Registered dietitians play essential role in effective management of diabetes in adults

Proper nutrition therapy is essential for the successful management of type 1 and type 2 diabetes and registered dietitians (RDs) can play a key role as part of the health care team.

An article in the December issue of the Journal of the American Dietetic Association reviews the evidence and nutrition practice recommendations presented in the American Dietetic Association Nutrition Practice Guidelines for Type 1 and Type 2 Diabetes in Adults. This complete and systematic review presents 29 key nutrition practice guidelines in order to best support people with diabetes.

According to Marion J Franz, MS, RD, lead author and noted nutrition consultant, “This publication has reviewed the process for developing the guidelines, identified major and contributing factors for diabetes nutrition therapy, reviewed and summarized research, and stated the nutrition practice recommendations that are to be integrated into the nutrition care process. The nutrition practice guidelines provide recommendations for assessing client/patient needs and for selecting interventions, monitoring and evaluating outcomes. The evidence is strong that medical nutrition therapy provided by RDs is an effective and essential therapy in the management of diabetes. RDs are uniquely skilled in this process.”

The authors conducted a thorough review of the research literature to distill evidence-based nutrition recommendations and practice guidelines regarding the major nutrition therapy factors – carbohydrates (intake, sucrose, non-nutritive sweeteners, glycemic index, fiber), protein intake, cardiovascular disease, and weight management. Armed with information regarding what works and why, RDs can encourage lifestyle changes and select appropriate interventions based on key recommendations that include consistency in day-to-day carbohydrate intake, adjusting insulin doses to match carbohydrate intake, substitution of sucrose-containing foods, usual protein intake, cardioprotective nutrition interventions, weight management strategies, regular physical activity, and use of self-monitored blood glucose data.

Key recommendations:

Consistency in day-to-day carbohydrate intake for persons with type 2 diabetes

Adjusting insulin dose to match carbohydrate intake for persons with type 1 diabetes
Focusing on total carbohydrate intake rather than the type of carbohydrate

Cardio protective nutrition interventions
Weight management strategies
Regular physical activity
Use of self glucose monitoring data to determine if goals are being met
The article is “The Evidence for Medical Nutrition Therapy for Type 1 and Type 2 Diabetes in Adults” by Marion J Franz, MS, RD; Margaret A Powers, PhD, RD; Carolyn Leontos, MS, RD; Lea Ann Holzmeister, RD; Karmeen Kulkarni, MS, RD; Arlene Monk, RD; Naomi Wedel, MS, RD; and Erica Gradwell, MS, RD. It appears in the Journal of the American Dietetic Association, Volume 110 Issue 12 (December 2010) published by Elsevier.

In an accompanying podcast interview lead author Marion J Franz, MS, RD, and Kari Kren, MPH, RD, LD, Manager, Evidence-based Practice, Research & Strategic Business Development, ADA, discuss the importance and implications of “The Evidence for Medical Nutrition Therapy for Type 1 and Type 2 Diabetes in Adults.” It is available at http://adajournal.org/content/podcast.