The approach of diabetological team to educational therapy of nutrition therapy in different clinical setting: our experiences

The medical nutrition therapy (MNT) is an essential element of therapy in diabetic patients and it should be included in the route of Structured therapeutic Education (ETS) in patients centered care. Our experience refers to a comparison among three working groups composed of teams experts in diabetes with a diabetologist, a nurse and a dietician who had to experience nutrition therapy in different clinical settings. We chose three scenarios: patient with diabetes who is mooving from peadiatric age to adulthood; patient with new diagnosed type 2 diabetes and bad glycometabolic control; patient with type 1 diabetes, already known, with frequent hypoglycemic crises. The method used was Metaplan. Each of the 3 groups followed sligthly different paths depending on the clinical situation that have influenced not only the choices of each operator, but of the whole group. In accordance with the individual competences, the team has operated synchronously. The premises have been widely shared, while respecting the individual skills, and with differences related to the different organizational situations. The MNT is a long and articulate path, but in our experience, a personalized initial approach has been recognized by the team as fundamental, both in the initial phase of taking charge, as in the group 1 and in the group 2, and when we have to face important criticalities, as in the group 3. KEY WORDS diabetologic team; medical nutrition therapy; therapeutic education; paths.