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Medical Nutrition Therapy Referral Guidelines
Health Care Providers should consider a consult for Outpatient Nutrition Services if a patient meets one of the following:

 

Cardiovascular Disease
  • Hyperlipidemia
  • CHF or CAD
  • Hypertension
    (
    Systolic >140; Diastolic >90)

Pediatrics

  • Failure to Thrive

  • Food Allergies

  • Malnutrition due to metabolic/organic disorder

  • Wt for Ht >95th%ile or <5th%ile

  • Wt for Age <5th%ile

Renal
  • Renal Failure
  • Chronic Renal Insufficiency
  • Nephrotic Syndrome

Malnutrition

  • Unintentional Wt loss  
    ³ 5% in 1 month
    ³ 10% in 6 months

  • Pre-albumin < 18 or Albumin < 3

Obesity

  • Nutrition for Gastric Bypass Surgery
  • BMI ³  30
  • BMI ³ 26 w/ HTN, DM, HLP

Eating Disorders
  • Anorexia Nervosa / Bulimia
Gastrointestinal Disorders
  • Chronic GI disorders that interfere with absorption of nutrients
  • IBS, GERD, Celiac Disease
  • Cirrhosis, Pancreatitis
Geriatric (>65 years)
  • Surgical Procedures requiring pre-op nutritional assessments
  • Difficulty chewing, swallowing or preparing meals

 

High Risk Pregnancy

  • Gestational Diabetes (GDM)

  • Hyperemesis Gravidarium

  • Prepregnancy Wt < 90% IBW
                           BMI < 19 or >29

  • Iron-deficiency Anemia

  • Inadequate or Excessive Wt Gain

  • Adolescent or < 3 yrs since menarche

  • Eating Disorders (Anorexia/Bulimia)

  • Vegan (restricts all animal products)

Diabetes
  • PreDiabetes 
    (fasting glucose >100mg/dL & <126mg/dL)
  • Gestational Diabetes (GDM)
  • New-onset DM1/DM2
  • HgA1C > 7%
  • Reactive Hypoglycemia
  • Patients on CSII Therapy

 

Other
  • Chemo or radiation therapy
  • Excessive nutritional supplements
  • Enteral Nutrition Dependency
  • Food Allergies
  • Failure to Thrive
NCD Home Page

This Web site provides an introduction to the U.S. Army Medical Department's headquarters organizations, which are the Office of the Army Surgeon General and
U.S. Army Medical Command headquarters. It is intended for interested members of the public, news media and Army Medical Department beneficiaries.
Last Modified 06 March, 2014