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Why Diabetics Should See a Registered Dietitian

Adopting and sticking with eating habits that maximize blood glucose control and heart health is, perhaps, the biggest challenge diabetes presents. First, for most people this represents a significant change. Second, misconceptions abound regarding what a diabetes-friendly diet includes, or more accurately doesn’t include — no sugar, no carbohydrates, no this, and none of that.

Some give up without ever trying. But, a skillful registered dietitian not only knows medical nutrition therapy to account for your weight, blood glucose control and medications, but also knows that enjoying food doesn’t have to be surrendered.

The DAWN study showed only about one third of participants adhered to their eating plan — a registered dietitian can help you embrace this crucial lifestyle change by providing a balanced, personalized meal plan for you.

The phrase diabetic diet sounds so restrictive. With the minor exception of accounting for carbohydrates, there is nothing about an eating plan for diabetes that’s different from a heart healthy diet for virtually anyone.

Losing body weight

More than 80 percent of people with type 2 diabetes are overweight or obese. There are lots of great reasons for losing weight — better mobility, improved sleep apnea, higher self-esteem, lower blood pressure, and a reduced risk for several cancers to name a few.

But, where type 2 diabetes is concerned, losing only a modest amount of weight — 5 to 7 percent of body weight — improves insulin sensitivity and blood glucose control. That means an improved A1C, and a reduced risk for diabetes-related complications.

Responsible and steady weight loss eases the burden on an overworked pancreas, helps diabetes medications work more effectively (including insulin for people with type 1 diabetes), and can greatly improve your quality of life as well.

A registered dietitian customizes an eating plan to help you lose weight, while making certain your food and medication remain appropriately matched. An excellent registered dietitian also works to achieve your weight loss goals by focusing on foods you can eat, not by declaring groups of foods as off limits.

Reducing risk for heart disease

Heart disease is the leading cause of death among the many diabetes-related complications, and heart disease is linked with diet even in the absence of diabetes. So, you can anticipate that your registered dietitian focuses as much on reducing your risk for heart disease as on controlling blood glucose levels.

A standard set of health indicators for diabetes, known as the ABCs, includes A1C as the A, blood pressure as the B, and cholesterol as the C. The target values are A1C less than 7 percent, blood pressure less than 140/80, and cholesterol LDL (bad cholesterol) less than 100 mg/dl with HDL (good cholesterol) greater than 40 mg/dl or 50 mg/dl for men and women, respectively.

Note that two of the three, blood pressure and cholesterol, are independent of diabetes as risks for heart disease and stroke in the general population (although poor blood glucose control worsens the risks).

Reducing heart disease risk in your diet includes

  • Replacing saturated fats from meat and full fat dairy products with lower fat foods, fish, and healthy unsaturated fats

  • Replacing refined grains like bread and rice and pasta with whole grains

  • Adding more fruits and vegetables

  • Replacing sodium with spices, and avoiding sodium in prepackaged or canned foods

Getting to know carbohydrates

Managing carbohydrates — not eliminating carbohydrates — is a key to controlling blood glucose levels, and reducing your risk for diabetes-related complications. And, carbohydrates are everywhere. Your registered dietitian helps you learn where to find carbohydrates, identifies healthier carbohydrate foods you can enjoy, and balances your intake of carbohydrate foods throughout the day in your personalized meal plan.

Routinely meeting with a registered dietitian help you gain confidence in your ability to eat freely while controlling your diabetes.

You may find a registered dietitian associated with your medical provider, a local hospital, in private practice, or available through your local department of public health. You can search for a registered dietitian in your local area on the website of the Academy of Nutrition and Dietetics.

Find a registered dietitian who is also a certified diabetes educator by looking for the CDE notation in their title, or by searching the website of the American Association of Diabetes Educators and look for the RD or RDN designation. A registered dietitian/certified diabetes educator has an advanced understanding of diabetes and nutrition.

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