Diabetes in Adults: Medical Nutrition Therapy

Biochemical data, medical tests and medication usage:

• Type of diabetes
• Glycemic control (target glucose and A1C levels are noted in the annual American Diabetes Association Standards of Medical Care in Diabetes)
• Lipid profiles
• Blood pressure
• Stage of chronic kidney disease
• Use of glucose-and lipid-lowering medications, anti-hypertensive medications, prescription and other over-the-counter medications, herbal supplements and complementary or alternative medications.

Nutrition-focused physical findings:

• Height, weight, BMI and waist circumference
• Injection sites
• Relative importance of weight management.

Client history:

• General health and demographic information
• Social history
• Cultural preferences
• Health literacy and numeracy
• Education and occupation
• Knowledge, beliefs, attitudes, motivation, readiness to change, self-efficacy and willingness and ability to make behavioral changes
• Physical activity
• Patient or family nutrition-related medical and health history
• Other medical or surgical treatments
• Previous nutrition care services and MNT recommendations.

Food and nutrition-related history:

• Food, beverage and nutrient intake including energy intake, serving sizes, meal-snack patterns, carbohydrate, fiber, types and amounts of fat, protein, micronutrient intake and alcohol intake
• Experience with food, previous and current food and nutrition history, eating environment, access to healthy foods and eating out.

Assessment of the patient’s psychological and social situation should be included as an ongoing part of the medical management of diabetes, which may include, but is not limited to, attitudes about the illness, expectations for medical management and outcomes, affect and mood, general and diabetes-related quality of life, resources (financial, social and emotional), and psychiatric history, as well as addressing common co-morbid conditions that may complicate diabetes management.