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Nutritional recommendations for type 2 diabetes: an international review of 15 guidelines

  • Author Footnotes
    # Liangying Hou and Long Ge are co-first author
    Liangying Hou
    Footnotes
    # Liangying Hou and Long Ge are co-first author
    Affiliations
    Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China

    Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, China
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  • Author Footnotes
    # Liangying Hou and Long Ge are co-first author
    Long Ge
    Footnotes
    # Liangying Hou and Long Ge are co-first author
    Affiliations
    Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, China

    Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou 730000, China
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  • Qi Wang
    Affiliations
    Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, China

    Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou 730000, China
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  • Juanjuan He
    Affiliations
    Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, China
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  • Tianzhu Qin
    Affiliations
    Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, China
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  • Liujiao Cao
    Affiliations
    West China School of Nursing, West China Hospital, Sichuan University, Chengdu, China
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  • Changhao Cao
    Affiliations
    Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, China
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  • Diru Liu
    Affiliations
    Department of Nutrition and Healthy Food, School of Public Health, Lanzhou University, Lanzhou 730000, China
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  • Xingrong Liu
    Correspondence
    Corresponding author: Xingrong Liu. ,Telephone number: 138 9311 7077; 139 1932 0882
    Affiliations
    Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, China
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  • Kehu Yang
    Correspondence
    Corresponding author: Kehu Yang ; Telephone number: 138 9311 7077; 139 1932 0882
    Affiliations
    Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China

    Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, China

    Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China
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  • Author Footnotes
    # Liangying Hou and Long Ge are co-first author
Published:September 01, 2022DOI:https://doi.org/10.1016/j.jcjd.2022.08.005
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      Abstract

      Background

      Recommendations for patients with T2DM from clinical practice guidelines (CPGs) may be inconsistent, and little is known about their quality.

      Methods

      To systematically review the consistency of globally available CPGs containing nutritional recommendations for T2DM and to assess their methodological and reporting quality, PubMed, CBM and four main guideline websites were searched. Four researchers independently assessed the methodological and reporting quality using the Appraisal of Guidelines for Research and Evaluation, 2nd edition (AGREE II) instrument and Reporting Items for Practice Guidelines in HealThcare (RIGHT) checklist.

      Results

      Fifteen CPGs involved 65 nutritional recommendations regarding six 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 were not completely consistent in different CPGs and failed 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 assigning the strength of recommendations. Overall, eight CPGs were classified as recommended for clinical practice used AGREE II. The 15 CPGs adhered to less than 60% of RIGHT checklist items.

      Conclusion

      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.

      Keywords

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