Transculturalization of a diabetes-specific nutrition algorithm: Asian application.
The prevalence of type 2 diabetes (T2D) in Asia is growing at an alarming rate, posing significant clinical and economic risk to health care stakeholders. Commonly, Asian patients with T2D manifest a distinctive combination of characteristics that include earlier disease onset, distinct pathophysiology, syndrome of complications, and shorter life expectancy. Optimizing treatment outcomes for such patients requires a coordinated inclusive care plan and knowledgeable practitioners. Comprehensive management starts with medical nutrition therapy (MNT) in a broader lifestyle modification program. Implementing diabetes-specific MNT in Asia requires high-quality and transparent clinical practice guidelines (CPGs) that are regionally adapted for cultural, ethnic, and socioeconomic factors. Respected CPGs for nutrition and diabetes therapy are available from prestigious medical societies. For cost efficiency and effectiveness, health care authorities can select these CPGs for Asian implementation following abridgement and cultural adaptation that includes: defining nutrition therapy in meaningful ways, selecting lower cutoff values for healthy body mass indices and waist circumferences (WCs), identifying the dietary composition of MNT based on regional availability and preference, and expanding nutrition therapy for concomitant hypertension, dyslipidemia, overweight/obesity, and chronic kidney disease. An international task force of respected health care professionals has contributed to this process. To date, task force members have selected appropriate evidence-based CPGs and simplified them into an algorithm for diabetes-specific nutrition therapy. Following cultural adaptation, Asian and Asian-Indian versions of this algorithmic tool have emerged. The Asian version is presented in this report.
Department of Dietetics, Taipei Medical University Hospital, Taipei, Taiwan.
Hsiu-Yueh
HY
Su
Man-Wo
MW
Tsang
Shih-Yi
SY
Huang
Jeffrey I
JI
Mechanick
Wayne H-H
WH
Sheu
Albert
A
Marchetti
D000465:Algorithms; D001208:Asia / Q000453:epidemiology; D044466:Asian People; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy* / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D008019:Life Style; D008297:Male; D044623:Nutrition Therapy / Q000379:methods; D009765:Obesity / Q000178:diet therapy* / Q000453:epidemiology / Q000517:prevention & control; D011236:Prediabetic State / Q000178:diet therapy* / Q000453:epidemiology / Q000517:prevention & control