Step 4: Evaluate

Evaluating the Nutrition Care Plan

After you have implemented the plan, you want to follow-up and evaluate it to see if it has been effective in addressing your nutrition concerns. This can help you to decide on appropriate changes to make to the nutrition care plan moving forward. To evaluate your plan in an outpatient setting, you will need to set up a follow-up appointment or phone call with your client to gather updated information.

In populations with diabetes, the 5 main areas to commonly re-assess in a follow-up are glycemic control, medication and insulin, diet or carb intake, abnormal lipids, and physical activity. These may or may not be a part of the SMART goals you set, so you’ll want to ask the client how they are doing in terms of meeting the SMART goals you set together last appointment.

Questions to Evaluate Nutrition Care Plan Effectiveness
Common Nutrition Issues Evaluate Effectiveness of NCP
Glycemic Control
  • Are their BGs better controlled?
  • Are they experiencing hypo- or hyperglycemia?
  • Are they using the 15:15 rule to treat hypoglycemia?
Medication and Insulin Adherence
  • Are they taking medication as directed?
  • Any improvements in glycemic control after a medication change?
Diet/Carbohydrate Intake
  • Have they made the suggested diet changes?
  • Any barriers to changes?
  • Are they distributing CHO intake throughout the day?
Abnormal Lipids
  • If any improvements to lipid profile?
Physical Activity
  • Have they made the suggested changes?
  • Any barriers to changes?


Evaluating Penelope’s Nutrition Care Plan

Possible Outcomes of Recommended Changes
Common Nutrition Issues Evaluate Effectiveness of NCP Outcome
Glycemic Control
  • Are her BGs better controlled?
  • Is she still experiencing hypo- or hyperglycemia?
  • Is she using the 15:15 rule?
  • No longer experiencing shakiness and hunger before lunch
  • Still sometimes waking up with FBG < 4.0mmol/L
Medication and Insulin Adherence
Diet/Carbohydrate Intake
  • Using the Plate Method to distribute CHO?
  • Any barriers to changes?
  • Using the Plate Method for most meals and snacks
  • 24-hr recall shows success
Abnormal Lipids
  • No concerns at this time
Physical Activity
  • No concerns at this time

Since hypoglycemia was a concern for Penelope, you booked a follow-up appointment with her for 5 days later to ensure she is not in danger of injury from frequent hypoglycemic events.

When assessing Penelope’s status after the implementation of the nutrition care plan, you want to see if the BG’s are better controlled and if she is still experiencing highs or lows. During your follow-up you discover that Penelope has been able to use the Plate Method to plan most meals and snacks, and is including more CHO in her breakfast and lunch, so she is no longer experiencing shakiness and hunger before lunch. Her logbook also shows her blood sugars are around 5-7 in the evening, and her FBG is above 4.

The changes Penelope has made are working well to manage her diabetes and prevent hypoglycemia. Penelope is pleased with these changes and will follow up with you in 3 months.

The Nutrition Care Process Model

As you use the Nutrition Care Process Model and the learning from this case study as a guide throughout your patient care in practicum, please keep in mind that the process is dynamic, and not step-by-step as all cases are different. You are encouraged to complete the recommended readings for this module and continue to expand your learning in this clinical area of practice.

PART 4: EVALUATE COMPLETE. Pause to reflect on the evaluation strategies discussed, and review the readings and resources in the following section for your information.

You’ve now completed the nutrition for Diabetes module. Please consider providing feedback through the embedded form in the next section.


Katie Brunke, RD, CDE, PHEc

Jess Wiles, RD, MHSc(c)


Icon for the Creative Commons Attribution-NonCommercial 4.0 International License

Preparation for Dietetic Practice Copyright © by Megan Omstead, RD, MPH is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.