Document Detail

Guidelines vs practice in the delivery of diabetes nutrition care.
MedLine Citation:
PMID:  8417090     Owner:  NLM     Status:  MEDLINE    
The American Dietetic Association and the American Diabetes Association have published recommendations for the nutrition care of people with diabetes. However, the frequency of this care is rarely documented. As part of a study of diabetes care and education practices, the Michigan Diabetes Research and Training Center collected extensive data from 440 randomly selected adults who receive diabetes care from community physicians. These data provided a basis for comparison between diabetes nutrition care as recommended and as delivered in typical American communities. In this population (mean age = 61 years; 54% women), 89% (393) had non-insulin-dependent diabetes mellitus (NIDDM). Of these, 152 were managed with insulin (NIDDM/I) and 241 were not managed with insulin (NIDDM/NI). Most of the NIDDM/NI group was overweight (71%) and had elevated levels of glycated hemoglobin (62%) and serum cholesterol (53%). Yet they were significantly less likely than those with NIDDM/I to see a dietitian. The most frequently reported reason for not seeing a dietitian was that a physician had not referred them (53%). More than 90% of those with NIDDM/I or NIDDM/NI who were referred to a dietitian saw one. Because this population was from randomly selected communities, physicians, and patients, the results are probably generalizable to other regions of the United States. This study shows that in community practice, insulin use is the primary marker of the need for nutrition intervention, and the lack of physician referral to a dietitian is an important barrier to people receiving recommended diabetes nutrition care.
M S Arnold; C J Stepien; G E Hess; R G Hiss
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American Dietetic Association     Volume:  93     ISSN:  0002-8223     ISO Abbreviation:  J Am Diet Assoc     Publication Date:  1993 Jan 
Date Detail:
Created Date:  1993-01-22     Completed Date:  1993-01-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7503061     Medline TA:  J Am Diet Assoc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  34-9     Citation Subset:  AIM; IM    
Michigan Diabetes Research and Training Center, University of Michigan Medical School, Ann Arbor 48109-0201.
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MeSH Terms
Age Factors
Aged, 80 and over
Body Mass Index
Cholesterol / blood
Delivery of Health Care*
Diabetes Mellitus, Type 1 / diet therapy*
Diabetes Mellitus, Type 2 / diet therapy*
Dietary Services*
Educational Status
Hemoglobin A, Glycosylated / analysis
Interviews as Topic
Middle Aged
Random Allocation
Grant Support
Reg. No./Substance:
0/Hemoglobin A, Glycosylated; 57-88-5/Cholesterol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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