Systematic Review of the Frequency of Registered Dietitian-Nutritionist Intervention in the Primary Care Setting for Diabetes Self-Management Education for Patients with Type II Diabetes

Purpose: The purpose of this systematic review is to discuss the ideal frequency of Registered Dietitian-Nutritionist (RDN) contact required to improve glycemic control in patients with type 2 diabetes in the primary care setting. Methods: Researchers completed a literature search between April 1 and June 30, 2020. Researchers identified 184 studies and included seven studies for full-text analysis. Eligible studies were required to occur in a primary care setting, use A1C as an outcome measure, and use some form of education or contact with an RDN. Study quality was assessed using the NIH Study Quality Assessment Tool. Results: Compared to the usual care group of each study, increased contact with an RDN improved A1C lowering regardless of frequency (round-the-clock, monthly, biannually). The largest decreases occurred in the round-the-clockand quarterly touch groups. Studies varied in modality (inperson, telehealth, etc.) and type of intervention. The participants had A1Cs between 8.07% and 10.25% before intervention. With RDN contact of any frequency between provider visits and participants saw A1Cs decreased between 0.66% and 2.2%. Conclusion: Greater glycemic control in patients with type 2 diabetes in the primary care environment is linked to more frequent RDN contact than that advised by the American Diabetes Association Standards of Care.