Medical nutrition therapy for gestational diabetes mellitus in Australia: What has changed in 10 years and how does current practice compare with best practice?
Background The present study aimed to report Australian dietetic practice regarding management of gestational diabetes mellitus (GDM) and to make comparisons with the findings from a 2009 survey of dietitians and with the Academy of Nutrition and Dietetics Evidence‐Based Nutrition Practice Guideline...
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| Veröffentlicht in: | Journal of human nutrition and dietetics 2022-12, Vol.35 (6), p.1059-1070 |
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| container_title | Journal of human nutrition and dietetics |
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| creator | Barnes, Robyn A. Morrison, Melinda Flack, Jeff R. Ross, Glynis P. Smart, Carmel E. Collins, Clare E. MacDonald‐Wicks, Lesley |
| description | Background
The present study aimed to report Australian dietetic practice regarding management of gestational diabetes mellitus (GDM) and to make comparisons with the findings from a 2009 survey of dietitians and with the Academy of Nutrition and Dietetics Evidence‐Based Nutrition Practice Guidelines (NPG).
Methods
Cross‐sectional surveys were conducted in 2019 and 2009 of dietitians providing medical nutrition therapy (MNT) to women with GDM in Australia. The present study compares responses on demographics, dietetic assessment and interventions, and guideline use in 2019 vs. 2009.
Results
In total, 149 dietitians (2019) and 220 (2009) met survey inclusion criteria. In both surveys >60% of respondents reported dietary interventions aiming for >45% energy from carbohydrate, 15%–25% energy from protein and 15%–30% energy from fat. Many variations in MNT found in 2009 continued to be evident in 2019, including the percentage of energy from carbohydrate aimed for (30%–65% in 2019 vs. 20%–75% in 2009) and the wide range in the recommended minimum daily carbohydrate intake (40–220 and 60–300 g). Few dietitians reported aiming for the NPG minimum of 175 g of carbohydrate daily in both surveys (32% in 2019 vs. 26% in 2009). There were, however, some significant increases in MNT consistent with NPG recommendations in 2019 vs. 2009, including the minimum frequency of visits provided (49%, n = 61 vs. 33%, n = 69; p |
| doi_str_mv | 10.1111/jhn.13013 |
| format | Article |
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The present study aimed to report Australian dietetic practice regarding management of gestational diabetes mellitus (GDM) and to make comparisons with the findings from a 2009 survey of dietitians and with the Academy of Nutrition and Dietetics Evidence‐Based Nutrition Practice Guidelines (NPG).
Methods
Cross‐sectional surveys were conducted in 2019 and 2009 of dietitians providing medical nutrition therapy (MNT) to women with GDM in Australia. The present study compares responses on demographics, dietetic assessment and interventions, and guideline use in 2019 vs. 2009.
Results
In total, 149 dietitians (2019) and 220 (2009) met survey inclusion criteria. In both surveys >60% of respondents reported dietary interventions aiming for >45% energy from carbohydrate, 15%–25% energy from protein and 15%–30% energy from fat. Many variations in MNT found in 2009 continued to be evident in 2019, including the percentage of energy from carbohydrate aimed for (30%–65% in 2019 vs. 20%–75% in 2009) and the wide range in the recommended minimum daily carbohydrate intake (40–220 and 60–300 g). Few dietitians reported aiming for the NPG minimum of 175 g of carbohydrate daily in both surveys (32% in 2019 vs. 26% in 2009). There were, however, some significant increases in MNT consistent with NPG recommendations in 2019 vs. 2009, including the minimum frequency of visits provided (49%, n = 61 vs. 33%, n = 69; p < 0.001) and provision of gestational weight gain advice (59%, n = 95 vs. 40%, n = 195; p < 0.05).
Conclusions
Although many dietitians continue to provide MNT consistent with existing NPG, there is a need to support greater uptake, especially for recommendations regarding carbohydrate intake.
Key points
Consistencies continue a decade later in broad education topics covered for gestational diabetes mellitus.
Variations in dietetic practice remain, especially regarding carbohydrate recommendations and frequency of review visits.
Adherence to some Nutrition Practice Guidelines (NPG) (2016) recommendations remain low, especially regarding minimum carbohydrate intake.
