FNCE 2023
Session 357. Providing MNT for the Pediatric Type 1 Diabetes Population: What Does the Evidence Show?
Monday, October 9, 8:30 AM - 9:30 AM
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  • Assessment
    In healthy adults, what is the acceptable coefficient of variation (CV) in oxygen consumption (vO2) and carbon dioxide (vCO2) production to reflect Steady State (SS) measure conditions and predict RMR?
    • Conclusion

      Use of a 10-minute protocol with 10% CV in vO2 and vCO2/minute using Steady State (SS) conditions and discarding the first 5 minutes of measurement, produces reliable results with minimal patient burden in an ambulatory, healthy population.

       

    • Grade: II
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    In older or medically-stable or chronically ill adults living at home, what is the acceptable coefficient of variation (CV) in oxygen consumption (vO2) and carbon dioxide (VCO2) production to reflect Steady State (SS) measure conditions and predict RMR?
    • Conclusion

      There are no studies reporting on steady state or coefficient of variation in these populations.

    • Grade: V
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    In U.S.-residing non-white ethnic groups, what is the acceptable coefficient of variation (CV) in oxygen consumption (vO2) and carbon dioxide (VCO2) production to reflect Steady State (SS) measure conditions and predict RMR?
    • Conclusion

      Although minimal or no representation, this conclusion statement can be generalized to include U.S.-residing ethnic groups of African Americans, Asian and Pacific Islanders, American Indians, Alaskan Natives and Hispanic populations.

    • Grade: IV
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    In critically ill, ventilated patients, what is the acceptable coefficient of variation (CV) in oxygen consumption (vO2) and carbon dioxide (VCO2) production to reflect Steady State (SS) measure conditions and predict RMR?
    • Conclusion

      For critically-ill, ventilator dependent patients, attaining 5-minute measures at <5% CV or 30-minutes with <10% CV provide results comparable to longer duration measures of energy expenditure, and the 5-minute and 30-minute measures are highly correlated. Sedation has a significant positive impact on successfully achieving the SS criteria. For spontaneously breathing, critically ill patients, the 5-minute SS protocol produces reliable RMR with minimal patient burden.

    • Grade: I
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    In chronically ill and medically stable institutionalized adults, what is the acceptable coefficient of variation (CV) in oxygen consumption (vO2) and carbon dioxide (VCO2) production to reflect Steady State (SS) measure conditions and predict RMR?
    • Conclusion

      There are no studies reporting on steady state or coefficient of variation in these populations.

    • Grade: V
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.