Diabetes-specific nutrition algorithm: A transcultural program to optimize diabetes and prediabetes care

Type 2 diabetes (T2D) and prediabetes impose a huge burden of illness on developed and developing nations through high disease prevalence (6.6% overall, >10% in many countries), direct and indirect multisystem pathophysiologic effects, and financial liabilities (US$376 billion annually worldwide) [1]. This enormous disease burden can be reduced by deliberate application of interventions with proven effectiveness [2-14]. Ideally, diagnostic and therapeutic interventions should be accessible, facile, affordable, cost-effective, and culturally sensitive [1]. To improve efficiency, they can be combined in coordinated disease management programs. Lifestyle management, including physical activity and diabetes-specific nutrition therapy, is an essential and necessary component of any comprehensive care plan for diabetes [15••, 16, 17]. Care plan implementation is facilitated by clinical practice guidelines (CPGs) intended to inform clinical decisions, standardize and optimize patient care, improve outcomes, and control costs [18, 19]. Recommendations within CPGs should be evidence-based, precise, clear, relevant, authoritative, and compatible with existing norms [20, 21••]. The purpose of this report is to describe pertinent background material and the development process of a transcultural diabetes-specific nutrition algorithm (tDNA) that can facilitate portability of evidence-based recommendations to better enable their implementation and validation across a broad geographic and cultural spectrum.