Diabetes white paper: Defining the delivery of nutrition services in Medicare medical nutrition therapy vs Medicare diabetes self-management training programs

J Am Diet Assoc. 2009 Mar;109(3):528-39. doi: 10.1016/j.jada.2008.11.004.


Registered dietitians (RDs) have a defined and unique role in care for patients with diabetes that differs depending on whether the service is for medical nutrition therapy (MNT) or part of a diabetes self-management training (DSMT) program (DSMT and diabetes self-management education [DSME] are used interchangeably in this article). The purpose of this article is to describe the current regulatory and practice framework that supports nutrition care under Medicare Part B for people with diabetes. A description of MNT and DSMT provided under Medicare Part B is included. The role of RDs and other health care professionals involved as program instructors in DSMT programs is also addressed. Revisions to the National Standards for Diabetes Self-Management Education are discussed to clarify RDs' involvement in DSME programs.

MeSH terms

  • Delivery of Health Care
  • Diabetes Mellitus / diet therapy
  • Diabetes Mellitus / therapy*
  • Dietetics / standards*
  • Disease Management
  • Humans
  • Medicare Part B*
  • Nutrition Therapy / methods*
  • Patient Education as Topic / methods*
  • Patient Education as Topic / standards
  • Practice Guidelines as Topic
  • Professional Role
  • Quality of Health Care
  • Self Care / methods*
  • Treatment Outcome
  • United States