| A survey was conducted to examine the clinical management by registered dietitians for patients with diabetic nephropathy (DN). The survey was mailed to a randomized sample of dietitians who are members of the ADA Diabetes Care and Education Practice Group (DC&E). The questionnaire consisted of closed ended questions, which addressed assessment, implementation, and follow-up of individuals with DN. The questionnaire was mailed to 696 dietitians, 485 (69.7%) questionnaires were returned of which 177 (36.5%) were included in the analysis. Of the dietitians who encounter DN, 62.7% counsel 15 or less patients on an annual basis. In the assessment of renal status, dietitians reported utilizing BUN most frequently, followed by serum creatinine, albuminuria and glomerular filtration rate. Forty five % monitor blood pressure and 61.0/55.9% assess blood glucose/HbAlc. To determine protein modification, dietitians used g protein/DBW (41.8%), g protein IBW (30%), specific g of protein (3.4%) or g protein based on % total calories (23.7%). Individual counseling was used most frequently with 1.7% following a written protocol. After initial education 75.1% of dietitians provide follow-up. The findings indicate a need for protocol development for consistent assessment, intervention and follow-up of patients with DN. |
