• Intervention
    How effective is MNT provided by Registered Dietitians in the management of persons with type 1 and type 2 diabetes?
    • Conclusion

      MNT has its greatest impact at diagnosis of diabetes.  Eight studies evaluating the effectiveness of diabetes MNT at three to six months, reported reductions in A1C, ranging from 0.25% to 2.9%, depending on the type and duration of diabetes. Individual sessions ranging from one to five or a series of 10 to 12 group sessions were employed. A variety of nutrition therapy interventions, such as a reduced energy and fat intake, carbohydrate counting, simplified meal plans, healthy food choices, individualized meal planning strategies, exchange lists, insulin-to-carbohydrate ratios and behavioral strategies were implemented. The number of initial and follow-up sessions varies in all the studies.  Studies reporting on effectiveness of MNT from six to twelve months  report a variety in the number and type of MNT sessions that lead to improved outcomes. Therefore, the RD needs to determine what is appropriate for individual clients.  Seven studies report sustained improvements in A1C at 12 months and longer. All involved regular sessions with an RD, ranging from monthly to three sessions per year. Seven studies report improvements in other outcomes, such as improved lipid profiles, weight management, decreased need for medications and reduced risk for onset and progression of comorbidities.

    • 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.
    • Search Plan and Results: Effectiveness of MNT by RDs 2006