Objective-Despite the increased emphasis on obesity and diet-related diseases, nutrition education remains lacking in many internal medicine training programs. We evaluated the attitudes, selfperceived proficiency, and knowledge related to clinical nutrition among a cohort of internal medicine interns.Methods-Nutrition attitudes and self-perceived proficiency were measured using previously validated questionnaires. Knowledge was assessed with a multiple-choice quiz. Subjects were asked whether they had prior nutrition training.Results-Of the 114 participants, 61 (54%) completed the survey. Although 77% agreed that nutrition assessment should be included in routine primary care visits, and 94% agreed that it was their obligation to discuss nutrition with patients, only 14% felt physicians were adequately trained to provide nutrition counseling. There was no correlation among attitudes, self-perceived proficiency, or knowledge. Interns previously exposed to nutrition education reported more negative attitudes toward physician self-efficacy (p = 0.03).Conclusions-Internal medicine interns' perceive nutrition counseling as a priority, but lack the confidence and knowledge to effectively provide adequate nutrition education.
Recommended A1C targets for people with type 2 diabetes are between 6.5 and 8%; however, real-world data suggest that an increasing proportion of people with diabetes have suboptimal control, and~15% have an A1C level .9%. People with A1C .9% are at increased risk for micro-and macrovascular complications and require treatment intensification to improve glycemic control as early as possible. In a series of short videos now available on the Clinical Diabetes website, the authors discuss the pathophysiological changes that occur during the progression of type 2 diabetes, with particular focus on the key role of declining b-cell function. The authors review clinical characteristics-long diabetes duration and A1C $9%-that are indicative of diminishing b-cell function, and they discuss the clinical data that support the use of available treatment options for these individuals, consistent with current diabetes treatment guidelines.
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