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Recommendations Summary

T1DM: Nutrition Assessment (2024)

Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.


  • Recommendation(s)

    T1DM: Nutrition Assessment

    In children and adolescents newly diagnosed with type 1 diabetes, it is reasonable for a registered dietitian nutritionist or international equivalent to complete a thorough nutrition and diabetes education assessment that also considers:

    • Review and assess data from regular screenings for glycemic labs, lipid abnormalities, blood pressure, and celiac disease per American Diabetes Association Standards of Care.
    • Current type 1 diabetes knowledge, skills, competency of required diabetes management.
    • Readiness to change of child/adolescents and their care partners.
    • Barriers to learning.
    • Access to diabetes management tools/resources and medications.
    • Psychosocial needs/barriers, including social support, financial resources.
    • Disordered eating behaviors.
    • Client/family input on glycemic targets.

    Rating: Consensus
    Imperative

    Rating: Consensus
    Imperative

    • Risks/Harms of Implementing This Recommendation

      No obvious harms or risks associated with screening or assessment of individuals for risk of eating disorders, vitamin D status or food insecurity issues. No significant cost may be associated with implementing this recommendation. Two recognized costs are the time and expense that may be required to train RDNs to perform the screening. However, most of the training materials are available in print or online and RDNs are typically familiar with these resources, or they are readily discoverable.

       

    • Conditions of Application

      Significant changes in disease treatment plans warrant full nutrition assessment and newly diagnosed individuals will have different needs compared to follow-up visits. There is the potential that individuals and families with lower socio-economic status will have more difficulty paying for additional expenses that they might incur while managing their children's condition. In these cases, practitioners may offer low-cost options to help them manage their needs.

    • Potential Costs Associated with Application

      No significant cost may be associated with implementing this recommendation. Two recognized costs are the time and expense that may be required to train RDNs to perform the screening. However, most of the training materials are available in print or online and RDNs are typically familiar with these resources, or they are readily discoverable.

    • Recommendation Narrative

      Evidence indicates that periodically evaluating growth, anthropometric parameters, and assessing the nutritional status should be considered during regular follow-up visits of children and adolescents living with T1DM (Grabia 2021, Hill-Briggs 2020). Managing diabetes during childhood and adolescence places a burden on the youth and family, and hence the RDN should conduct ongoing assessments of psychosocial status, social determinants of health, and diabetes distress in the youth and the parents/caregivers during routine diabetes visits (Hill-Briggs 2020, Hagger 2016).

    • Recommendation Strength Rationale

      This recommendation is based on consensus of expert panel members.

    • Minority Opinions

      None.