Nutrition management of diabetes in acute care

Nutrition therapy in hospital includes the integration of diabetes into the care plan for the presenting condition, basic self-management education and care coordination to promote optimal glycemic control in hospital and an appropriate plan for discharge. Estimated nutrient requirements for people with diabetes are the same as those for the general population, and diets should be designed based on individual metabolic needs. Distribution of meals and snacks should employ a consistent carbohydrate meal-planning approach for both patient safety and management of glycemia. Referral to a registered dietitian for a full assessment is warranted for those at higher risk for hyperglycemia, including those on insulin or nutrition support. Consideration may be given to the use of lower carbohydrate oral nutrition supplements. A team approach should be employed to ensure there is coordination among blood glucose testing, insulin administration and meal timing. Self-management education should focus on patient safety, and an appropriate plan for discharge should be created to manage the ongoing needs of patients with this chronic disease.