What good is a dietitian, if I have been living with diabetes for years?

The proof is in the sugar. Within 1 year of beginning treatment with a registered dietitian, a study of 2,500 people with diabetes helped participants achieve between 7.9 and 9.4% weight loss. Those 65 to 74 years of age were the most successful, achieving healthy weight loss toward the higher end of results. Insulin dependent participants still achieved 7.4% weight loss.

The direct relationship between diet & diabetes management increases the value of individualized attention from a Registered Dietitian. According to the American Diabetes Association, Medical Nutritional Therapy (MNT) provided by a registered dietitian is important for improving your level of personalized care by managing existing diabetes and preventing or slowing the onset of diabetes-related complications.

Is there a difference between a Nutritionist & Registered Dietitian (RD)?

RDs are even more regulated than nutritionists, and their studies go several steps further. Both, however, begin with a bachelor degree from a college or university. Then...

  • College or university is accredited by the Commission on Accreditation for Dietetics Education (CADE)
    • Standard, official coursework is required
  • 900 hours of supervised training at health care facilities, food service organizations, and community agencies
  • Required to pass a registration exam administered by the American Dietetic Association (ADA)
  • Required 75 hours of continuing education every 5 years.

What is Medical Nutritional Therapy (MNT)?

It's big, fancy term for the valuable work of a registered dietitian in diabetes management:

  1. Follows referral documentation provided by Dr.
  2. Assesses your nutrition and dietary patterns
    • Needs vs. intake
    • Consistency of meals
    • Carbohydrate intake
    • Quality of diet
  3. Evaluates and customizes new plan with future treatment goals

The American Diabetes Association recommends MNT: "Individuals who have pre-diabetes or diabetes should receive individualized MNT as needed to achieve treatment goals, preferably provided by a registered dietitian [. . .] (Clinical Diabetes 2010)"

What can/can't I eat?

People with diabetes can—and should—eat the same foods as people without diabetes. These food tips can help:

  • Choose healthy options:
    • Fruits
    • Vegetables
    • Whole grains (high-fiber cereals, whole-grain bread, brown rice, whole grain pasta, etc.)
    • Skim or low-fat milk and yogurt
    • Lean meat, poultry, and fish
    • Heart-healthy fats (trans fat-free margarine, olive or canola oil, nuts, seeds, etc.)
  • Go easy on red meats, cheeses, fried foods, high-fat snacks, & desserts (ice cream, cake, cookies, etc.)
  • Choose drinks that contain little or no carbs (water or seltzer water, diet soft drinks, vegetable juice, coffee, tea, etc.)
  • Limit fruit juices, regular soda/soft drinks, & sports drinks. They contain a lot of carbohydrates & calories!

Carbs have the most impact on your blood sugar levels when compared to protein and fat.

  • Eating the same daily amount of carbs (starchy foods, fruits, vegetables, & milk)
  • Eat meals at the same times every day and do not skip meals
  • Meet with a registered dietitian to create a personalized diabetes diet plan. By meeting your preferences for food & meal times, coordinating any diabetes medications you require, and achieving your weight & blood sugar goals, an RD is a key partner in managing diabetes.

Can I ever eat candy or sweets?

You can. The key is controlling the portion size & the frequency with which you indulge, so you can make adjustments to maintain healthy blood sugar levels. Many sweets now have nutritional labels that include the amount of carbohydrates & fats, making it easier to keep track. Armed with this info, you can compensate by exercising, eating less of something else, or taking more insulin (if this is an option).

What about artificial sweeteners?

They may be a good alternative to sugar. Unlike sugar, artificial sweeteners generally don't raise blood sugar levels because they are not carbohydrates. But because of concerns about how sugar substitutes are labeled and categorized, always check with your doctor or dietitian about using any sugar substitutes if you have diabetes. Common examples include Sweet & Low® and Stevia®.

Does reading food labels really help me stay healthy?

Yes! Food labels provide important information to help us eat healthy meals & snacks in the right portions. New government regulations have increased the information put on food labels to include:

  • Proper serving size
  • Natural calories & calories from fat per serving
  • List of nutrients and ingredients
  • Recommended daily amounts of nutrients in the food
  • Relationship between the food and any disease it may affect

America's Dietitians strongly recommend reading food labels, working directly with you to get to know label displays of sugar calories, fat, carbs, & sodium contained in each item. Accurately comparing food label information will help you choose healthier brands & options as well as keep track of your intake.

Are there benefits to eating 4 or 5 small meals during the day instead of 3 large meals?

Yes! These benefits include decreased blood sugar levels after a meal, reduced insulin needs over the course of the day, and decreased cholesterol levels.

These benefits are probably a result of slow, continuous absorption of food from your gut, which saves the body some work. Eating several small meals a day may reduce your hunger and your daily calorie intake. Nibbling throughout the day is not always easy but, if it helps you maintain blood sugar control and healthy body weight, then it is worth the slight lifestyle change.