Exploring dietitians’ views and practice on dietary pattern advice for adults managing type 2 diabetes

A new study from researchers at the National Institute for Health Research Bristol Biomedical Research Centre (NIHR Bristol BRC) has provided much needed insight into the practices and views of dietitians in the UK. They hope it will inform and improve the current processes of support available for individuals with type 2 diabetes mellitus (T2DM) who manage their condition through diet.

Diabetes effects 4.7 million people in the UK, with 90% of these cases being T2DM. Patients with the condition are advised to follow a suitable diet that is tailored on an individual basis to ensure it is feasible and sustainable. This advice is often delivered by a dietitian. The evidence on the most effective dietary patterns (DPs) for T2DM management is mixed, often leading to variations in the advice that dietitians provide to patients. Adults with T2DM also report that they find dietary advice confusing and contradictory, and that making healthy eating choices is challenging.

To better understand the practices of dietitians in the UK and their views in advising patients on different DPs, the researchers hosted a series of interviews. They enquired about the dietary patterns that have shown to be effective for T2DM management and those recommended by current guidelines for the management of blood sugar levels. These included the low-fat diet, the Mediterranean diet, the Dietary Approaches to Stop Hypertension (DASH) diet, the low-carbohydrate diet and the low-glycaemic diet.

The interviews highlighted several barriers to providing advice on certain DPs, including safety and compliance challenges. They also highlighted that educational resources, social support and more robust scientific evidence would help to support patients to follow advice on whole dietary patterns.

Dr Angeliki Papadaki, who led the study said:

“Weight management and total carbohydrate intake, based on individual needs, are important for the management of T2DM. However, this advice should also incorporate the whole diet (a dietary pattern), as people do not consume nutrients or foods in isolation.

“Our exploratory study found several important barriers to providing advice on whole dietary patterns, but also ways to help dietitians support individuals with T2DM follow whole dietary patterns. We invite Dietetic Associations to acknowledge these when developing future practice guidance and professional development resources for dietitians.”

Paper: Exploring dietitians’ practice and views of giving advice on dietary patterns to patients with type 2 diabetes mellitus: A qualitative study Konstantina E. Moutou et al., Journal of Human Nutrition and Dietetics