{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:41:56Z","timestamp":1792190516551,"version":"4.4.0"},"reference-count":37,"publisher":"Georg Thieme Verlag KG","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Exp Clin Endocrinol Diabetes"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Treatment guidelines recommend nutrition therapy and nutrition counselling as\nessential components in diabetes management. Little is known about how\nnutrition therapy\/nutrition counselling is implemented in diabetes care.\nTherefore, the aim of this survey was to collect data on nutrition\ntherapy\/nutrition counselling in persons with diabetes in Germany.<\/jats:p>\n                  <jats:p>An online survey using a standardized questionnaire was conducted from August\n2021 to April 2022. People with diabetes were invited to answer questions on\ntheir diabetes management with a focus on nutrition counselling. The dataset\nwas descriptively analyzed.<\/jats:p>\n                  <jats:p>In total, 1,208 adults were included in the analysis. Approximately half of\nall participants (49.2%, n=594) suffered from type 1 diabetes and the\nother half (50.8%, n=614) from type 2 diabetes. Among the participants with\ntype 1 diabetes, 66.8% reported to have had any dietary counselling as\ncompared to 62.9% of those with type 2 diabetes. In addition, repeated\ndietary counselling was reported by 44.9% of participants with type 1\ndiabetes and 36.3% of those with type 2 diabetes. In these, dietary\ncounselling was provided in 42.1% (type 1 diabetes) and 40.6% (type 2\ndiabetes), respectively, by nutritionists\/dietitians. Provision of nutrition\ncounselling was not related to body mass index or the mode of medication in\nboth types of diabetes. The majority of survey participants expressed\ninterest in receiving more and regular dietary counselling and identified a\nneed for improvements regarding nutrition counselling.<\/jats:p>\n                  <jats:p>This survey showed that nutrition counselling in patients with diabetes in\nGermany is not in accordance with current treatment guidelines and widely\nunderutilized. With respect to the potential of an adequate diet for\nmetabolic control and prevention of cardiovascular diseases, there is an\nurgent need for a better and more structured implementation of nutrition\ncounselling in diabetes care.<\/jats:p>","DOI":"10.1055\/a-2881-7638","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T23:08:56Z","timestamp":1783984136000},"page":"327-336","source":"Crossref","is-referenced-by-count":0,"title":["Nutrition Counselling in Patients with Diabetes in Germany\u2014Results\nfrom an Online Survey"],"prefix":"10.1055","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0155-9338","authenticated-orcid":false,"given":"Christina","family":"Holzapfel","sequence":"additional","affiliation":[{"name":"Technical University of Munich School of Medicine and\nHealth, BY, Germany","place":["Munich"],"department":["Institute for Clinical Nutritional Medicine"]},{"name":"Fulda University of Applied Sciences, HE, Germany","place":["Fulda"],"department":["Department of Nutritional, Food and Consumer Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Schemmer","sequence":"additional","affiliation":[{"name":"Technical University of Munich School of Medicine and\nHealth, BY, Germany","place":["Munich"],"department":["Institute for Clinical Nutritional Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Meyer","sequence":"additional","affiliation":[{"name":"Technical University of Munich School of Medicine and\nHealth, BY, Germany","place":["Munich"],"department":["Institute for Clinical Nutritional Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Hauner","sequence":"additional","affiliation":[{"name":"Technical University of Munich School of Medicine and\nHealth, BY, Germany","place":["Munich"],"department":["Institute for Clinical Nutritional Medicine"]},{"name":"Technical University of Munich School of Life Sciences, Germany","place":["Freising"],"department":["Else Kr\u00f6ner Fresenius Center for Nutritional Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"109119","DOI":"10.1016\/j.diabres.2021.109119","article-title":"IDF diabetes atlas: Global, regional and country-level diabetes prevalence\nestimates for 2021 and projections for 2045","volume":"183","author":"H Sun","year":"2022","journal-title":"Diabetes Res Clin Pract"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1217","DOI":"10.1111\/dme.13902","article-title":"Projected number of people with diagnosed type 2 diabetes in Germany in\n2040","volume":"36","author":"T T\u00f6nnies","year":"2019","journal-title":"Diabet Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e013058","DOI":"10.1136\/bmjopen-2016-013058","volume-title":"Temporal changes in predicted risk of type 2 diabetes in Germany: findings from\nthe german health interview and examination surveys 1997\u20131999 and 2008\u20132011","author":"R Paprott","year":"2017"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2753","DOI":"10.2337\/dci22-0034","article-title":"Management of hyperglycemia in type 2 diabetes, 2022. 