Last Updated on 18 July 2024 by Brisbane Livewell Clinic
Why You May Need a Dietician for Diabetes
Discover what is Diabetes, how it can affect your health, and why you may need support from a Dietician for Diabetes to improve your overall wellbeing and lifestyle.
What is Diabetes?
Diabetes, medically referred to as Diabetes Mellitus, is a chronic condition in which the body has an impaired ability to control the amount of glucose (a simple sugar molecule) in the blood stream. Glucose is an important source of fuel for our bodies. It’s especially important for our brain and muscle function although, like most substances in our body, needs to be maintained within certain ranges for optimal health.
What Does Diabetes Do?
The development of diabetes is not simply due to how much sugar you eat. It refers to how well your body is equipped to handle changes in your blood glucose levels.
The body naturally produces a hormone called insulin which encourages glucose to be moved from the blood into our body’s cells. It can then be used for essential bodily functions and helps to control blood glucose levels.
In people with diabetes of any form (yes, there is more than one type and it’s important to know the difference!), this process does not proceed as normal. There is either insufficient insulin being produced in the body, or the insulin produced is being resisted by the body and is ineffective to control blood glucose levels.
Due to this change in the glucose processing system within the body, the levels of glucose in the blood in people with diabetes rise above normal levels. This is how your doctor is able to detect if you have developed diabetes through regular blood tests or a process called an Oral Glucose Tolerance Test (OGTT).
What Are the Risk Factors for Diabetes?
Risk factors for some forms of Diabetes include:
- Being overweight
- Being inactive
- Older age
- Having genetic factors including a history of diabetes in the family
- Some ethnicities.
Without changes to your diet and lifestyle and, in some cases, the use of some prescribed medications when diagnosed with diabetes, your blood glucose control will remain outside of target ranges. This can put you at increased risk of short- and long-term complications including:
- Heart disease and stroke
- Kidney disease
- Eye, foot and circulation problems
- Higher risk of infections
- Higher risk of complications during pregnancy
What Are the Different Types of Diabetes?
Type 2 Diabetes
85-90% of all diabetes cases are Type 2 Diabetes. This is a progressive condition in which the body becomes resistant to the normal effects of insulin or gradually loses the capacity to produce adequate insulin within the pancreas.
Type 2 Diabetes can be managed with a modified carbohydrate diet to stabilise blood sugars, regular physical activity, healthy eating and healthy weight. In addition to these lifestyle changes, patients with Type 2 Diabetes are often required to take oral medications or regular injections over time as the condition progresses.
Type 1 Diabetes
10-15% of all cases of diabetes are Type 1 Diabetes and it is one of the most common chronic childhood conditions. It is an auto-immune condition in which the cells in the pancreas that make insulin have been destroyed by the body’s immune system.
Type 1 Diabetes is not linked to modifiable lifestyle risk factors and can only be managed with insulin injections several times a day or the use of an insulin pump device to deliver vital insulin that the body is unable to produce. Healthy lifestyle choices are also important to control the progression of the disease.
Gestational Diabetes
Gestational Diabetes develops in 12-14% of pregnant women. It usually occurs between the 24-28th week of pregnancy and is diagnosed through screening using an Oral Glucose Tolerance Test (OGTT).
Gestational Diabetes is a form of diabetes that occurs due to insulin being resisted by pregnancy hormones and the body being unable to produce additional insulin to compensate. It usually goes away naturally once the baby has been born.
The majority of women with Gestational Diabetes have a healthy pregnancy, normal delivery and healthy baby if measures are taken to maintain normal blood glucose levels throughout the remainder of pregnancy. It is managed with a modified carbohydrate diet consisting of regular meals and snacks to stabilise blood glucose levels in addition to healthy eating to meet pregnancy requirements and regular physical activity.
Latent Autoimmune Diabetes of Adults
Latent Autoimmune Diabetes of Adults occurs in 6-10% of people presenting with diabetes. It is an autoimmune condition in which immune antibodies destructive to insulin producing pancreatic cells are present but the progression of destruction of the pancreatic cells is slow (unlike type 1 where the onset is rapid).
