Success of nutrition-therapy interventions in persons with type 2 diabetes: challenges and future directions
Marion J Franz,1 Janice MacLeod2 1Nutrition Concepts by Franz, Minneapolis, MN, 2Clinical Innovation, WellDoc, Columbia, MD, USA Abstract: A systematic review was conducted by the Academy of Nutrition and Dietetics to determine the evidence for the effectiveness of individualized nutrition therapy p...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2018-06-01
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| Series: | Diabetes, Metabolic Syndrome and Obesity |
| Subjects: | |
| Online Access: | https://www.dovepress.com/success-of-nutrition-therapy-interventions-in-persons-with-type-2-diab-peer-reviewed-article-DMSO |
| _version_ | 1797935318516629504 |
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| author | Franz MJ MacLeod J |
| author_facet | Franz MJ MacLeod J |
| author_sort | Franz MJ |
| collection | DOAJ |
| description | Marion J Franz,1 Janice MacLeod2 1Nutrition Concepts by Franz, Minneapolis, MN, 2Clinical Innovation, WellDoc, Columbia, MD, USA Abstract: A systematic review was conducted by the Academy of Nutrition and Dietetics to determine the evidence for the effectiveness of individualized nutrition therapy provided by a dietitian nutritionist and evidence-based (EB) nutrition-therapy interventions in adults with diabetes. This article briefly reviews the systematic process used and summarizes the effectiveness evidence and intervention recommendations. In persons with type 2 diabetes (T2D), 18 studies met study criteria for the effectiveness question. A 0.3%–2.0% decrease from baseline in glycated hemoglobin was reported at 3 months in 13 study arms, a 0.3%–1.8% decrease at 6 months in 12 study arms, a 0.3%–1.6% decrease at 12 months with ongoing support in six study arms, and a 0.6%–1.8% decrease at >12 months in four study arms. An initial series of encounters with follow-up visits and implementation of a variety of nutrition-therapy interventions, all of which reduced energy intake, were reported. Nutrition therapy also significantly decreased doses or number of glucose-lowering medications used and resulted in improvements in quality of life. Mixed effects on cardiovascular risk factors and body weight were reported. Fourteen questions were identified related to nutrition-therapy interventions. A total of 38 studies met study criteria for the nutrition-intervention questions, from which 30 conclusion statements and 19 nutrition-practice guideline recommendations for T2D were written. Three additional NPG recommendations for T2D were written based on evidence reviewed by the American Diabetes Association. The 22 nutrition-intervention recommendations for T2D are summarized. How to implement nutrition-practice guideline recommendations effectively by health care providers and individuals with T2D remains challenging. Of importance, it is recognized that identifying and integrating EB digital health-technology tools into clinical practice are major challenges for future management of diabetes, self-management education, and support. Keywords: nutrition therapy, dietitian nutritionists, systematic review, effectiveness, interventions, implementation, technology |
| first_indexed | 2024-04-10T18:13:41Z |
| format | Article |
| id | doaj.art-691e091ac99b481ebea140e37748fd55 |
| institution | Directory Open Access Journal |
| issn | 1178-7007 |
| language | English |
| last_indexed | 2024-04-10T18:13:41Z |
| publishDate | 2018-06-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Diabetes, Metabolic Syndrome and Obesity |
| spelling | doaj.art-691e091ac99b481ebea140e37748fd552023-02-02T10:06:15ZengDove Medical PressDiabetes, Metabolic Syndrome and Obesity1178-70072018-06-01Volume 1126527038750Success of nutrition-therapy interventions in persons with type 2 diabetes: challenges and future directionsFranz MJMacLeod JMarion J Franz,1 Janice MacLeod2 1Nutrition Concepts by Franz, Minneapolis, MN, 2Clinical Innovation, WellDoc, Columbia, MD, USA Abstract: A systematic review was conducted by the Academy of Nutrition and Dietetics to determine the evidence for the effectiveness of individualized nutrition therapy provided by a dietitian nutritionist and evidence-based (EB) nutrition-therapy interventions in adults with diabetes. This article briefly reviews the systematic process used and summarizes the effectiveness evidence and intervention recommendations. In persons with type 2 diabetes (T2D), 18 studies met study criteria for the effectiveness question. A 0.3%–2.0% decrease from baseline in glycated hemoglobin was reported at 3 months in 13 study arms, a 0.3%–1.8% decrease at 6 months in 12 study arms, a 0.3%–1.6% decrease at 12 months with ongoing support in six study arms, and a 0.6%–1.8% decrease at >12 months in four study arms. An initial series of encounters with follow-up visits and implementation of a variety of nutrition-therapy interventions, all of which reduced energy intake, were reported. Nutrition therapy also significantly decreased doses or number of glucose-lowering medications used and resulted in improvements in quality of life. Mixed effects on cardiovascular risk factors and body weight were reported. Fourteen questions were identified related to nutrition-therapy interventions. A total of 38 studies met study criteria for the nutrition-intervention questions, from which 30 conclusion statements and 19 nutrition-practice guideline recommendations for T2D were written. Three additional NPG recommendations for T2D were written based on evidence reviewed by the American Diabetes Association. The 22 nutrition-intervention recommendations for T2D are summarized. How to implement nutrition-practice guideline recommendations effectively by health care providers and individuals with T2D remains challenging. Of importance, it is recognized that identifying and integrating EB digital health-technology tools into clinical practice are major challenges for future management of diabetes, self-management education, and support. Keywords: nutrition therapy, dietitian nutritionists, systematic review, effectiveness, interventions, implementation, technologyhttps://www.dovepress.com/success-of-nutrition-therapy-interventions-in-persons-with-type-2-diab-peer-reviewed-article-DMSOtype 2 diabetesnutrition therapyeffectivenessintervention recommendationschallengestechnology |
| spellingShingle | Franz MJ MacLeod J Success of nutrition-therapy interventions in persons with type 2 diabetes: challenges and future directions Diabetes, Metabolic Syndrome and Obesity type 2 diabetes nutrition therapy effectiveness intervention recommendations challenges technology |
| title | Success of nutrition-therapy interventions in persons with type 2 diabetes: challenges and future directions |
| title_full | Success of nutrition-therapy interventions in persons with type 2 diabetes: challenges and future directions |
| title_fullStr | Success of nutrition-therapy interventions in persons with type 2 diabetes: challenges and future directions |
| title_full_unstemmed | Success of nutrition-therapy interventions in persons with type 2 diabetes: challenges and future directions |
| title_short | Success of nutrition-therapy interventions in persons with type 2 diabetes: challenges and future directions |
| title_sort | success of nutrition therapy interventions in persons with type 2 diabetes challenges and future directions |
| topic | type 2 diabetes nutrition therapy effectiveness intervention recommendations challenges technology |
| url | https://www.dovepress.com/success-of-nutrition-therapy-interventions-in-persons-with-type-2-diab-peer-reviewed-article-DMSO |
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