Diabetes, Diet and the Dietitian

Finding a registered dietitian who is also a certified diabetes educator can make all the difference in your day.

For many people living with diabetes, the hardest part is eating. What used to be something you rarely thought about –– and enjoyed with abandon –– turns into a sometimes laborious job of planning, timing, counting, and resisting. Finding a good dietitian who is trained in all aspects of diabetes can make life much easier and may even be the ticket to managing your disease in the best way possible.

The ABCs of R.D.’s and C.D.E.’s

Here’s something you might not know: Anyone can call himself or herself a nutritionist. There is no legal definition and no centralized registration agency. So if you are considering seeing someone who has hung a shingle with this moniker, check their background and training. On the other hand, a registered dietitian (R.D.) has met academic and professional experience requirements established by a commission of the American Dietetic Association. These requirements include a minimum of a bachelor’s degree with specific course work, as well as an accredited, supervised practice program, similar to a clinical internship. Then, R.D.’s must pass a national examination and meet continuing education requirements to maintain their status. C.D.E. stands for certified diabetes educator. Certification is voluntary, but it is available only to health care professionals with dedicated knowledge and experience educating people with diabetes. Along with other rigorous eligibility requirements, before being certified the educator must have completed at least 1,000 hours of what the certification board calls “diabetes self-management training.”

A New Ally

Your doctor’s office or hospital likely stocks pamphlets and fact sheets on eating and meal planning with diabetes, and you may go home with a folder full. But, as we all know, reading material is no substitute for a knowledgeable, supportive person who can work with you and your individual needs.

“You’re not going to get just a print-out from a dietitian,” says Janis Roszler, R.D., C.D.E., and an advisor to dLife. “An R.D. really knows how to translate your dietary needs into actual practice. For instance, a doctor may say your blood pressure is high and ask you to watch your sodium, but the doctor is not going to tell you how to do that. The dietitian will say, ‘OK, let’s sit down together and go over how you normally eat, and let’s find things that are high sodium that we can substitute.’ ” Dietitians are trained to look at your habits, preferences, and lifestyle and come up with customized and realistic ways for you to change your diet. “They don’t start with a sheet and say, ‘How will you fit in?’” says Roszler. “They start with you and say, ‘How can we move you to the next step?’”

And when that dietitian is also a certified diabetes educator, he or she will have an in-depth knowledge of all areas of diabetes and will be able to advise you on when to take your insulin, when and how to test, and what to watch for as you change your diet or introduce new foods.

Making an Appointment

The easiest way to find an R.D./C.D.E. is through your doctor or hospital, but if you can’t find one in your immediate area, you may want to make a special trip. You can use the dLife Diabetes Locator to find diabetes specialists by location.

Before your appointment, spend some time thinking about your diet. What are your favorite foods –– those which you’d prefer not to live without? What is a typical breakfast for you? Lunch? Dinner? What snacks do you usually eat and when? Be honest and realistic. If you’re a take-out aficionado, a diagnosis of diabetes is not likely to turn you into someone who loves to cook. Your dietitian will want to know how you really live, and will help you strategize so that eating can still be one of life’s great pleasures.

Stolen from DLife’s Janis Roszler, RD, CDE

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