Nutritional Management Of Diabetes Research Articles

Nurses’ knowledge, attitudes, and practice with regards to nutritional management of diabetes mellitus

BackgroundThe prevalence of diabetes is increasing rapidly worldwide. Nurses work collaboratively with multidisciplinary teams to improve diabetes management. Yet, little is known about nurses’ role in nutritional management of diabetes. This study aimed to evaluate nurses’ knowledge, attitudes, and practice (KAP) toward nutritional management of diabetes.MethodsThis cross-sectional study was conducted with 160 nurses, who were recruited between July 4 and July 18, 2021 from two referral tertiary teaching hospitals in Iran. A validated paper-based self-reported questionnaire was used to assess nurses’ KAP. Data were analyzed using descriptive statistics and multiple linear regression analysis.ResultsThe mean knowledge score of nurses about nutritional management of diabetes was 12.16 ± 2.83, and 61.2% showing a moderate knowledge level on nutritional management of diabetes. The mean attitudes score was 60.68 ± 6.11, with 86.92% of participants demonstrating positive attitudes. The mean practice score of study participants was 44.74 ± 7.81, with 51.9% having a moderate level of practice. Higher knowledge scores were observed among male nurses (B = -7.55, p = 0.009) and those with blended learning as a preferred learning method (B = 7.28, p = 0.029). Having an opportunity to provide education to patients with diabetes during shifts affected nurses’ attitudes positively (B = -7.59, p = 0.017). Practice scores were higher among nurses who perceived themselves competent in the nutritional management of diabetes (B = -18.05, p = 0.008).ConclusionNurses’ knowledge and practice in the nutritional management of diabetes should be increased to help improve the quality of the dietary care and patient education they provide these patients. Further studies are needed to confirm the results of this study both in Iran and internationally.

Knowledge, attitude, and practice of the 2009 Institute of Medicine (IOM) recommendations on the nutritional management of diabetes in pregnancy: an online national survey

AimsAs recommended by the Institute of Medicine (IOM), health practitioners should encourage a healthy nutrition and adequate weight gain during pregnancy in order to ensure favorable pregnancy and fetal outcomes, and to prevent diseases later in life for both mother and child. The purpose of this online survey was to determine the knowledge, attitude, and practice of the 2009 IOM recommendations among healthcare professionals managing nutritional therapy in pregnancies complicated by diabetes in Italy.MethodsA cross-sectional survey was conducted by using an online self-administered questionnaire undertaken between October and December 2021.ResultsOf the 220 participants 89% were diabetologists/endocrinologists/internal medicine specialists and 11% dietitians/nutritionists. The survey found that the 53% of respondents provide a personalized diet to pregnant women with diabetes, while 32% a standard diet plan and only 15% healthy dietary advice. The 69% of the participants investigated for appropriate gestational weight gain, mainly based on pre-pregnancy BMI (96%), gestational weight gain (GWG) at first prenatal visit (80%) and presence of twin pregnancy (58%). Maternal weight gain was evaluated at each regularly scheduled prenatal visit and compared with IOM recommendations for the 87% of healthcare professionals. Diet plan was periodically re-evaluated and/or modified (90% of participants), based on inadequate maternal weight gain and/or fetal growth abnormalities (78%), trimester transition (53%), changes in physical activity and/or a “feel hungry” (50%).ConclusionsThis survey reported the knowledge and attitude of IOM guidelines and the nutritional knowledge and practice of Italian professionals on the nutritional management of diabetes in pregnancy. The application of these recommendations seemed more feasible in clinics/team dedicated to "Diabetes in Pregnancy".

