Nutritional Recommendations for Type 2 Diabetes: An International Review of 15 Guidelines

Published:September 01, 2022DOI:



      Recommendations for patients with type 2 diabetes mellitus (T2DM) from clinical practice guidelines (CPGs) may be inconsistent, and little is known about their quality. Our aim in this study was to systematically review the consistency of globally available CPGs containing nutritional recommendations for T2DM and to assess the quality of their methodology and reporting.


      PubMed, China Biology Medicine and 4 main guideline websites were searched. Four researchers independently assessed quality of the methodology and reporting using the Appraisal of Guidelines for Research and Evaluation, second edition (AGREE II) instrument and the Reporting Items for Practice Guidelines in HealThcare (RIGHT) checklist.


      Fifteen CPGs include 65 nutritional recommendations with 6 sections: 1) body weight and energy balance; 2) dietary eating patterns; 3) macronutrients; 4) micronutrients and supplements; 5) alcohol; and 6) specific, functional foods. Current nutritional recommendations for patients with T2DM on specific elements and amounts are not completely consistent in different CPGs and fail to assign the specific supporting evidence and strength of recommendations. To use nutritional recommendations to guide and manage patients with T2DM, it is important to address the current challenges by establishing a solid evidence base and indicating the strength of recommendations. Overall, 8 CPGs classified as recommended for clinical practice used AGREE II. Fifteen CPGs adhere to <60% of RIGHT checklist items.


      High-quality evidence is needed to potentially close knowledge gaps and strengthen the recommendation. The AGREE II instrument along with the RIGHT checklist should be endorsed and used by CPG developers to ensure higher quality and adequate use of their products.



      On sait que les recommandations des lignes directrices de pratique clinique (LDPC) destinées aux patients atteints du diabète sucré de type 2 (DST2) peuvent être contradictoires, mais on en sait peu sur leur qualité. L’objectif de notre étude était d’examiner de façon systématique la cohérence des LDPC disponibles dans le monde entier qui contiennent des recommandations nutritionnelles lors de DST2 et d’évaluer la qualité de leur méthodologie et de leurs rapports.


      Nous avons effectué des recherches dans PubMed, China Biology Medicine et les 4 principaux sites Web de lignes directrices. Quatre chercheurs ont évalué de façon indépendante la qualité de la méthodologie et des rapports à l’aide de l’outil Appraisal of Guidelines for Research and Evaluation, deuxième édition (AGREE II) et de la liste de vérification Reporting Items for Practice Guidelines in HealThcare (RIGHT).


      Quinze LDPC regroupaient 65 recommandations nutritionnelles en 6 sections : 1) le poids corporel et le bilan énergétique; 2) les habitudes de consommation alimentaire; 3) les macronutriments; 4) les micronutriments et les suppléments; 5) l’alcool; 6) les aliments fonctionnels ou particuliers. Les recommandations nutritionnelles actuelles destinées aux patients atteints du DST2 concernant les éléments et les quantités spécifiques ne sont pas entièrement cohérentes entre les différentes LDPC et ne fournissent pas de données probantes à l’appui ni la force des recommandations. En vue d’utiliser les recommandations nutritionnelles pour orienter et prendre en charge les patients atteints du DST2, il est important de surmonter les difficultés actuelles en établissant un corpus de données scientifiques solides et en indiquant la force des recommandations. Dans l’ensemble, 8 LDPC classifiées selon les recommandations de pratique clinique utilisaient AGREE II. Quinze LDPC adhèrent à < 60 % des questions de la liste de vérification RIGHT.


      Des données probantes de haute qualité sont nécessaires pour potentiellement combler les lacunes en matière de connaissances et renforcer les recommandations. Les auteurs des LDPC devraient approuver et appliquer l’outil AGREE II parallèlement à la liste de vérification RIGHT afin de garantir une qualité accrue et une utilisation adéquate de leurs produits.


      Mots clés

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