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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Autores principales:	Franz MJ, MacLeod J
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	type 2 diabetes nutrition therapy effectiveness intervention recommendations challenges technology Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/691e091ac99b481ebea140e37748fd55
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spelling	oai:doaj.org-article:691e091ac99b481ebea140e37748fd552021-12-02T00:36:14ZSuccess of nutrition-therapy interventions in persons with type 2 diabetes: challenges and future directions1178-7007https://doaj.org/article/691e091ac99b481ebea140e37748fd552018-06-01T00:00:00Zhttps://www.dovepress.com/success-of-nutrition-therapy-interventions-in-persons-with-type-2-diab-peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007Marion 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, technologyFranz MJMacLeod JDove Medical Pressarticletype 2 diabetesnutrition therapyeffectivenessintervention recommendationschallengestechnologySpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 11, Pp 265-270 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	type 2 diabetes nutrition therapy effectiveness intervention recommendations challenges technology Specialties of internal medicine RC581-951
spellingShingle	type 2 diabetes nutrition therapy effectiveness intervention recommendations challenges technology Specialties of internal medicine RC581-951 Franz MJ MacLeod J Success of nutrition-therapy interventions in persons with type 2 diabetes: challenges and future directions
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
format	article
author	Franz MJ MacLeod J
author_facet	Franz MJ MacLeod J
author_sort	Franz MJ
title	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_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_sort	success of nutrition-therapy interventions in persons with type 2 diabetes: challenges and future directions
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/691e091ac99b481ebea140e37748fd55
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Success of nutrition-therapy interventions in persons with type 2 diabetes: challenges and future directions

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