Nutrition knowledge and attitude of Babcock University medical and nursing students and Inter-professional collaboration with Dietitians in patient care

Objective: The study assessed nutrition knowledge and attitude of final year medical and nursing students and inter-professional collaboration with dietitians in the management of patients. Methodology: This cross-sectional study of all final year medical and nursing and Babcock University students collected quantitative data using a structured questionnaire that contains sections on nutrition instruction hours, knowledge, attitude, and barriers to nutrition. Data obtained was analyzed using the Statistical Package for Social Sciences (SPSS) version 20. Statistics were significant at p<0.05. Result: A total of 159 students participated in the study, 73 medical students and 86 nursing students. The proportion of those who had good, average, and poor knowledge scores were 50.3%, 39%, and 10.7% respectively. The attitude towards nutrition was positive. There was no significant relationship between nutrition knowledge and nutrition instruction hours during pre-clinical (P=0.368) and clinical years (P=0.245). Conclusion: Significant proportions of the students had good nutrition knowledge, however, there were gaps in knowledge in clinical nutrition; nutritional management of diabetes, hypertension, and renal diseases, respectively. There was a high positive attitude towards nutrition among the students but nutrition education was not perceived as sufficient to adequately prepare them for nutrition care of patients. Insufficient training for doctors and nurses, lack of confidence in the efficacy of the intervention of dietitians/nutritionists, and Lack of interest from patients to see the dietitian were the prominent barriers to inter-professional collaboration with dietitians/nutritionists.

Nutritional self-care practices and skills of patients with diabetes mellitus: A study at a tertiary hospital in Ghana

Nutritional management decreases and/or prevents the complications and deaths associated with diabetes mellitus. However, the majority of patients living with diabetes do not engage in optimal nutritional management of diabetes because they see it as the most difficult aspect of managing the condition. This study aimed to explore and describe the practices and skills on nutritional management of diabetes mellitus among patients living with diabetes attending a Ghanaian hospital. This study employed an exploratory, descriptive qualitative research design. Fifteen participants were recruited using purposive sampling, and interviewed with a semi-structured interview guide. Content analysis was performed on the data gathered, following which three main themes emerged. More than two-thirds of the participants of this study had adequate meal planning skills, ate the right quantity of foods, engaged in healthy eating habits, and consumed healthy sources of carbohydrates, fats and protein when eating. However, more than half of the participants had insufficient knowledge and skills in the reading and usage of food labels. The participants of this study largely engaged in optimal nutritional management of diabetes due to their healthy dietary practices and preferences. It is recommended that health care professionals in Ghana find practical and robust ways to factor the reading and usage of food labels into the care and management of patients with diabetes.

Assessing nurses’ knowledge levels in the nutritional management of diabetes

Although nutrition education for diabetes patients is the responsibility of dieticians and/or nutritionist, nurses have an important role to play. This study measured the knowledge level of nurses’ and associated factors in the nutritional management of diabetes. In this cross-sectional study a sample of 200 nurses completed a 21-item nutritional management of diabetes knowledge test developed based on the ADA and WHO guidelines for the nutritional management of diabetes. Using Cronbach's alpha, reliability was 0.62. The nurses (n=200) had almost a 1:1 male to female ratio (n=99, 49.5% and n=101, 50.5%) and a mean age of 27.24±3.66 years. Total mean score was 12.13±3.17 (44.9% correct). Over 70% of the nurses said diabetes patients could exclude any of the major nutrients from their meals. Almost 90% (n=179) of the nurses did not know the recommended daily caloric intake of carbohydrates for diabetes patients. Higher mean scores were found in nurses who have ever had a refresher course in nutrition, ever counseled a diabetes patient and took 2–3 nutrition courses during school. Nurses’ knowledge in the nutritional management of diabetes was poor. It raises questions about the adequacy of nurses’ knowledge in the nutritional management of diabetes.

3.15 Nutritional management of diabetes in childhood.

3.15 Nutritional management of diabetes in childhood.

Development of a diabetes mellitus nutritional management manual for South African healthcare professionals

Background: The objective was to develop a standardised education manual for healthcare professionals in South Africa on the nutritional management of diabetes mellitus.Method: The manual was developed using seven steps: needs assessment and problem definition, a literature search, the first draft of the manual, peer review, the second draft of the manual, expert panel evaluation and the final manual.Results: Following the literature search, the first draft of the manual was developed and sent for peer review and language editing. Recommended changes were made and the second draft was developed and sent to 77 dietitians, of whom the majority were satisfied with the content, which led to the final manual.Conclusion: A diabetes mellitus nutritional management manual for healthcare professionals in South Africa was developed using a systematic approach using peer review and expert panels. The next step will be to evaluate its impact on the knowledge of healthcare professionals.

