Monk A, Barry B, McClain K, Weaver T, Cooper N, Franz M J
International Diabetes Center, Park Nicollet Medical Foundation, Minneapolis, Minn. 55416, USA.
J Am Diet Assoc. 1995 Sep;95(9):999-1006; quiz 1007-8. doi: 10.1016/s0002-8223(95)00274-x.
Nutrition practice guidelines define a systematic approach for medical nutrition therapy (MNT) provided by dietitians and are derived from scientific evidence and expert opinion. Nutrition practice guidelines for persons with non-insulin-dependent diabetes mellitus (NIDDM) can be implemented for those with newly diagnosed or previously diagnosed NIDDM at the first visit to a dietitian for initial or ongoing MNT. The guidelines apply to patients treated with MNT alone, MNT and oral glucose-lowering agents, or MNT and insulin. They provide a framework to assist the dietitian in the assessment, intervention (nutrition prescription, education, goal setting), and evaluation of outcomes for MNT. Minimum referral data for clinical decision making and outcome criteria are defined. Basic nutrition care is defined as one visit with the dietitian. Nutrition practice guidelines care consists of a series of visits with the dietitian. At the second follow-up visit, the dietitian assesses what has been accomplished with the nutrition interventions. If the patient has implemented the nutrition recommendations to the best of his or her ability and has not achieved the treatment goals, the dietitian should notify the physician and recommend that changes in medical management are needed. Ongoing nutrition care is recommended at 6-month to 1-year intervals for both basic and practice guidelines care.
营养实践指南定义了营养师提供医学营养治疗（MNT）的系统方法，这些指南源自科学证据和专家意见。非胰岛素依赖型糖尿病（NIDDM）患者的营养实践指南可应用于首次就诊营养师接受初始或持续MNT的新诊断或既往诊断的NIDDM患者。这些指南适用于仅接受MNT治疗、接受MNT和口服降糖药治疗或接受MNT和胰岛素治疗的患者。它们提供了一个框架，以协助营养师进行MNT的评估、干预（营养处方、教育、目标设定）和结果评估。定义了临床决策和结果标准的最低转诊数据。基本营养护理定义为与营养师进行一次就诊。营养实践指南护理包括与营养师进行一系列就诊。在第二次随访就诊时，营养师评估营养干预取得了哪些成效。如果患者已尽最大能力实施了营养建议但未达到治疗目标，营养师应通知医生并建议需要改变医疗管理。对于基本护理和实践指南护理，建议每6个月至1年进行一次持续营养护理。
