Skip to main content
Top

04-01-2019 | Nutritional management | Practical approach | Article

A Practical Guide to Delivering Nutritional Advice to People with Diabetes

Journal: Diabetes Therapy

Author: Pamela A. Dyson

Publisher: Springer Healthcare

Abstract

Dietary advice is fundamental to the management of diabetes. Although ideally such advice should be delivered by a state-registered dietitian, it is more usually delivered by other health professionals. The primary focus for those with type 1 diabetes is carbohydrate counting and insulin adjustment and for the majority of people with type 2 diabetes, weight management is key. Patient-centred care is emphasised for the delivery of dietary advice. It is widely recognised that knowledge alone is not sufficient to induce behaviour change and practical approaches to a variety of behavioural interventions are discussed.
Literature
1.
Dyson PA, Twenefour D, Breen C, et al. Diabetes UK evidence-based nutrition guidelines for the prevention and management of diabetes. Diabet Med. 2018;35(5):541–7.PubMedCrossRef
2.
Evert AB, Boucher JL, Cypress M, et al. Nutrition therapy recommendations for the management of adults with diabetes. Diabetes Care. 2014;37(Suppl 1):S120–43.PubMedCrossRef
3.
Franz MJ, Powers MA, Leontos C, et al. The evidence for medical nutrition therapy for type 1 and type 2 diabetes in adults. J Am Diet Assoc. 2010;110(12):1852–89.PubMedCrossRef
4.
Gillett M, Royle P, Snaith A, et al. Non-pharmacological interventions to reduce the risk of diabetes in people with impaired glucose regulation: a systematic review and economic evaluation. Health Technol Assess. 2012;16(33):1–236.PubMedPubMedCentralCrossRef
5.
Lean ME, Leslie WS, Barnes AC, et al. Primary care-led weight management for remission of type 2 diabetes: (DiRECT): an open-label, cluster-randomised trial. Lancet. 2018;391(10120):541–51.PubMedCrossRef
6.
Briggs Early K, Stanley K. Position of the Academy of Nutrition and Dietetics: The role of medical nutrition therapy and registered dietitian nutritionists in the prevention and treatment of prediabetes and type 2 diabetes. J Acad Nutr Diet. 2018;118(2):343–53.PubMedCrossRef
7.
Winocour PH, Mearing C, Ainsworth A, Williams DR, Association of British Clinical Diabetologists. Association of British Clinical Diabetologists (ABCD): survey of specialist diabetes care services in the UK, 2000. 4. Dietetic services and nutritional issues. Diabet Med. 2002;19(Suppl 4):39–43.
8.
International Diabetes Federation. International charter of rights and responsibilities of people with diabetes. Brussels: IDF; 2013.
9.
American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2019;42(Suppl 1):S46–60.
10.
National institute for Health and Care Excellence. Type 1 diabetes in adults: diagnosis and management (NG17). London: NICE; 2015.
11.
National institute for Health and Care Excellence. Type 2 diabetes in adults: management (NG28). London: NICE; 2015.
13.
Wormersley K, Ripullone K. Medical schools should be prioritising nutrition and lifestyle education. BMJ. 2017;359:j4861.CrossRef
14.
Xu X, Parker D, Ferguson C, Hickman L. Where is the nurse in nutritional care? Contemp Nurse. 2017;53(3):267–70.PubMedCrossRef
15.
Diabetes UK; Douglas Twenefour, personal communication.
16.
Vaz EC, Porfírio GJM, Nunes HRC, Nunes-Nogueira VDS. Effectiveness and safety of carbohydrate counting in the management of adult patients with type 1 diabetes mellitus: a systematic review and meta-analysis. Arch Endocrinol Metab. 2018;62(3):337–45.PubMed
17.
Fu S, Li L, Deng S, Liu Z. Effectiveness of advanced carbohydrate counting in type 1 diabetes mellitus: a systematic review and meta-analysis. Sci Rep. 2016;6:37067.PubMedPubMedCentralCrossRef
18.
19.
Royal Bournemouth Hospital: Bertie type 1 diabetes education programme. https://​www.​bertieonline.​org.​uk. Accessed 18 Oct 2018.
20.
Franz MJ, Boucher JL, Rutten-Ramos S, VanWormer JJ. Lifestyle weight-loss intervention outcomes in overweight and obese adults with type 2 diabetes: a systematic review and meta-analysis of randomized clinical trials. J Acad Nutr Diet. 2015;115(9):1447–63.PubMedCrossRef
21.
Johnston BC, Kanters S, Bandayrel K, et al. Comparison of weight loss among named diet programs in overweight and obese adults: a meta-analysis. JAMA. 2014;312(9):923–33.PubMedCrossRef
22.
Naude CE, Schoonees A, Senekal M, Young T, Garner P, Volmink J. Low carbohydrate versus isoenergetic balanced diets for reducing weight and cardiovascular risk: a systematic review and meta-analysis. PLoS One. 2014;9(7):e100652.PubMedPubMedCentralCrossRef
23.
Thom G, Lean M. Is there an optimal diet for weight management and metabolic health? Gastroenterology. 2017;152(7):1739–51.PubMedCrossRef
24.
Jacob A, Moullec G, Lavoie KL, et al. Impact of cognitive-behavioral interventions on weight loss and psychological outcomes: a meta-analysis. Health Psychol. 2018;37(5):417–32.PubMedCrossRef
25.
