Diabetes nutrition recommendations for health care institutions.

T he “Nutrition Recommendations and Principles for People with Diabetes Mellitus” (1,2) provide diabetes medical nutrition therapy (MNT) guidelines for individuals living in a home setting; however, they do not include information about how to incorporate the recommendations into health care facilities. Health care facilities are defined as institutions providing acute and longterm medical and nursing care for people with diabetes. The purpose of the technical review (3) and position statement is to provide recommendations and suggestions regarding how the recommendations may be translated for health care institutions. The position paper is based on the technical review, which discusses published research and issues that remain unresolved. For some issues, limited studies are available on which to base the suggested recommendations. In these instances, consensus was reached by the American Diabetes Association (ADA) task force that was charged with addressing these concerns. Central to the nutrition recommendations is the need to individualize MNT, integrate nutrition into the overall diabetes management plan, and use an interdisciplinary team approach. Nutrition recommendations for people with diabetes are based on nutrition assessment, desired treatment outcomes, and modification of usual food intake. Measurement and documentation of desired outcomes—medical, clinical, educational, psychosocial—are essential and provide the information needed to evaluate how well MNT has been integrated into the overall diabetes management plan. Primary goals of MNT for diabetes are to attain and maintain optimal metabolic control (glucose, lipids, and blood pressure), prevent and treat the chronic complications of diabetes, improve overall health through healthy food choices and optimal nutrition, and address individual needs. There are numerous strategies that can be used to implement and achieve these goals.