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Int J Endocrinol. 2013;2013:679396. doi: 10.1155/2013/679396. Epub 2013 Dec 9.

Transcultural diabetes nutrition algorithm: a malaysian application.

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  • 1Department of Medicine, Hospital Putrajaya, Pusat Pentadbiran Kerajaan Persekutuan, Presint 7, 62250 Putrajaya, Malaysia.
  • 2Division of Endocrinology, Diabetes and Metabolism, Joslin Diabetes Center, Harvard Medical School, Boston, MA 02215, USA.
  • 3Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia.
  • 4Department of Medicine, Hospital Pulau Pinang, Penang, Malaysia.
  • 5Department of Medicine, Hospital Tengku Ampuan Rahimah, Selangor, Malaysia.
  • 6Family Medicine, Putrajaya Health Clinic, Putrajaya, Malaysia.
  • 7Department of Health Care, International Medical University, Kuala Lumpur, Malaysia.
  • 8Department of Dietetics and Food Services, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
  • 9Department of Nutrition and Dietetics, University Putra Malaysia, Selangor, Malaysia.
  • 10Department of Nutrition and Dietetics, International Medical University, Kuala Lumpur, Malaysia.
  • 11Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey, Newark, NJ 07101, USA.
  • 12Abbott Nutrition, Columbus, OH 43219, USA.
  • 13Division of Endocrinology, Diabetes, and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.


Glycemic control among patients with prediabetes and type 2 diabetes mellitus (T2D) in Malaysia is suboptimal, especially after the continuous worsening over the past decade. Improved glycemic control may be achieved through a comprehensive management strategy that includes medical nutrition therapy (MNT). Evidence-based recommendations for diabetes-specific therapeutic diets are available internationally. However, Asian patients with T2D, including Malaysians, have unique disease characteristics and risk factors, as well as cultural and lifestyle dissimilarities, which may render international guidelines and recommendations less applicable and/or difficult to implement. With these thoughts in mind, a transcultural Diabetes Nutrition Algorithm (tDNA) was developed by an international task force of diabetes and nutrition experts through the restructuring of international guidelines for the nutritional management of prediabetes and T2D to account for cultural differences in lifestyle, diet, and genetic factors. The initial evidence-based global tDNA template was designed for simplicity, flexibility, and cultural modification. This paper reports the Malaysian adaptation of the tDNA, which takes into account the epidemiologic, physiologic, cultural, and lifestyle factors unique to Malaysia, as well as the local guidelines recommendations.

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