Adherence to NPG recommendations increased for the minimum frequency of visits provided and provision of gestational weight gain advice.
There is a need to further increase medical nutrition therapy consistent with existing NPG, especially for recommendations regarding carbohydrate intake.</description><identifier>ISSN: 0952-3871</identifier><identifier>EISSN: 1365-277X</identifier><identifier>DOI: 10.1111/jhn.13013</identifier><identifier>PMID: 35384099</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Australia ; Best practice ; Body weight gain ; Carbohydrates ; Clinical Practice ; Cross-Sectional Studies ; Diabetes mellitus ; Diabetes, Gestational - therapy ; Diet ; Dietetics ; Dietitians ; Energy ; Female ; Gestational diabetes ; Guidelines ; Humans ; medical nutrition therapy ; Nutrition ; Nutrition Therapy ; Polls & surveys ; Pregnancy ; Surveys ; Therapy</subject><ispartof>Journal of human nutrition and dietetics, 2022-12, Vol.35 (6), p.1059-1070</ispartof><rights>2022 The Authors. published by John Wiley & Sons Ltd on behalf of British Dietetic Association.</rights><rights>2022 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.</rights><rights>2022. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4433-19bd8500c2b95e9d5d9d229916cfcf143373479137b942f3a7508e346ed9e6fc3</citedby><cites>FETCH-LOGICAL-c4433-19bd8500c2b95e9d5d9d229916cfcf143373479137b942f3a7508e346ed9e6fc3</cites><orcidid>0000-0003-3298-756X ; 0000-0002-7738-0940</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjhn.13013$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjhn.13013$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35384099$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Barnes, Robyn A.</creatorcontrib><creatorcontrib>Morrison, Melinda</creatorcontrib><creatorcontrib>Flack, Jeff R.</creatorcontrib><creatorcontrib>Ross, Glynis P.</creatorcontrib><creatorcontrib>Smart, Carmel E.</creatorcontrib><creatorcontrib>Collins, Clare E.</creatorcontrib><creatorcontrib>MacDonald‐Wicks, Lesley</creatorcontrib><title>Medical nutrition therapy for gestational diabetes mellitus in Australia: What has changed in 10 years and how does current practice compare with best practice?</title><title>Journal of human nutrition and dietetics</title><addtitle>J Hum Nutr Diet</addtitle><description>Background
The present study aimed to report Australian dietetic practice regarding management of gestational diabetes mellitus (GDM) and to make comparisons with the findings from a 2009 survey of dietitians and with the Academy of Nutrition and Dietetics Evidence‐Based Nutrition Practice Guidelines (NPG).
Methods
Cross‐sectional surveys were conducted in 2019 and 2009 of dietitians providing medical nutrition therapy (MNT) to women with GDM in Australia. The present study compares responses on demographics, dietetic assessment and interventions, and guideline use in 2019 vs. 2009.
Results
In total, 149 dietitians (2019) and 220 (2009) met survey inclusion criteria. In both surveys >60% of respondents reported dietary interventions aiming for >45% energy from carbohydrate, 15%–25% energy from protein and 15%–30% energy from fat. Many variations in MNT found in 2009 continued to be evident in 2019, including the percentage of energy from carbohydrate aimed for (30%–65% in 2019 vs. 20%–75% in 2009) and the wide range in the recommended minimum daily carbohydrate intake (40–220 and 60–300 g). Few dietitians reported aiming for the NPG minimum of 175 g of carbohydrate daily in both surveys (32% in 2019 vs. 26% in 2009). There were, however, some significant increases in MNT consistent with NPG recommendations in 2019 vs. 2009, including the minimum frequency of visits provided (49%, n = 61 vs. 33%, n = 69; p < 0.001) and provision of gestational weight gain advice (59%, n = 95 vs. 40%, n = 195; p < 0.05).
Conclusions
Although many dietitians continue to provide MNT consistent with existing NPG, there is a need to support greater uptake, especially for recommendations regarding carbohydrate intake.
Key points
Consistencies continue a decade later in broad education topics covered for gestational diabetes mellitus.
Variations in dietetic practice remain, especially regarding carbohydrate recommendations and frequency of review visits.