The second Diabetes Attitudes Wishes and Needs (DAWN2) study: Insights into nutritional management of diabetes in India

The second Diabetes Attitudes Wishes and Needs (DAWN2) study: Insights into nutritional management of diabetes in India

The need for additional training for nutritional management of diabetes

The purpose of this study was to investigate nurses' and nursing students'knowledge and perceived role in assisting patients with the nutritional management of diabetes. Three focus groups were conducted and the results were used to modify a previously developed survey regarding the nutritional management of diabetes. The survey was administered via an online survey tool and completed by 231 nurses and students. Over 70% of respondents agreed that nurses have an important role in reinforcing patient nutritional education. Results indicated,however, that knowledge gaps in the nutritional management of diabetes exist among nurses, including not knowing the carbohydrate content of 120ml of orange juice, a common treatment for hypoglycaemia (47.5%), not knowing where to locate carbohydrate content on a food label (60%), and not identifying the correct treatment for hypoglycaemia (47.5%). These results indicate that there may be a need to improve the nutritional education of nurses with respect to diabetes management.

Diabetes UK evidence‐based nutrition guidelines for the prevention and management of diabetes

This article summarizes the Diabetes UK evidence-based guidelines for the prevention of Type 2 diabetes and nutritional management of diabetes. It describes the development of the recommendations and highlights the key changes from previous guidelines. The nutrition guidelines include a series of recommendations for the prevention of Type 2 diabetes, nutritional management of Type 1 and Type 2 diabetes, weight management, management of microvascular and macrovascular disease, hypoglycaemia management, and additional considerations such as nutrition support, end-of-life care, disorders of the pancreas, care of the older person with diabetes, nutrition provided by external agencies and fasting. The evidence-based recommendations were graded using the Scottish Intercollegiate Guidelines Network methodology and, in a small number of topic areas, where strong evidence was lacking, the recommendations were reached by consensus. The Diabetes UK 2011 guidelines place an emphasis on carbohydrate management and a more flexible approach to weight loss, unlike previous guidelines which were expressed in terms of recommendations for individual nutrient intakes. Additionally, the guidelines for alcohol have been aligned to national recommendations. The full evidence-based nutrition guidelines for the prevention and management of diabetes are available from: http://www.diabetes.org.uk/nutrition-guidelines.

Journal of Diabetes News

<i>Journal of Diabetes</i> News

The Role Of Carbohydrate In Diabetic Nutrition: A Review

This review looks at the definition of carbohydrate and its classification; the type and effect of food processing that affect blood glucose and insulin response to carbohydrate. The glycaemic index of carbohydrate food and its role in nutritional management of diabetes was emphasized. The goals of MNT in diabetes management were briefly mentioned.

Canadian Dietitians’ Use and PerceptionsOf Glycemic Index in Diabetes Management

Several health organizations, including the Canadian Diabetes Association, advocate use of the glycemic index (GI) in the nutritional management of diabetes. However, the clinical utility and applications of the GI remain controversial. Our goal was to determine, via a postal survey, whether dietitians were using the GI and barriers to its use if they were not. This cross-sectional study was conducted in 2003. Members of Dietitians of Canada and the Ordre professionnel des diététistes du Québec (n=6,060) were first contacted by mail to identify those working with individuals with diabetes. Among respondents (n=2,857), 1,805 worked with individuals with diabetes and were sent a questionnaire. Using Chi-square analyses, users and nonusers were compared for their professional characteristics, perceived benefits, barriers, general knowledge about the concept, and confidence in teaching the GI. Among questionnaire respondents (n=1,057), 39% (n=415) used the GI and 61% (n=642) did not. Overall, users were more likely to have a greater diabetes patient caseload, perceived greater benefits and had greater confidence in teaching the concept. Nonusers cited lack of teaching tools and lack of knowledge on how to teach the concept as major barriers. Further research is required to identify the clinical reasoning that triggers dietitians to apply the concept in their practice.

