Reviewed by Sharon Denny, MS, RDN
Diabetes affects the body's ability to make or properly use insulin, which leads to high blood glucose — or sugar — in the blood. Maintaining a healthy blood sugar level is essential to managing diabetes. Choosing nutritious foods and monitoring portion sizes help keep blood sugar levels as stable as possible. If you have diabetes, a registered dietitian (RD) or registered dietitian nutritionist (RDN) can provide medical nutrition therapy to help manage the disease while ensuring you get necessary nutrients.
What Is Medical Nutrition Therapy?
Medical nutrition therapy includes a lifestyle examination, a thorough review of current diet and eating habits and development of a personalized nutrition treatment plan. These services are covered by a variety of insurance plans. Medicare Part B covers medical nutrition therapy for diabetes and kidney disease; diabetic patients with private insurance should check their individual plan for specific coverage details. An RD or RDN who meets certain requirements can provide these services, including nutritional assessment, education and individual counseling to address specific dietary needs and preferences.
Why a Dietitian?
RDs and RDNs are food and nutrition experts who have completed multiple levels of training established by the Academy of Nutrition and Dietetics. While many RDs and RDNs are generalists with knowledge about a variety of nutrition subjects, some might have a specialty interest or an advanced credential such as Certified Diabetes Educator (CDE). An RD or RDN who is a CDE will have a unique and specialized skill set to help educate people with diabetes on how to manage their condition and improve their outcomes. "If you have a complicated schedule of medications for diabetes, are on an insulin pump or use a continuous glucose monitor to help manage your diabetes, I recommend consulting with a CDE," says Andrea Dunn, RD, LD, CDE, chair of the Academy's Diabetes Care and Education Dietetic Practice Group.
How Does the Dietitian Help?
People with diabetes need to understand how foods and nutrition affect their bodies to successfully manage the disease. Dietitians can provide more detailed information about how to eat and practical tips to address daily challenges. A dietitian can help put together a daily meal plan that considers individual food preferences, level of physical activity and lifestyle, and will work with diabetes patients to set nutrition goals to improve their health. "The [RD or RDN] is going to individualize the nutrition information for you. He or she will review the medications you are on, your recent blood work, ask about any recent medical visits or hospitalizations, obtain your height and weight and check your last blood pressure reading," says Dunn.
What Should I Expect?
The length of a visit with an RD or RDN may vary; the first visit typically lasts 45 to 90 minutes. Three to four visits over the next three to six months may be needed depending on additional medical conditions or if weight management is also a consideration. Annual follow-ups for updated information on diabetes and nutrition, or for help with questions or concerns about eating and blood sugar management are to be expected. The dietitian will determine an appropriate follow-up schedule.
"The goal of a [dietitian's] treatment for diabetic patients is tailored to the patient's needs and focused on preventing diabetes progression, troubleshooting specific concerns, teaching valuable skills like medication administration and monitoring, and empowering patients to make behavior modifications with nutrition and exercise," says Jessica Crandall, RDN, CDE, and spokesperson for the Academy of Nutrition and Dietetics.
Personalized nutritional counseling and advice will help people with diabetes set and prioritize their goals. "Remember to make goals that are realistic and achievable. Be honest with yourself and your dietitian about your interests, skills and willingness to change. Begin with a few adjustments and your dietitian will help you take the next steps," says Dunn.
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Reviewed April 2013