Diabetes and prediabetes are serious chronic diseases affecting over 133 million Americans or approximately 43% of the U.S. population, but, unfortunately, more than 23% of people with diabetes are undiagnosed and 38% of U.S. adults have prediabetes with only a third aware of it (Centers for Disease Control and Prevention, 2021). It is costly in both economic terms and its impact on an individual’s quality of life. Clinical trials and outcomes research report that diabetes medical nutrition therapy (MNT) provided by Registered Dietitian Nutritionists (RDNs) and delivered using a variety of nutrition interventions and multiple encounters is effective in improving glycemia and other metabolic outcomes (American Diabetes Association, 2024e;Franz, 2017a). However, for RDNs to be effective clinicians and educators requires not only knowledge and skills in diabetes nutrition therapy, but also in the overall management of diabetes and in effective diabetes education and counseling. By developing these competencies, MNT can be integrated effectively into diabetes management. This allows the person with diabetes flexibility in lifestyle and improved quality of life while still achieving and maintaining metabolic goals. The goal of this continuing education program is to provide the information and skills needed by dietetic/nutrition professionals to develop these competencies.

Chapter 1 discusses the classifications, screening, and diagnosis of prediabetes and diabetes. Chapter 2 outlines lifestyle interventions for the prevention of diabetes and obesity management. Chapter 3 reviews the management of diabetes, beginning with a review of the goals of diabetes therapy. The section on MNT reviews MNT goals and outcomes and nutrition-related interventions that have been shown to be effective. Also summarized are the roles of physical activity, medications—both glucose-lowering medications and insulin, self-management education and support, and how diabetes is monitored. Another section discusses the role of technology and data-informed, continuous, on-demand care and education. Chapter 4 provides an overview of the acute complications of diabetes—hypo- and hyperglycemia—and the role of nutrition therapy in treatment and prevention. The long-term complications of diabetes and MNT for macrovascular disease, hypertension, microvascular disease, and nephropathy are discussed in chapter 5. Issues related to nutrition therapy for preexisting diabetes and pregnancy and for gestational diabetes are covered in chapter 6.

The implementation of MNT for diabetes is a primary responsibility for RDNs and implementation of MNT and the role of RDNs beyond MNT are addressed in chapter 7. Implementation steps as outlined in the Nutrition Care Process (NCP) include nutrition assessment, nutrition diagnosis, nutrition intervention (planning and implementation), nutrition monitoring and evaluation. Chapter 7 also includes a brief discussion of the implementation of nutrition interventions in healthcare facilities. A case study provides the opportunity to apply the overall information gained from the learning program to clinical situations.

This continuing education activity is designed to help you earn 20.0 continuing education credits for dietetics (CDR CPEU).