Adherence to some Nutrition Practice Guidelines (NPG) (2016) recommendations remain low, especially regarding minimum carbohydrate intake.
Adherence to NPG recommendations increased for the minimum frequency of visits provided and provision of gestational weight gain advice.
There is a need to further increase medical nutrition therapy consistent with existing NPG, especially for recommendations regarding carbohydrate intake.</description><subject>Australia</subject><subject>Best practice</subject><subject>Body weight gain</subject><subject>Carbohydrates</subject><subject>Clinical Practice</subject><subject>Cross-Sectional Studies</subject><subject>Diabetes mellitus</subject><subject>Diabetes, Gestational - therapy</subject><subject>Diet</subject><subject>Dietetics</subject><subject>Dietitians</subject><subject>Energy</subject><subject>Female</subject><subject>Gestational diabetes</subject><subject>Guidelines</subject><subject>Humans</subject><subject>medical nutrition therapy</subject><subject>Nutrition</subject><subject>Nutrition Therapy</subject><subject>Polls & surveys</subject><subject>Pregnancy</subject><subject>Surveys</subject><subject>Therapy</subject><issn>0952-3871</issn><issn>1365-277X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><recordid>eNp1kVGP1CAUhYnRuOPqg3_AkPiiD92FUkrxYc1mo65m1ReNvhEKt1MmbalAncy_8afKOOtETeSFhPPlcO49CD2m5Izmc77ppzPKCGV30IqymhelEF_vohWRvCxYI-gJehDjhhBSU0LuoxPGWVMRKVfox3uwzugBT0sKLjk_4dRD0PMOdz7gNcSk96-ZsE63kCDiEYbBpSViN-HLJaagB6df4C-9TrjXEZteT2uwe5kSvAMdItaTxb3fYuuzgVlCgCnhOWiTnAFs_DjrAHjrUo_b_OdRevkQ3ev0EOHR7X2KPr9-9enqurj5-Obt1eVNYaqKsYLK1jacEFO2koO03EpbllLS2nSmoxkRrBKSMtHKquyYFpw0wKoarIS6M-wUXRx856UdwZqcL8-l5uBGHXbKa6f-VibXq7X_rqSQpGYyGzy7NQj-25JnUKOLJq9KT-CXqMq6EjXnFaUZffoPuvFLyDvOlGCCMNqIJlPPD5QJPsYA3TEMJWrfu8q9q1-9Z_bJn-mP5O-iM3B-ALZugN3_ndS76w8Hy59IrLni</recordid><startdate>202212</startdate><enddate>202212</enddate><creator>Barnes, Robyn A.</creator><creator>Morrison, Melinda</creator><creator>Flack, Jeff R.</creator><creator>Ross, Glynis P.</creator><creator>Smart, Carmel E.</creator><creator>Collins, Clare E.</creator><creator>MacDonald‐Wicks, Lesley</creator><general>Blackwell Publishing Ltd</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T7</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-3298-756X</orcidid><orcidid>https://orcid.org/0000-0002-7738-0940</orcidid></search><sort><creationdate>202212</creationdate><title>Medical nutrition therapy for gestational diabetes mellitus in Australia: What has changed in 10 years and how does current practice compare with best practice?</title><author>Barnes, Robyn A. ; Morrison, Melinda ; Flack, Jeff R. ; Ross, Glynis P. ; Smart, Carmel E. ; Collins, Clare E. ; MacDonald‐Wicks, Lesley</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4433-19bd8500c2b95e9d5d9d229916cfcf143373479137b942f3a7508e346ed9e6fc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Australia</topic><topic>Best practice</topic><topic>Body weight gain</topic><topic>Carbohydrates</topic><topic>Clinical Practice</topic><topic>Cross-Sectional Studies</topic><topic>Diabetes mellitus</topic><topic>Diabetes, Gestational - therapy</topic><topic>Diet</topic><topic>Dietetics</topic><topic>Dietitians</topic><topic>Energy</topic><topic>Female</topic><topic>Gestational diabetes</topic><topic>Guidelines</topic><topic>Humans</topic><topic>medical nutrition therapy</topic><topic>Nutrition</topic><topic>Nutrition Therapy</topic><topic>Polls & surveys</topic><topic>Pregnancy</topic><topic>Surveys</topic><topic>Therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Barnes, Robyn A.</creatorcontrib><creatorcontrib>Morrison, Melinda</creatorcontrib><creatorcontrib>Flack, Jeff R.</creatorcontrib><creatorcontrib>Ross, Glynis P.</creatorcontrib><creatorcontrib>Smart, Carmel E.</creatorcontrib><creatorcontrib>Collins, Clare E.</creatorcontrib><creatorcontrib>MacDonald‐Wicks, Lesley</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of human nutrition and dietetics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Barnes, Robyn A.