Dietitian

[DiabeticDi]

Hi

If your diabetic nurse makes an appt for you to see a dietitian, what should they go through with you? Shouldn't they be a specific person to deal with food and not just another diabetic nurse?

 

[Juicyj]

Hello @DiabeticDi A dietitian is trained to speak specifically about diet with knowledge of nutritional values and the impact of food on glucose levels, they aren't a diabetic nurse per se so cannot give you advice about your diabetes care. I believe they will want to analyse your current diet to see that your nutritional needs are being met and will offer advice in regards to a healthy diet. I met a dietitian a year or so after diagnosis and although it was interesting opportunity to discuss diet, I didn't feel it necessary to change my dietary approach.

 

[Squire Fulwood]

Dietitians toe the party line. The NICE guidelines say/said that type 2 diabetics should be encouraged to eat as the rest of the population does so you probably will get the same advice as everyone else. In my case I got an action plan with four items on it. I remember that two of them were to take more exercise and eat carbohydrates with every meal. She then asked if I wanted another appointment. I will leave you to guess.

https://www.nice.org.uk/guidance/ng28/chapter/1-Recommendations#dietary-advice-and-bariatric-surgery

 

[Deleted member 308541]

I had an a appointment for two free visits to a dietitian on a hcp, they wanted to charge me $90.00 per visit,

Needless to say I have never seen a dietician, and my T2 is under very good control on a moderate LCHF diet.

 

[Daibell]

Hi. I think you may well find any dietician appointment a waste of time and you may well be given bad, old, NHS advice. I think myself lucky as I've never been offered to see one by my nurse and not had to refuse.

 

[Tophat1900]

I had an a appointment for two free visits to a dietitian on a hcp, they wanted to charge me $90.00 per visit,

Needless to say I have never seen a dietician, and my T2 is under very good control on a moderate LCHF diet.

$90.... yeah, I can think of better things to spend $90 on, like steak!

 

[porl69]

My dietitian was amazing. She got me on the Libre and insulin pump. Best advice I have had off any of my diabetes team in over 40 years.

 

[Deleted Account]

My hospital has a dedicated dietician for diabetes.
I have no idea what she says with regard to type 2 but I have no problems with her type 1 advice.

She shared the responsibility for running the equivalent of the DAFNE course in my area and, as such, her focus is around understanding what needs to be carb counting.
As my weight is not a problem, I have never discussed this with her but I get the idea she does provide advice on this to those with the need.

When I was first diagnosed, I saw a diabetes nurse who was supposed to be providing advice on how to avoid BG drops during a 26 mile overnight walk. She had no clue about eating for prolonged exercise when first diagnosed but I don't think she needed this information very often.

 

[Tophat1900]

Hi

If your diabetic nurse makes an appt for you to see a dietitian, what should they go through with you? Shouldn't they be a specific person to deal with food and not just another diabetic nurse?

I think it's worth going to... if you get a good dietician, it can be really helpful.

 

[TriciaWs]

I was offered an appointment to see a dietitian as an alternative to going on the DESMOND course. I didn't want to do either as I went low carb when diagnosed and knew they didn't support this last year (hopefully desmond has updated). But I didn't want my GP surgery to see me as too awkward and 'non compliant'.

I took the output from my meter and a copy of the letter provided by thelowcarbprogram.
She ignored the letter, went through my day's meals with me, and even through I'd had a second blood test that showed my HbA1c was at non diabetic levels and my own meter was showing good results, and I'd lost some of the weight they were concerned about, she told me to eat more carbs, eat carbs at every meal, eat three meals a day, etc. She gave me a copy of the Eatwell guide.
I thanked her, and turned down a follow up appointment when the letter came through and carried on with low carb.
I still think it was better than having to do a full day of being told to eat more carbs on the course.

I am still low carb (not keto) and in remission as all my blood results were good/normal at the 6 month checkup - so my diabetic nurse put me straight onto 6 monthly for now. And onto annual if my second 6 month appt is fine.

 

[kitedoc]

I think it's worth going to... if you get a good dietician, it can be really helpful.

I agree @Tophat1900 I see no point in seeing a dietitian who gives only one diet option type advice. A dietitian needs to be across all diabetic dietary options and help you find what will suit you best, In my experience such dietitians are quite rare.

 

[Deleted Account]

Guys, when expressing your opinions on whether the OP would gain anything from seeing a dietician, please bear in mind they have type 1 diabetes as clearly indicated by their avatar.

 

[kitedoc]

Guys, when expressing your opinions on whether the OP would gain anything from seeing a dietician, please bear in mind they have type 1 diabetes as clearly indicated by their avatar.

Yes, I agree @helensaramay, and there are a number of diet options for TIDs.

 

[WuTwo]

There certainly are - the dietician I saw on diagnosis was very helpful indeed!

 

[Tophat1900]

I agree @Tophat1900 I see no point in seeing a dietitian who gives only one diet option type advice. A dietitian needs to be across all diabetic dietary options and help you find what will suit you best, In my experience such dietitians are quite rare.

Agreed, best one I had got me set up with NDSS here and I never knew what NDSS was back then. Extremely helpful, sometimes it's not always just dietary advice they can help with.

 

[kitedoc]

I was not aware that NDSS did that! That sounds like a great service! I reckon they have a fair idea about life skills too which certainly does not go astray with teaching.

 

[NicoleC1971]

Hi

If your diabetic nurse makes an appt for you to see a dietitian, what should they go through with you? Shouldn't they be a specific person to deal with food and not just another diabetic nurse?

He or she should be a specialist with degree level knowledge of nutrition in relation to type 1 diabetes.
In the case of type 1, that dietician will likely help you with carb counting in a practical way in order to best match your dose to those carbs but in the context of a 'healthy diet' .

I have seen a couple over my type 1 career (in 1981 they suggested cheese and bacon - yay - to counteract my newly on insulin hunger) and many of them are open to different dietary approaches and how to best help you achieve what they see as a healthy diet. One Aussie version told me they would even discuss keto!
So it depends on what you are after as to whether you can get any value from them. May be useful to note some questions, issues that you wish to resolve and see what they say and whether you can actually implement it in your daily life. You are then free to ignore all or some of the advice of course!

 

[Deleted member 308541]

$90.... yeah, I can think of better things to spend $90 on, like steak!

Steaks good for the diet...

 

[Daibell]

Guys, when expressing your opinions on whether the OP would gain anything from seeing a dietician, please bear in mind they have type 1 diabetes as clearly indicated by their avatar.

Thanks. I hadn't spotted that and broader advice relevant to T1 could be important. Still important to keep the carbs under control to avoid weight gain and spikes.

 

[fairylights]

Hi

If your diabetic nurse makes an appt for you to see a dietitian, what should they go through with you? Shouldn't they be a specific person to deal with food and not just another diabetic nurse?

In my experience a dietician working in the diabetes team will not necessarily talk about food, they are trained in diabetes management (for T1 anyway). I see my dietician every 6 weeks or so, we don't really talk about diet at all (although she has told me to be careful, how many carbs I eat), I see her to go through my insulin settings on my pump and for her to help me with any issues I have with high or low blood sugar. I know she does dafne and pump starts as well.