Introduction and Objectives: The addition of a new anti-diabetes drugs have further strengthened pharmacological management of diabetes. However, attention to diet continues to be a cornerstone of diabetes management, particularly because of the preponderance of obesity in individuals with diabetes. Our objective was to address the gap experienced by many diabetes care providers in providing effective dietary guidance.
Methods: We developed Small Changes, a software program that facilitates patient-selected meal planning. Bilingual videos instruct patients on selection of meal options that align with their usual eating habits and dietary preferences, including options for from-scratch recipe, convenience foods, and restaurant options. The algorithm provides a structured meal plan that includes instructions and recipes based on patient selections and tailored to the patient’s calorie needs for weight loss (~ 500 Calorie deficit from daily energy requirements based on Mifflin St. Jeor equation). Macronutrients are distributed throughout the day to optimize fat loss and reduce hunger (~20% Cal as protein, <30% as fat), while providing patients with moderate flexibility in choices to enhance compliance.
Results: Mixed methods pilot testing in multiple settings indicates high patient and provider satisfaction and average weight loss that is clinically significant (>5%). Providers indicated program addressed a need for dietary guidance that was not time consuming and did not require clinic personnel to have extensive nutrition knowledge. Patients expressed appreciation for variety and flexibility of the program.
Conclusion: Software-based tools that support nutrition guidance for weight loss offer a scalable approach to meet an important need in diabetes management.
L. Whigham: None. N. Dhurandhar: Advisory Panel; Medifast, Inc. Research Support; Insparin Inc, Borealis Foods, National Cattleman's Beef Association, Novo Nordisk.
