Landa-Anell María Victoria, Del Razo-Olvera Fabiola M, Bodnar Irene, Cordova-Isidro Brenda, Lagunas-Valdepeña Daniela, Arias-Marroquín Ana T, García-Ulloa Ana Cristina, Melgarejo-Hernández Marco Antonio, Hernández-Jiménez Sergio
Centro de Atención Integral del Paciente con Diabetes (CAIPaDi) del Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Unidad de investigación de Enfermedades Metabólicas del Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Front Nutr. 2024 Oct 18;11:1473429. doi: 10.3389/fnut.2024.1473429. eCollection 2024.
Nutritional diagnosis involves identifying a nutritional problem, its cause, and the signs that indicate it to guide appropriate treatment. Few studies report on the most prevalent nutritional diagnoses in people living with type 2 diabetes (T2D).
To define nutritional diagnoses across different domains and their association with metabolic, anthropometric, and dietary parameters in individuals with T2D.
A personalized nutritional intervention was conducted using the Nutrition Care Process (NCP) model, which encompasses assessment, diagnosis, intervention, and evaluation, utilizing standardized terminology from the Nutrition Care Process Terminology (NCPT). Two dietitians, trained and standardized in applying the NCP and NCPT, performed patient assessments and established the diagnoses. Patients over 18 years old with a diagnosis of T2D for less than 5 years were included.
Data from 2,050 patients were analyzed, of whom 55.3% were women, and 44.7% were men, with a median age of 57 and 54 years, respectively. The most prevalent nutritional diagnosis was excessive energy and carbohydrate intake. Diagnoses were distributed across domains: Intake (55.9%), Behavioral/Environmental (32.7%), Clinical (10.2%), and 1.2% without nutritional diagnosis. Significant intergroup differences were observed in anthropometric variables such as BMI, waist circumference, and body fat percentage ( < 0.05). HbA1c and glucose levels were significantly higher in the Intake and Behavioral groups ( < 0.001). Albumin/creatinine ratio (ACR) was higher in the ingestion group ( = 0.007). Caloric and carbohydrate intake were higher in the ingestion group, while protein and fat intake were higher in the clinical and behavioral groups ( < 0.001).
Nutritional diagnoses in the intake domain, followed by behavioral/ environmental and clinical domains, are highly prevalent in people with T2D and are associated with worse metabolic control, higher BMI, and increased energy and carbohydrate intake. Timely identification of issues in these domains can support targeted nutritional therapy to improve disease management and promote a healthy lifestyle.
https://clinicaltrials.gov/study/NCT02836808?term=caipadi&rank=2, Identifier (NCT02836808).
营养诊断包括识别营养问题、其成因以及表明该问题的体征，以指导适当的治疗。很少有研究报告2型糖尿病（T2D）患者中最常见的营养诊断情况。
确定T2D患者不同领域的营养诊断及其与代谢、人体测量和饮食参数的关联。
使用营养护理流程（NCP）模型进行个性化营养干预，该模型包括评估、诊断、干预和评价，采用营养护理流程术语（NCPT）中的标准化术语。两名接受过NCP和NCPT应用培训并标准化的营养师对患者进行评估并确定诊断。纳入年龄超过18岁、诊断为T2D且病程少于5年的患者。
分析了2050例患者的数据，其中55.3%为女性，44.7%为男性，中位年龄分别为57岁和54岁。最常见的营养诊断是能量和碳水化合物摄入过多。诊断分布在各个领域：摄入（55.9%）、行为/环境（32.7%）、临床（10.2%），1.2%无营养诊断。在人体测量变量如BMI、腰围和体脂百分比方面观察到显著的组间差异（<0.05）。摄入组和行为组的糖化血红蛋白（HbA1c）和血糖水平显著更高（<0.001）。摄入组的白蛋白/肌酐比值（ACR）更高（=0.007）。摄入组的热量和碳水化合物摄入量更高，而临床组和行为组的蛋白质和脂肪摄入量更高（<0.001）。
摄入领域的营养诊断最为普遍，其次是行为/环境和临床领域，在T2D患者中很常见，并且与较差的代谢控制、更高的BMI以及能量和碳水化合物摄入量增加有关。及时识别这些领域的问题有助于进行有针对性的营养治疗，以改善疾病管理并促进健康的生活方式。
https://clinicaltrials.gov/study/NCT02836808?term=caipadi&rank=2，标识符（NCT02836808）。
