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Recommendations Summary

DM: Individualize Nutrition Prescription (2015)

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)

    DM: Individualize Nutrition Prescription

    The registered dietitian nutritionist (RDN) should individualize the nutrition prescription and implement evidence-based guidelines in collaboration with the adult with diabetes. A variety of eating patterns (combinations of different foods or food groups) are acceptable for the management of diabetes. Personal preferences (e.g., tradition, culture, religion, health beliefs and goals, economics) and metabolic goals should be considered when recommending one eating pattern over another. Treatment decisions should be founded on evidence-based guidelines tailored to individual patient preferences, prognoses and co-morbidities.

    Rating: Fair
    Imperative

    • Risks/Harms of Implementing This Recommendation

      None.

    • Conditions of Application

      None.

    • Potential Costs Associated with Application

      Costs of MNT sessions and reimbursement vary; however, MNT sessions are essential for improved outcomes.

    • Recommendation Narrative

      From the 2013 American Diabetes Association Nutrition Therapy Recommendations

      • It is recommended that individualized meal planning include optimization of food choices to meet recommended dietary allowance and dietary reference intake for all micronutrients. Grade E
      • A variety of eating patterns (combinations of different foods or food groups) are acceptable for the management of diabetes. Personal preferences (e.g., tradition, culture, religion, health beliefs and goals, economics) and metabolic goals should be considered when recommending one eating pattern over another. Grade E
      From the 2015 American Diabetes Association Standards of Medical Care in Diabetes

      Strategies for Improving Care
      • A patient-centered communication style that incorporates patient preferences, assesses literacy and numeracy and addresses cultural barriers to care should be used. Grade B
      • Treatment decisions should be timely and founded on evidence-based guidelines that are tailored to individual patient preferences, prognoses and co-morbidities. Grade B

    • Recommendation Strength Rationale

      • The 2013 American Diabetes Association Nutrition Therapy Recommendations received Grade E.
      • The 2015 American Diabetes Association Standards of Medical Care in Diabetes received Grade 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).