EXPANDED ROLE OF THE DIETITIAN IN THE DIABETES CONTROL AND COMPLICATIONS TRIAL - IMPLICATIONS FOR CLINICAL-PRACTICE
EXPANDED ROLE OF THE DIETITIAN IN THE DIABETES CONTROL AND COMPLICATIONS TRIAL - IMPLICATIONS FOR CLINICAL-PRACTICE
复制标题
DOI：
10.1016/0002-8223(93)91748-f
复制
发表时间：
1993-07-01
影响因子：
--
通讯作者：
CAMELON, K
中科院分区：
文献类型：
--
作者：
DELAHANTY, L;SIMKINS, SW;CAMELON, K
最初，营养师在糖尿病控制和并发症试验（DCCT）中的作用被明确定义为包括评估潜在的研究志愿者，收集饮食史，提供营养教育和参与团队管理会议。随着研究的进展，认识到坚持饮食对实现血红蛋白A1c目标的重要性，以及随机分配到强化治疗的患者中出现不良体重增加，为营养师提供了一个机会，使他们能够集中和广泛地使用他们的技能。对饮食依从性的需求使DCCT团队意识到，营养师需要更加积极地招募和选择研究志愿者，并实施和评估强化糖尿病治疗的各个方面。参与这些活动的增加使营养师能够与研究患者建立关系，这对于谈判治疗目标和改善对影响护理的饮食问题的见解是必要的。认识到营养师对DCCT的重要性以及DCCT营养师年会的授权性质，促进了营养师在临床中心和研究范围内活动（如促进饮食依从性、辅助研究和出版物）中的作用持续扩大。鼓励参与临床试验的营养师发展他们的沟通和咨询技能，寻求与其他团队成员的联盟，并探索辅助研究的机会。这些努力将有助于使营养师在临床试验中的作用的扩大模式永久化。
Initially, the dietitians' role in the Diabetes Control and Complications Trial (DCCT) was specifically defined to include evaluation of potential study volunteers, collection of dietary histories, provision of nutrition education, and participation in team management meetings. As the study progressed, recognition of the importance of adherence to diet in achieving hemoglobin A1c goals and the occurrence of undesirable weight gain in patients assigned randomly to intensive therapy provided an opportunity for dietitians to use their skills intensively and broadly. The need for dietary adherence made DCCT teams aware that dietitians needed to become more active in recruiting and selecting study volunteers and in implementing and evaluating all aspects of intensive diabetes treatment. Increased involvement in these activities allowed dietitians to develop relationships with research patients that were necessary to negotiate treatment goals and improve insights into dietary issues affecting care. Recognition of the importance of dietitians to the DCCT and the empowering nature of the annual meeting of DCCT dietitians fostered continued expansion of the dietitians' role in the clinical centers and in studywide activities such as promotion of dietary adherence, ancillary studies, and publications. Dietitians participating in clinical trials are encouraged to develop their communication and counseling skills, seek out alliances with other team members, and explore opportunities for ancillary research. Such efforts will help to perpetuate this expanded model of the dietitians' role in clinical trials.