11
Nutrition Monitoring and Evaluation
DM: Monitor and Evaluate Effectiveness of MNT
➤ The RDN should monitor and evaluate the following in adults with type
1 diabetes and type 2 diabetes, to determine the effectiveness of MNT:
Biochemical data, medical tests and medication usage:
• Glycemic control (target glucose and A1C levels are noted in the annual
American Diabetes Association Standards of Medical Care in Diabetes)
• Results of glucose monitoring
• Lipid profiles
• Blood pressure
• Stage of chronic kidney disease
• Use of glucose-and lipid-lowering medications, anti-hypertensive
medications, prescription and other over-the-counter medications, herbal
supplements and complementary or alternative medications.
Nutrition-focused physical findings:
• Height, weight, BMI and waist circumference
• Injection sites
• Relative importance of weight management.
Client history:
• Knowledge, beliefs, attitudes, motivation, readiness to change, self-
efficacy and willingness and ability to make behavioral changes
• Physical activity
• Other medical or surgical treatments.
Food and nutrition-related history:
• Food, beverage and nutrient intake including energy intake, serving
sizes, meal-snack patterns, carbohydrate, fiber, types and amounts of fat,
protein, micronutrient intake and alcohol intake
• Eating environment, access to healthy foods and eating out.
Monitoring and evaluation of the patient's psychological and social
situation should be included as an ongoing part of the medical
management of diabetes, which may include but is not limited to
attitudes about the illness, expectations for medical management and
outcomes, affect or mood, general and diabetes-related quality of life,
resources (financial, social and emotional) and psychiatric history, as
well as addressing common co-morbid conditions that may complicate
diabetes management. (Fair, Imperative)
