PDM: Introduction (2014)

Guideline Overview

Guideline Title

Prevention of Type 2 Diabetes (2014) Evidence-Based Nutrition Practice Guideline

Purpose

The focus of this guideline is on medical nutrition therapy (MNT) for individuals who are at high risk for type 2 diabetes, such as individuals with prediabetes and adults with metabolic syndrome.

The primary goals of MNT are to improve glycemic control and minimize the impact of other comorbidities, such as obesity, hypertension and disorders of lipid metabolism, in order to prevent progression to type 2 diabetes.

Guideline Development

This guideline is intended for use by registered dietitian nutritionists (RDNs) involved in providing medical nutrition therapy (MNT) for individuals who are at high risk for type 2 diabetes. The application of the guideline must be individualized to assist the RDN to successfully integrate MNT into the overall medical management of persons at high risk for type 2 diabetes. The recommendations in the guideline are based on a systematic review of the literature and the work performed by the Academy of Nutrition and Dietetics Expert Working Group on Prevention of Type 2 Diabetes, and/or recommendations from the evidence-based guidelines developed by the American Diabetes Association and Project IMAGE, A European Evidence-Based Guideline for the Prevention of Type 2 Diabetes.

Recommendations include:

Screen for Type 2 Diabetes Risk
MNT for Prevention of Type 2 Diabetes in High Risk Groups
Assessment in High Risk Groups
Weight Loss and Prevention of Type 2 Diabetes
Nutrition Prescription for Macronutrients
Fiber and Prevention of Type 2 Diabetes
Whole Grains and Prevention of Type 2 Diabetes
Vegetable-based Protein and Prevention of Type 2 Diabetes
Type of Fat and Prevention of Type 2 Diabetes
Fruits and Vegetables and Prevention of Type 2 Diabetes
Sugar and Prevention of Type 2 Diabetes
Glycemic Index/Glycemic Load and Prevention of Type 2 Diabetes
Physical Activity and Prevention of Type 2 Diabetes
Nutrition-related Effects of Medications
Nutrition Counseling
Coordination of Care
Monitoring and Evaluation in High Risk Groups

The number of supporting documents for these topics is below:

Recommendations: 17
Conclusion Statements: 108
Evidence Summaries: 108
Article Worksheets: 300

Revision

All Academy guidelines are revised every five years. The literature search will begin for each guideline topic three years after publication to identify new research that has been published since the previous search was completed. An expert workgroup will convene to determine the need for new and revised recommendations. See Revision under Guideline Development for more information. The updated guideline will be developed using the Academy of Nutrition and Dietetics Evidence Analysis Process (see EAL Policy and Process tab).

New research may warrant a revision to a specific question or recommendation prior to the full project or guideline revision. Once identified, information is gathered and the Evidence-Based Practice Committee will make a decision on the appropriate action.

Contraindications

Clinical judgment is crucial in the application of these guidelines. People planning interventions should consider what adaptations may be needed for different ethnic groups (particularly with regard to culturally-specific dietary advice), people with physical limitations and people with mental health problems.
Careful consideration should be given to the application of these guidelines for patients with significant medical co-morbidities.

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