Article type
Year
Abstract
Background:
Several organizations have developed clinical practice guidelines (CPGs) to guide patients with T2DM for nutrition management. However, these CPGs recommendations may be inconsistent, and little is known about their quality.
Objectives:
To systematically review the consistency of globally available nutritional recommendations for managing T2DM and assessed their methodological and reporting quality.
Methods:
PubMed, China Biology Medicine disc (CBM), and four main guideline websites were searched for T2DM CPGs and nutritional recommendations. Four researchers independently assessed their methodological and reporting quality using the AGREE II instrument and RIGHT checklist and extracted nutritional recommendations on managing T2DM.
Results:
Fifteen CPGs involved 65 nutritional recommendations regarding six topics. Finally, eight CPGs (six broad and two nutrition specific guidelines) were classified as recommended for clinical practice. The 15 CPGs adhered to less than 60% of RIGHT checklist items. The AGREE II instrument and the RIGHT checklist should be endorsed and used by CPG developers to ensure higher quality and adequate use of their products. Seven CPGs support lifestyle modification to achieve modest weight loss and energy balance. The general recommendations regarding macronutrient intake for T2DM range: carbohydrates 45–60% total energy, fat: 25%–35% total energy, protein: 15–20% total energy. However, the ideal macronutrient distribution for the management of diabetes may vary, depending on the quality of the various macronutrients, the goals of the dietary treatment regimen and the individual’s values and preferences. Three CPGs recommend integration of food and dietary pattern-based approaches such as dietary patterns emphasizing dietary pulses (e.g. beans, peas, chickpeas, and lentils), fruit and vegetables and nuts. Specific functional foods are not recommended by two CPGs. Eight CPGs recommended vitamin or mineral supplementation are necessary unless malnourished. Based on three recommendations given in six CPGs, a cultural context may influence recommendations on alcohol drinking from.
Conclusions:
The AGREE instrument and the RIGHT reporting checklist should be endorsed and used by CPG developers to ensure higher quality and adequate use of their products. The ideal amount of the nutrition for the management of diabetes may vary, depending on the goals of the dietary treatment regimen, the cultural context and the individual’s values and preferences.
Patient or healthcare consumer involvement:
Not applicable
Several organizations have developed clinical practice guidelines (CPGs) to guide patients with T2DM for nutrition management. However, these CPGs recommendations may be inconsistent, and little is known about their quality.
Objectives:
To systematically review the consistency of globally available nutritional recommendations for managing T2DM and assessed their methodological and reporting quality.
Methods:
PubMed, China Biology Medicine disc (CBM), and four main guideline websites were searched for T2DM CPGs and nutritional recommendations. Four researchers independently assessed their methodological and reporting quality using the AGREE II instrument and RIGHT checklist and extracted nutritional recommendations on managing T2DM.
Results:
Fifteen CPGs involved 65 nutritional recommendations regarding six topics. Finally, eight CPGs (six broad and two nutrition specific guidelines) were classified as recommended for clinical practice. The 15 CPGs adhered to less than 60% of RIGHT checklist items. The AGREE II instrument and the RIGHT checklist should be endorsed and used by CPG developers to ensure higher quality and adequate use of their products. Seven CPGs support lifestyle modification to achieve modest weight loss and energy balance. The general recommendations regarding macronutrient intake for T2DM range: carbohydrates 45–60% total energy, fat: 25%–35% total energy, protein: 15–20% total energy. However, the ideal macronutrient distribution for the management of diabetes may vary, depending on the quality of the various macronutrients, the goals of the dietary treatment regimen and the individual’s values and preferences. Three CPGs recommend integration of food and dietary pattern-based approaches such as dietary patterns emphasizing dietary pulses (e.g. beans, peas, chickpeas, and lentils), fruit and vegetables and nuts. Specific functional foods are not recommended by two CPGs. Eight CPGs recommended vitamin or mineral supplementation are necessary unless malnourished. Based on three recommendations given in six CPGs, a cultural context may influence recommendations on alcohol drinking from.
Conclusions:
The AGREE instrument and the RIGHT reporting checklist should be endorsed and used by CPG developers to ensure higher quality and adequate use of their products. The ideal amount of the nutrition for the management of diabetes may vary, depending on the goals of the dietary treatment regimen, the cultural context and the individual’s values and preferences.
Patient or healthcare consumer involvement:
Not applicable