</au><au>Morrison, Melinda</au><au>Flack, Jeff R.</au><au>Ross, Glynis P.</au><au>Smart, Carmel E.</au><au>Collins, Clare E.</au><au>MacDonald‐Wicks, Lesley</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Medical nutrition therapy for gestational diabetes mellitus in Australia: What has changed in 10 years and how does current practice compare with best practice?</atitle><jtitle>Journal of human nutrition and dietetics</jtitle><addtitle>J Hum Nutr Diet</addtitle><date>2022-12</date><risdate>2022</risdate><volume>35</volume><issue>6</issue><spage>1059</spage><epage>1070</epage><pages>1059-1070</pages><issn>0952-3871</issn><eissn>1365-277X</eissn><abstract>Background
The present study aimed to report Australian dietetic practice regarding management of gestational diabetes mellitus (GDM) and to make comparisons with the findings from a 2009 survey of dietitians and with the Academy of Nutrition and Dietetics Evidence‐Based Nutrition Practice Guidelines (NPG).
Methods
Cross‐sectional surveys were conducted in 2019 and 2009 of dietitians providing medical nutrition therapy (MNT) to women with GDM in Australia. The present study compares responses on demographics, dietetic assessment and interventions, and guideline use in 2019 vs. 2009.
Results
In total, 149 dietitians (2019) and 220 (2009) met survey inclusion criteria. In both surveys >60% of respondents reported dietary interventions aiming for >45% energy from carbohydrate, 15%–25% energy from protein and 15%–30% energy from fat. Many variations in MNT found in 2009 continued to be evident in 2019, including the percentage of energy from carbohydrate aimed for (30%–65% in 2019 vs. 20%–75% in 2009) and the wide range in the recommended minimum daily carbohydrate intake (40–220 and 60–300 g). Few dietitians reported aiming for the NPG minimum of 175 g of carbohydrate daily in both surveys (32% in 2019 vs. 26% in 2009). There were, however, some significant increases in MNT consistent with NPG recommendations in 2019 vs. 2009, including the minimum frequency of visits provided (49%, n = 61 vs. 33%, n = 69; p < 0.001) and provision of gestational weight gain advice (59%, n = 95 vs. 40%, n = 195; p < 0.05).
Conclusions
Although many dietitians continue to provide MNT consistent with existing NPG, there is a need to support greater uptake, especially for recommendations regarding carbohydrate intake.
Key points
Consistencies continue a decade later in broad education topics covered for gestational diabetes mellitus.
Variations in dietetic practice remain, especially regarding carbohydrate recommendations and frequency of review visits.
Adherence to some Nutrition Practice Guidelines (NPG) (2016) recommendations remain low, especially regarding minimum carbohydrate intake.
Adherence to NPG recommendations increased for the minimum frequency of visits provided and provision of gestational weight gain advice.
There is a need to further increase medical nutrition therapy consistent with existing NPG, especially for recommendations regarding carbohydrate intake.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>35384099</pmid><doi>10.1111/jhn.13013</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-3298-756X</orcidid><orcidid>https://orcid.org/0000-0002-7738-0940</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Australia Best practice Body weight gain Carbohydrates Clinical Practice Cross-Sectional Studies Diabetes mellitus Diabetes, Gestational - therapy Diet Dietetics Dietitians Energy Female Gestational diabetes Guidelines Humans medical nutrition therapy Nutrition Nutrition Therapy Polls & surveys Pregnancy Surveys Therapy |
| title | Medical nutrition therapy for gestational diabetes mellitus in Australia: What has changed in 10 years and how does current practice compare with best practice? |
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