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Transcultural diabetes nutrition algorithm (tDNA): Venezuelan application

By April 1, 2014September 24th, 2020No Comments



Ramfis Nieto-Martínez 1 ,
Osama Hamdy 2 ,
Daniel Marante 3 ,
María Inés Marulanda 4 ,
Albert Marchetti 5 ,
Refaat A Hegazi 6 ,
Jeffrey I Mechanick 7

Medical nutrition therapy (MNT) is a necessary component of comprehensive
type 2 diabetes (T2D) management, but optimal outcomes require
culturally-sensitive implementation. Accordingly, international experts
created an evidence-based transcultural diabetes nutrition algorithm (tDNA)
to improve understanding of MNT and to foster portability of current
guidelines to various dysglycemic populations worldwide. This report
details the development of tDNA-Venezuelan via analysis of region-specific
cardiovascular disease (CVD) risk factors, lifestyles, anthropometrics, and
resultant tDNA algorithmic modifications. Specific recommendations include:
screening for prediabetes (for biochemical monitoring and lifestyle
counseling); detecting obesity using Latin American cutoffs for waist
circumference and Venezuelan cutoffs for BMI; prescribing MNT to people
with prediabetes, T2D, or high CVD risk; specifying control goals in
prediabetes and T2D; and describing regional differences in prevalence of
CVD risk and lifestyle. Venezuelan deliberations involved evaluating
typical food-based eating patterns, correcting improper dietary habits
through adaptation of the Mediterranean diet with local foods, developing
local recommendations for physical activity, avoiding stigmatizing obesity
as a cosmetic problem, avoiding misuse of insulin and metformin,
circumscribing bariatric surgery to appropriate indications, and using
integrated health service networks to implement tDNA. Finally, further
research, national surveys, and validation protocols focusing on CVD risk
reduction in Venezuelan populations are necessary.


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