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A consensus report by the american\ndiabetes association (ADA) and the European Association for the Study of\nDiabetes (EASD)","volume":"64","author":"RI G Holt","year":"2021","journal-title":"Diabetologia"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"731","DOI":"10.2337\/dci19-0014","article-title":"Nutrition therapy for adults with diabetes or prediabetes: A consensus\nreport","volume":"42","author":"A B Evert","year":"2019","journal-title":"Diabetes Care"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1016\/j.jand.2017.11.021","article-title":"Position of the academy of nutrition and dietetics: The role of medical\nnutrition therapy and registered dietitian nutritionists in the prevention and\ntreatment of prediabetes and type 2 diabetes","volume":"118","author":"K Briggs Early","year":"2018","journal-title":"J Acad Nutr Diet"},{"key":"ref12","first-page":"5","article-title":"Adult obesity and type 2 diabetes","author":"M Gatineau","year":"2014","journal-title":"Public Health England"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1016\/s0140-6736(17)33102-1","article-title":"Primary care-led weight management for remission of type 2 diabetes (DiRECT): An\nopen-label, cluster-randomised trial","volume":"391","author":"M E Lean","year":"2018","journal-title":"Lancet"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1016\/s2213-8587(19)30068-3","article-title":"Durability of a primary care-led weight-management intervention for remission of\ntype 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised\ntrial","volume":"7","author":"ME J Lean","year":"2019","journal-title":"Lancet Diabetes Endocrinol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1659","DOI":"10.1016\/j.jand.2017.03.022","article-title":"Academy of nutrition and dietetics nutrition practice guideline for type 1 and\ntype 2 diabetes in adults: Systematic review of evidence for medical nutrition\ntherapy effectiveness and recommendations for integration into the nutrition\ncare process","volume":"117","author":"M J Franz","year":"2017","journal-title":"J Acad Nutr Diet"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1016\/0026-0495(90)90299-R","article-title":"UK prospective diabetes study 7: Response of fasting plasma glucose to diet\ntherapy in newly presenting type II diabetic patients","volume":"39","author":"UKDPS Group","year":"1990","journal-title":"Metabolism"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1016\/S0002-8223(95)00276-6","article-title":"Effectiveness of medical nutrition therapy provided by dietitians in the\nmanagement of non\u2013insulin-dependent diabetes mellitus: A randomized, controlled\nclinical trial","volume":"95","author":"M J Franz","year":"1995","journal-title":"J Am Diet Assoc"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1016\/j.jada.2004.09.024","article-title":"Outcomes monitoring of health, behavior, and quality of life after nutrition\nintervention in adults with type 2 diabetes","volume":"104","author":"C C Lemon","year":"2004","journal-title":"J Am Diet Assoc"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1777","DOI":"10.2337\/dc06-0606","article-title":"A low-fat vegan diet improves glycemic control and cardiovascular risk factors\nin a randomized clinical trial in individuals with type 2 diabetes","volume":"29","author":"N D Barnard","year":"2006","journal-title":"Diabetes Care"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1111\/j.1464-5491.2011.03405.x","article-title":"Effectiveness of medical nutrition treatment delivered by dietitians on\nglycaemic outcomes and lipid profiles of Arab, Omani patients with type 2\ndiabetes","volume":"29","author":"A Al-Shookri","year":"2012","journal-title":"Diabetic Med"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/0002-8223(93)91552-2","article-title":"Impact of intensified dietary therapy on energy and nutrient intakes and fatty\nacid composition of serum lipids in patients with recently diagnosed\nnon-insulin-dependent diabetes mellitus","volume":"93","author":"J H Laitinen","year":"1993","journal-title":"J Am Diet Assoc"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"24","DOI":"10.2337\/diacare.26.1.24","article-title":"Randomized controlled community-based nutrition and exercise intervention\nimproves glycemia and cardiovascular risk factors in type 2 diabetic patients in\nrural costa rica","volume":"26","author":"J D Goldhaber-Fiebert","year":"2003","journal-title":"Diabetes Care"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1712","DOI":"10.2337\/dc09-1919","article-title":"TeleHealth improves diabetes self-management in an underserved community:\nDiabetes TeleCare","volume":"33","author":"R M Davis","year":"2010","journal-title":"Diabetes Care"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1139\/h2012-025","article-title":"Dietitian-coached management in combination with annual endocrinologist follow\nup improves global metabolic and cardiovascular health in diabetic participants\nafter 24 months","volume":"37","author":"M-C Battista","year":"2012","journal-title":"Appl Physiol Nutr Metab"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1038\/sj.ijo.0802295","article-title":"Effect of intensive dietetic interventions on weight and glycaemic control in\noverweight men with type II diabetes: A randomised trial","volume":"27","author":"S Ash","year":"2003","journal-title":"Int J Obes"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1570","DOI":"10.2337\/diacare.27.7.1570","article-title":"Translating lifestyle intervention to practice in obese patients with type 2\ndiabetes: Improving control with activity and nutrition (ICAN) study","volume":"27","author":"A M Wolf","year":"2004","journal-title":"Diabetes Care"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"c3337","DOI":"10.1136\/bmj.c3337","article-title":"Nutritional