PES Statements for Diabetes - Dietitian Direction

Introduction to PES Statements

PES statements are structured sentences used by dietitians to communicate the nutrition diagnosis of a patient.

Writing a PES Statement

PES statements are written as follows:

[Problem/nutrition diagnosis] related to [Etiology], as evidenced by [Signs/symptoms].

Looking for more information on PES statements before diving in? Check out these other blog posts:

What is a PES Statement?

Nutrition Diagnosis: Definition & Examples

Nutrition Care Process Steps

Potential Nutrition Diagnoses for Diabetes

Excessive energy intake
Excessive oral intake
Inadequate fluid intake
Excessive carbohydrate intake
Intake of types of carbohydrate inconsistent with needs
Inconsistent carbohydrate intake
Overweight/obesity
Unintended weight loss
Unintended weight gain
Food and nutrition related knowledge deficit
Not ready for nutrition related behavior change
Self monitoring deficit
Disordered eating pattern
Limited adherence to nutrition related recommendations
Physical inactivity

PES Statements for Diabetes Examples

Excessive energy intake related to binge eating behaviors as evidenced by patient feeling loss of control around food, consuming a whole bag of chips in one sitting.

Intake of types of carbohydrate inconsistent with needs related to frequent consumption of soda and sweet tea as evidenced by having ~15-20 bottles and cans per week, multiple blood sugar readings >300.

Obesity Class III related to physical inactivity as evidenced by an average of 2000 steps per day, BMI 42.4.

Unintended weight loss related to hyperglycemia as evidenced by 10% weight loss in 12 months, time in range of 52% in last two weeks.

Unintended weight gain related to fear of hypoglycemia as evidenced by 7 lb weight gain in 2 months, patient consuming skittles to keep blood sugars >100.

Food and nutrition related knowledge deficit related to limited previous nutrition education as evidenced by HbA1c 8.9%, low perceived severity of risk.

Self monitoring deficit related to no previous glucometer training as evidenced by unopened glucometer box, blank blood sugar logs.

Limited adherence to nutrition related recommendations related to inadequate social support as evidenced by wife’s frustration with recommendations provided at last nutrition appointment.

Quick Tips for Writing the Perfect Diabetes PES Statement

Use information gathered in the assessment to determine the nutrition problem
The nutrition diagnosis should ideally be resolved, or at least improved, through a nutrition intervention provided by the dietitian
PES statements should be clear and concise

Conclusion

Diabetes is a complex disease that can have a wide variety of nutrition problems and etiologies. There is no “right” or “wrong” PES statement, but make sure yours is specific to the patient, using the data you collected in your assessment.

Note that the 2023 edition of the Nutrition Care Process Terminology (eNCP) is used, which is the most current version at the time of this article being published.