To begin with, it usually doesn’t require insulin injections and can be managed with a healthy diet and exercise. However, it will eventually require insulin injections as bodily insulin production gradually declines.
Pre-Diabetes
Pre-Diabetes describes people who are at increased risk of developing Type 2 Diabetes. Their blood tests show glucose levels that are elevated but not high enough to be diagnosed as Type 2 Diabetes.
Diet and lifestyle changes can be effective to return blood glucose levels to normal and stop progression to diabetes.
Insulin Resistance
Insulin resistance is not a form of diabetes, rather an underlying mechanism. It is a medical term to describe when the hormone of insulin is not working effectively to stabilise blood glucose levels due to its actions being resisted by muscles and liver. As a result, the body must produce greater amounts of insulin to keep blood glucose levelswithin the normal range.
Insulin resistance is common in people with family history of diabetes, overweight, physically inactive, women with Polycystic Ovarian Syndrome (PCOS) and some ethnic groups. It can be improved through healthy eating, weight loss and physical activity including resistance exercise.
How Can Our Dietitian for Diabetes Support Your Health?
Unfortunately, there is no cure for diabetes. However, our Dietitian for Diabetes can assist you to manage your condition using practical and achievable diet and lifestyle changes.
At Brisbane Livewell Clinic, we believe that diabetes doesn’t have to define you. Often people are very overwhelmed after receiving a diagnosis of diabetes and are very confused as to what they are allowed to eat. Our Dietitian for Diabetes can clarify any questions you may have about your diet and diabetes such as the following:
- Can I reverse my diabetes?
- Am I allowed to have sugar?
- Should I completely eliminate carbohydrate foods?
- Will eating this giant dessert milkshake give me diabetes?
Our Dietician can also provide education, resources and support in the context of a healthy diet and lifestyle whether you are newly diagnosed or have had diabetes for a long time. Topics often include:
- Carbohydrate modified diet appropriate to the form of diabetes you are living with.
- Glycaemic Index and effect on diabetes management.
- Meeting nutritional requirements – especially important during pregnancy.
- Effect of weight and physical activity on blood glucose levels.
- Managing eating out and social occasions.
- Trouble-shooting and day-to-day practicalities of living with the condition.
- Label reading and cooking skills.
- Handy resources including phone applications and recipes.
- Dietary fats and sources.
- Macronutrients – carbohydrate, fat, protein, alcohol.
What’s Involved In Seeing Our Dietitian for Diabetes?
Firstly, it’s important to realise that a Dietitian is not the diet police! Rather we want to assist you to make better choices and improve your health and wellbeing taking into consideration your personal situation. Often this may involve making changes to what and how much food you eat and improving your relationship with food overall.
When you see our Dietitian for Diabetes, you will complete a pre-appointment questionnaire. This helps our Dietitian understand your needs and personal goals.
An open and confidential discussion around your relevant social, medical and weight background, current medications, recent pathology results, self-blood glucose monitoring results if applicable, usual foods and drinks eaten, timings of meals, eating behaviours and physical activity levels allows us to assess your current health situation.
Our Dietitian for Diabetes will answer nutrition-related queries and provide explanations of diet-disease relationships so you understand your health condition better and why changes may be necessary.
Our Dietitian will also be able to provide you with tailored nutrition education to equip you with the skills and confidence to make your own educated choices.
They will also discuss various nutrition strategies to apply to your diet so that you can set achievable and realistic goals with ongoing support and motivation to make changes for the long-term.
How Often Will I Need To See My Dietitian?
After the initial appointment with your Dietitian, follow-up consultations within 2-3 weeks will usually be encouraged. This will help ensure you have been able to implement any strategies, address any obstacles that may have arisen and provide support and accountability while making diet and lifestyle changes.
Subsequent consultations are then scheduled as often as patients find necessary to assist in meeting their health goals.