Johns DJ, Hartmann-Boyce J, Jebb SA, Aveyard P, Behavioural Weight Management Review Group. Diet or exercise interventions vs combined weight management programs: a systematic review and meta-analysis of direct comparisons. J Acad Nutr Diet. 2014;114(10):1557–68.
26.
Mann J, McLean R, Skeaff M, Morenga LT. Low carbohydrate diets: going against the grain. Lancet. 2014;384(9953):1479–80.PubMedCrossRef
27.
Feinman RD, Pogozelski WK, Astrup A, et al. Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base. Nutrition. 2015;31:1–13.PubMedCrossRef
28.
Richards T, Coulter A, Wicks P. Time to deliver patient centred care. BMJ. 2015;350:h530.PubMedCrossRef
29.
Marvel MK, Epstein RM, Flowers K, Beckman HB. Soliciting the patient’s agenda: have we improved? JAMA. 1999;281(3):283–7.PubMedCrossRef
30.
Eby D. Empathy in general practice: its meaning for patients and doctors. Br J Gen Pract. 2018;68(674):412–3.PubMedCrossRef
31.
Funnell MM, Anderson RM. Empowerment and self-management of diabetes. Clin Diabetes. 2004;22:123–7.CrossRef
32.
Mead N, Bower P. Patient-centredness: a conceptual framework and review of the empirical literature. Soc Sci Med. 2000;51(7):1087–110.PubMedCrossRef
33.
Griffin SJ, Kinmonth AL, Veltman MW, Gillard S, Grant J, Stewart M. Effect on health-related outcomes of interventions to alter the interaction between patients and practitioners: a systematic review of trials. Ann Fam Med. 2004;2(6):595–608.PubMedPubMedCentralCrossRef
34.
Fisher L, Polonsky WH, Hessler D, Potter MB. A practical framework for encouraging and supporting positive behaviour change in diabetes. Diabet Med. 2017;34(12):1658–66.PubMedPubMedCentralCrossRef
35.
Peyrot M, Rubin RR. Behavioral and psychosocial interventions in diabetes: a conceptual review. Diabetes Care. 2007;30(10):2433–40.PubMedCrossRef
36.
Harvey J. Psychosocial interventions for the diabetic patient. Diabetes Metab Syndr Obes. 2015;8:29–43.PubMedPubMedCentralCrossRef
37.
De Jong P, Berg IK. Interviewing for solutions. 3rd ed. Pacific Grove: Brooks/Cole; 2007.
38.
Zhang A, Franklin C, Currin-McCulloch J, Park S, Kim J. The effectiveness of strength-based, solution-focused brief therapy in medical settings: a systematic review and meta-analysis of randomized controlled trials. J Behav Med. 2018;41(2):139–51.PubMedCrossRef
39.
Mason P, Rollnick S, Butler C. Health behaviour change: a practitioner’s guide. 3rd ed. London: Churchill Livingstone; 2018.
40.
Uchendu C, Blake H. Effectiveness of cognitive-behavioural therapy on glycaemic control and psychological outcomes in adults with diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. Diabet Med. 2017;34(3):328–39.PubMedCrossRef
41.
Christie D, Channon S. The potential for motivational interviewing to improve outcomes in the management of diabetes and obesity in paediatric and adult populations: a clinical review. Diabetes Obes Metab. 2014;16(5):381–7.PubMedCrossRef
42.
Ekong G, Kavookjian J. Motivational interviewing and outcomes in adults with type 2 diabetes: a systematic review. Patient Educ Couns. 2016;99(6):944–52.PubMedCrossRef
43.
Shilts MK, Horowitz M, Townsend MS. Goal setting as a strategy for dietary and physical activity and behavior change: a review of the literature. Am J Health Prom. 2004;19(2):81–93.CrossRef
44.
Doran GT. There’s a S.M.A.R.T. way to write management’s goals and objectives. Manag Rev. 1981;70:35–6.
45.
DiClemente CC, Marinilli AS, Singh M, Bellino LE. The role of feedback in the process of health behavior change. Am J Health Behav. 2001;25(3):217–27.PubMedCrossRef
46.
Machry RV, Rados DV, Gregório GR, Rodrigues TC. Self-monitoring blood glucose improves glycemic control in type 2 diabetes without intensive treatment: a systematic review and meta-analysis. Diabetes Res Clin Pract. 2018;142:173–87.PubMedCrossRef
47.
Zhu H, Zhu Y, Leung SW. Is self-monitoring of blood glucose effective in improving glycaemic control in type 2 diabetes without insulin treatment: a meta-analysis of randomised controlled trials. BMJ Open. 2016;6(9):e010524.PubMedPubMedCentralCrossRef
48.
Burke LE, Wang J, Sevick MA. Self-monitoring in weight loss: a systematic review of the literature. J Am Diet Assoc. 2011;111(1):92–102.PubMedPubMedCentralCrossRef
49.
Shieh C, Knisely MR, Clark D, Carpenter JS. Self-weighing in weight management interventions: a systematic review of literature. Obes Res Clin Pract. 2016;10(5):493–519.PubMedCrossRef
50.
Greenwood DA, Gee PM, Fatkin KJ, Peeples M. A systematic review of reviews evaluating technology-enabled diabetes self-management education and support. J Diabetes Sci Technol. 2017;11(5):1015–27.PubMedPubMedCentralCrossRef

Be confident that your patient care is up to date

Medicine Matters is being incorporated into Springer Medicine, our new medical education platform. 

Alongside the news coverage and expert commentary you have come to expect from Medicine Matters diabetes, Springer Medicine's complimentary membership also provides access to articles from renowned journals and a broad range of Continuing Medical Education programs. Create your free account »