![]() To address individual nutrition needs based on personal and cultural preferences, health literacy and numeracy, access to healthful food choices, willingness and ability to make behavioral changes, as well as barriers to change.○ Delay or prevent complications of diabetes Further recommendations for individualization of goals can be found in the ADA Standards of Medical Care in Diabetes ) ○ Improve A1C, blood pressure, and cholesterol levels (goals differ for individuals based on age, duration of diabetes, health history, and other present health conditions. To promote and support healthful eating patterns, emphasizing a variety of nutrient-dense foods in appropriate portion sizes, in order to improve overall health and specifically to:.How is diabetes nutrition therapy defined and provided? Refer people with prediabetes and overweight/obesity to an intensive lifestyle intervention program that includes individualized goal-setting components, such as the Diabetes Prevention Program (DPP) and/or to individualized MNT.ĭiabetes MNT is a covered Medicare benefit and should be adequately reimbursed by insurance and other payers or bundled in evolving value-based care and payment models.ĭPP-modeled intensive lifestyle interventions and individualized MNT for prediabetes should be covered by third-party payers or bundled in evolving value-based care and payment models. Refer adults with diabetes to comprehensive diabetes self-management education and support (DSMES) services according to national standards.ĭiabetes-focused MNT is provided by a registered dietitian nutritionist/registered dietitian (RDN), preferably one who has comprehensive knowledge and experience in diabetes care. Coordinate and align the MNT plan with the overall management strategy, including use of medications, physical activity, etc., on an ongoing basis. Refer adults living with type 1 or type 2 diabetes to individualized, diabetes-focused MNT at diagnosis and as needed throughout the life span and during times of changing health status to achieve treatment goals. EFFECTIVENESS OF DIABETES NUTRITION THERAPY ![]() ![]() Though evidence-based, the recommendations presented are the informed, expert opinions of the authors after consensus was reached through presentation and discussion of the evidence. The consensus report was peer reviewed (see acknowledgments) and suggestions incorporated as deemed appropriate by the authors. In addition to the search results, in select cases the authors identified relevant research to include in reaching consensus. An exception was made to the inclusion criteria for the use of meal studies for the insulin dosing section. ![]() Details on the keywords and the search strategy are reported in the Supplementary Data, emphasizing randomized controlled trials (RCTs), systematic reviews, and meta-analyses of RCTs. The 2014 position statement ( 4) was used as a starting point, and a search was conducted on PubMed for studies published in English between 1 January 2014 and 28 February 2018 to provide the updated evidence of nutrition therapy interventions in nonhospitalized adults with prediabetes and type 1 and type 2 diabetes. Focused teleconference calls, email, and web-based collaboration were also used to reach consensus on final recommendations between November 2018 and January 2019. The authors convened in person for one group meeting and actively participated in monthly teleconference calls between February and November 2018. An outside market research company was used to conduct the literature search and was paid using ADA funds. The authors of this report were chosen following a national call for experts to ensure diversity of the members both in professional interest and cultural background, including a person living with diabetes who served as a patient advocate.
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