo N, Barengo R, Boavida JM, Charlesworth K, Christov V, Claussen B, Cos X, Cosson E, Deceukelier S, Dimitrijevic-Sreckovic V, Djordjevic P, Evans P, Felton AM, Fischer M, Gabriel-Sanchez R, Gilis-Januszewska A, Goldfracht M, Gomez JL, Greaves CJ, Hall M, Handke U, Hauner H, Herbst J, Hermanns N, Herrebrugh L, Huber C, Hühmer U, Huttunen J, Jotic A, Kamenov Z, Karadeniz S, Katsilambros N, Khalangot M, Kissimova-Skarbek K, Köhler D, Kopp V, Kronsbein P, Kulzer B, Kyne-Grzebalski D, Lalic K, Lalic N, Landgraf R, Lee-Barkey YH, Liatis S, Lindström J, Makrilakis K, McIntosh C, McKee M, Mesquita AC, Misina D, Muylle F, Neumann A, Paiva AC, Pajunen P, Paulweber B, Peltonen M, Perrenoud L, Pfeiffer A, Pölönen A, Puhl S, Raposo F, Reinehr T, Rissanen A, Robinson C, Roden M, Rothe U, Saaristo T, Scholl J, Schwarz PE, Sheppard KE, Spiers S, Stemper T, Stratmann B, Szendroedi J, Szybinski Z, Tankova T, Telle-Hjellset V, Terry G, Tolks D, Toti F, Tuomilehto J, Undeutsch A, Valadas C, Valensi P, Velickiene D, Vermunt P, Weiss R, Wens J, Yilmaz T. Quality indicators for the prevention of type 2 diabetes in Europe: IMAGE. Horm Metab Res. 2010 Apr; 42 Suppl 1: S56-S63.

      Paulweber B, Valensi P, Lindström J, Lalic NM, Greaves CJ, McKee M, Kissimova-Skarbek K, Liatis S, Cosson E, Szendroedi J, Sheppard KE, Charlesworth K, Felton AM, Hall M, Rissannen A, Tuomilehto J, Schwarz PE, Roden M, for the Writing Group: Paulweber M, Stadlmayr A, Kedenko L, Katsilambros N, Makrilakis K, Kamenov Z, Evans P, Gilis-Januszewska A, Lalic K, Jotic A, Djordevic P, Dimitrijevic-Sreckovic V, Hühmer U, Kulzer B, Puhl S, Lee-Barkey YH, AlKerwi A, Abraham C, Hardeman W, on behalf of the IMAGE Study Group: Acosta T, Adler M, AlKerwi A, Barengo N, Barengo R, Boavida JM, Charlesworth K, Christov V, Claussen B, Cos X, Cosson E, Deceukelier S, Dimitrijevic-Sreckovic V, Djordjevic P, Evans P, Felton AM, Fischer M, Gabriel-Sanchez R, Gilis-Januszewska A, Goldfracht M, Gomez JL, Greaves CJ, Hall M, Handke U, Hauner H, Herbst J, Hermanns N, Herrebrugh L, Huber C, Hühmer U, Huttunen J, Jotic A, Kamenov Z, Karadeniz S, Katsilambros N, Khalangot M, Kissimova-Skarbek K, Köhler D, Kopp V, Kronsbein P, Kulzer B, Kyne-Grzebalski D, Lalic K, Lalic N, Landgraf R, Lee-Barkey YH, Liatis S, Lindström J, Makrilakis K, McIntosh C, McKee M, Mesquita AC, Misina D, Muylle F, Neumann A, Paiva AC, Pajunen P, Paulweber B, Peltonen B, Perrenoud L, Pfeiffer A, Pölönen A, Puhl S, Raposo F, Reinehr T, Rissanen A, Robinson C, Roden M, Rothe U, Saaristo T, Scholl J, Schwarz PE, Sheppard KE, Spiers S, Stemper T, Stratmann B, Szendroedi J, Szybinski Z, Tankova T, Telle-Hjellset V, Terry G, Tolks D, Toti F, Tuomilehto J, Undeutsch A, Valadas C, Valensi P, Velickiene D, Vermunt P, Weiss R, Wens J, Yilmaz T. A European evidence-based guideline for the prevention of type 2 diabetes. Horm Metab Res. 2010 Apr; 42 Suppl 1: S3-S36.