Using an RD(N)/CDE
Finding the right dietitian can make all the difference
For many people living with diabetes, the hardest part is eating healthy. It used to be something you hardly thought about and just enjoyed. Diabetes can turn into an endless job of planning, counting, and saying "no." Finding a dietitian who is trained in diabetes can make life much easier. And it can help you take better care of your diabetes.
The ABCs of RD's/RDN's and CDE's
Anyone can call himself or herself a nutritionist. So if you're thinking of making an appointment with someone whose card says only "nutritionist," check his or her training. On the other hand, a registered dietitian (RD) / registered dietitian nutritionist (RDN) has to have specific schooling. The RDN credential is the newest credential being adopted by some RDs to further distinguish them from nutritionists. According to the Academy of Nutrition and Dietetics' Board of Directors and the Commission on Dietetic Registration, including the word "nutritionist" in the credential communicates a broader concept of wellness (including prevention of health conditions beyond medical nutrition therapy) as well as treatment of conditions. RDs/RDNs must have finished a program like an internship, where they learn on the job. Then, RDs/RDNs must pass a very comprehensive exam.
CDE. stands for certified diabetes educator. Only healthcare providers with the required diabetes experience can be certified. Also, a CDE must have completed at least 1,000 hours of training in diabetes education.
A New Teammate
Your doctor's office or hospital probably has handouts on eating and meal planning with diabetes. You may even go home with a folder full of papers. But handouts are never as good as an informed, helpful person who can work with you and your needs.
"You're not going to get just a print-out from a dietitian," says Janis Roszler, RD, CDE, and an advisor to dLife. "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, likes and dislikes, and lifestyle. Then, with your help, they come up with ways for you to change your diet.
And when that dietitian is also a certified diabetes educator, he or she will be able to help you with things like: when to take your insulin or other medicines, when and how to test, and what to watch for as you change your diet or try new foods.
Make an Appointment
The easiest way to find an RD(N)/CDE is through your doctor or hospital. But if you can't find one in your area, you may want to make a special trip.
Before your appointment, spend some time thinking about your diet. What are your favorite foods? 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 lover, 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 plain so that eating can still be one of life's great joys.
Reviewed by Constance Brown-Riggs, MSEd, RD, CDE, CDN 01/14.
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Years before I was diagnosed with type 2 diabetes, The Other Half came out of a doctor's appointment with a diagnosis of "borderline diabetes" and an ADA exchange diet sheet. His health insurance agency followed up on the diagnosis with a glucometer and test strips. After a year or so of trying to follow the diet plan and test his glucose levels, things appeared to be back in "normal" range, and stood there until a couple of years after my own diagnosis. Shortly...