Diabetes-specific nutrition algorithm: a transcultural program to optimize diabetes and prediabetes care.
Type 2 diabetes (T2D) and prediabetes have a major global impact through high disease prevalence, significant downstream pathophysiologic effects, and enormous financial liabilities. To mitigate this disease burden, interventions of proven effectiveness must be used. Evidence shows that nutrition therapy improves glycemic control and reduces the risks of diabetes and its complications. Accordingly, diabetes-specific nutrition therapy should be incorporated into comprehensive patient management programs. Evidence-based recommendations for healthy lifestyles that include healthy eating can be found in clinical practice guidelines (CPGs) from professional medical organizations. To enable broad implementation of these guidelines, recommendations must be reconstructed to account for cultural differences in lifestyle, food availability, and genetic factors. To begin, published CPGs and relevant medical literature were reviewed and evidence ratings applied according to established protocols for guidelines. From this information, an algorithm for the nutritional management of people with T2D and prediabetes was created. Subsequently, algorithm nodes were populated with transcultural attributes to guide decisions. The resultant transcultural diabetes-specific nutrition algorithm (tDNA) was simplified and optimized for global implementation and validation according to current standards for CPG development and cultural adaptation. Thus, the tDNA is a tool to facilitate the delivery of nutrition therapy to patients with T2D and prediabetes in a variety of cultures and geographic locations. It is anticipated that this novel approach can reduce the burden of diabetes, improve quality of life, and save lives. The specific Southeast Asian and Asian Indian tDNA versions can be found in companion articles in this issue of Current Diabetes Reports.
Division of Endocrinology, Diabetes, and Bone Disease, Mount Sinai School of Medicine, New York, NY, USA. jeffreymechanick@gmail.com
Jeffrey I
JI
Mechanick
Albert E
AE
Marchetti
Caroline
C
Apovian
Alexander Koglin
AK
Benchimol
Peter H
PH
Bisschop
Alexis
A
Bolio-Galvis
Refaat A
RA
Hegazi
David
D
Jenkins
Enrique
E
Mendoza
Miguel Leon
ML
Sanz
Wayne Huey-Herng
WH
Sheu
Patrizio
P
Tatti
Man-Wo
MW
Tsang
Osama
O
Hamdy
D000465:Algorithms; D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy* / Q000453:epidemiology; D019317:Evidence-Based Medicine; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D044623:Nutrition Therapy / Q000379:methods*; D009752:Nutritional Status; D011236:Prediabetic State / Q000178:diet therapy* / Q000453:epidemiology; D016730:Program Development
D001786:Blood Glucose