A touch of sugar: A multimedia case study to facilitate student dietitians learning about the clinical management of diabetes

This paper describes the development, implementation and evaluation of a multimedia case study on dietetic case management of diabetes. A multimedia web-based program was developed to use the interactive capacity of the web-based environment to enable student dietitians to develop the skills of clinical reasoning and to trigger their learning about the nutritional management of diabetes. A case study of a person with diabetes was developed using a simulated medical history, video clips and sound clips. The students were asked to manage the patient online by responding to the patient's questions, attending a team meeting and outpatient clinic, attending to food service tasks and responding to visual cues. Tutors were able to access the student's responses to submissions online. Evaluation of the program was by questionnaire, which gathered quantitative and qualitative data on the student's perceptions of their experiences in using the web-based case. The students rated the content and the interactive parts of the case highly but experienced technical difficulties and found the case took too much time to complete.

Nutrition and diabetes in the Asia-Pacific region with reference to cardiovascular disease.

In many parts of the Asia-Pacific region, diabetes prevalence is increasing and seems destined to become a major risk factor for cardiovascular disease. The phenomenon seems predicated on insulin resistance (IR), partly attributable to an early impact of abdominal (visceral) adiposity than in Caucasian populations. Food intake along with physical activity and emotional stress are all determinants of glycaemic status. The glycaemic index (GI) of foods indicates that a number of food factors other than glucose content are important for good glycaemic response to foods and meals. These include (i) low GI foods could also be ones low in fat, (ii) foods that have the lowest GI which include lentils, pasta, noodles, multigrain breads and some fruits (e.g. grapefruit, plums) and (iii) fruits are to be preferred to their juices. The nutritional management of diabetes is best served by counselling changes in a sociocultural context and step-wise fashion by negotiation rather than prescription. It needs to be accompanied by advice to engage in regular physical activity, both aerobic and strength training. The same concept applies to the prevention of abdominal adiposity and diabetes mellitus type II in the Asia-Pacific region, but with particular reference to protective regional food.

Nutritional Management of Diabetes in Home Care

Medical nutrition therapy is a vital component of nutritional management of diabetes in home health care. Many studies document the cost-saving and therapeutic benefit of nutrition intervention in diabetes care. Home health care agencies need to have dietitians on staff for nutrition assessment, counseling, and development of individual patient care plans. Dietitians can help to train nurses and home health care aides in interdisciplinary patient care that incorporates the 1994 nutrition recommendations and principles for people with diabetes mellitus. There are benefits and barriers to home health care nutrition visits, and providing medical nutrition therapy to home health care patients with diabetes can bring about lasting, permanent change.

NUTRITIONAL MANAGEMENT OF DIABETES

The ideal therapeutic diet for diabetes mellitus is currently unknown; however, it continues as a cornerstone of treatment for this complex disease. Dietary guidelines dictate a prudent, healthy diet that is recommended for all healthy people, with or without diabetes. Individuals with diabetes are counseled according to their life-style demands and presence of complications. In fact, there may be as many diets for diabetes as people with diabetes, based on the many manifestations, presentations, and complications of diabetes mellitus. Nutrition research in diabetes is a viable pursuit and will continue to generate interest and further modifications until the cure for diabetes is found.

A realistic approach to the nutritional management of diabetes in home health care

In this article the author focuses on the nutritional management of diabetes in situations where access to a dietitian may be limited. Consequently, the home health care provider must assess the day-to-day knowledge and application of appropriate nutritional man agement. The author presents information on the concepts of when to eat, what kind of food to eat, how much food to eat, how to prepare the food, and how to purchase food. Patient education resources as well as tables on desirable body weight and assessing per cent of calories from fat are also included.

Newer Concepts of the Causes and Treatment of Diabetes Mellitus.

This book, containing a symposium on diabetics, sponsored by the New York Diabetic Association, contains several articles of interest to the pediatrician, especially the following: "The Action of Insulin," by W. C. Stadie; "The Hyperglycemic Glycogenolytic Factor of Pancreas," by Gerald A. Wrenshall; "Indications for the Use of Various Insulins," by Franklin B. Peck; "The Management of Diabetes During Pregnancy," by David Hurwitz; "The Effects of Life Situations and Emotions Upon the Management of Diabetes," by Lawrence E. Hinkle Jr.; "The Nutritional Management of Diabetes," by Herbert Pollack. The book is printed in large type, so that it is very readable.