intervention in patients with type 2 diabetes who are hyperglycaemic\ndespite optimised drug treatment\u2014lifestyle over and above drugs in diabetes\n(LOADD) study: Randomised controlled trial","volume":"341","author":"K J Coppell","year":"2010","journal-title":"BMJ"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/S0140-6736(11)60442-X","article-title":"Diet or diet plus physical activity versus usual care in patients with newly\ndiagnosed type 2 diabetes: The Early ACTID randomised controlled trial","volume":"378","author":"R C Andrews","year":"2011","journal-title":"Lancet"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1089\/dia.2009.0102","article-title":"Telemedicine intervention effects on waist circumference and body mass index in\nthe IDEATel project","volume":"12","author":"R Izquierdo","year":"2010","journal-title":"Diabetes Technol Ther"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1007\/s11428-021-00784-2","article-title":"Evidenz in der Ern\u00e4hrungstherapie des diabetes mellitus","volume":"17","author":"H Hauner","year":"2021","journal-title":"Der Diabetologe"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1007\/s11428-021-00764-6","article-title":"Therapie des Typ-1-Diabetes","volume":"17","author":"T Haak","year":"2021","journal-title":"Der Diabetologe"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"969360","DOI":"10.3389\/fnut.2022.969360","article-title":"A quasi-experimental study provides evidence that registered dietitian\nnutritionist care is aligned with the Academy of nutrition and dietetics\nevidence-based nutrition practice guidelines for type 1 and 2 diabetes","volume":"9","author":"E Lamers-Johnson","year":"2022","journal-title":"Front Nutr"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"655","DOI":"10.2337\/dc07-1871","article-title":"Nutritionist visits, diabetes classes, and hospitalization rates and charges:\nThe urban diabetes study","volume":"31","author":"J M Robbins","year":"2008","journal-title":"Diabetes Care"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"982","DOI":"10.1038\/s41591-023-02278-8","article-title":"Incident type 2 diabetes attributable to suboptimal diet in 184 countries","volume":"29","author":"M O'Hearn","year":"2023","journal-title":"Nat Med"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"1958","DOI":"10.1016\/s0140-6736(19)30041-8","article-title":"Health effects of dietary risks in 195 countries, 1990-2017: A systematic\nanalysis for the global burden of disease study 2017","volume":"393","author":"GBD 2017 Diet Collaborators","year":"2019","journal-title":"Lancet"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"965","DOI":"10.1007\/s00125-023-05894-8","article-title":"Evidence-based European recommendations for the dietary management of\ndiabetes","volume":"66","author":"Diabetes and Nutrition Study Group (DNSG) of the European\nAssociation for the Study of Diabetes (EASD)","year":"2023","journal-title":"Diabetologia"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"j4849","DOI":"10.1136\/bmj.j4849","article-title":"Effects of weight loss interventions for adults who are obese on mortality,\ncardiovascular disease, and cancer: Systematic review and meta-analysis","volume":"359","author":"C Ma","year":"2017","journal-title":"BMJ"},{"key":"ref40","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.ajcnut.2025.04.023","article-title":"Nutritional priorities to support GLP-1 therapy for obesity: A joint Advisory\nfrom the American College of Lifestyle Medicine, the American Society for\nNutrition, the Obesity Medicine Association, and The Obesity Society","volume":"122","author":"D Mozaffarian","year":"2025","journal-title":"Am J Clin Nutr"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"120","DOI":"10.2337\/cd21-0129","article-title":"MOVE! Enhanced: A virtual multidisciplinary weight and diabetes management\nprogram for high-risk veterans. A feasibility pilot","volume":"41","author":"C E Mendez","year":"2022","journal-title":"Clin Diabetes"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"e000135","DOI":"10.1136\/bmjdrc-2015-000135","article-title":"Changes in diabetes care indicators: Findings from German National Health\nInterview and Examination Surveys 1997\u20131999 and 2008\u20132011","volume":"3","author":"Y Du","year":"2015","journal-title":"BMJ Open Diabetes Res Care"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1007\/s43999-022-00007-1","article-title":"Exploring regional and sociodemographic disparities associated with unenrollment\nfor the disease management program for type 2 Diabetes Mellitus using Bayesian\nspatial modelling","volume":"1","author":"B Kauhl","year":"2022","journal-title":"Res Health Serv Reg"}],"container-title":["Experimental and Clinical Endocrinology &amp; Diabetes"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2881-7638.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:35:37Z","timestamp":1792190137000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2881-7638"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,13]]},"references-count":37,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,10,16]]},"published-print":{"date-parts":[[2026,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2881-7638","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0947-7349","1439-3646"],"issn-type":[{"value":"0947-7349","type":"print"},{"value":"1439-3646","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,13]]}}}