Diabetes UK recommendations for nutrition management:
- Nutrition management is recommended as part of an integrated package of education and clinical care for all people with diabetes and those at risk of developing Type 2 diabetes
- Offer on-going nutritional advice guided by a Registered Dietitian to all people with diabetes, and those at high risk of Type 2 diabetes
- Offer structured diabetes education at the time of diagnosis with annual follow-up
- Adopt a person-centred approach and a variety of learning styles during education
The Referral Pathway can be accessed here
Type 1 Diabetes
All patients newly diagnosed with Type 1 Diabetes should be referred to a Registered Dietitian for personalised nutritional advice. This forms part of a structured diabetes education programme that is jointly delivered with the Diabetes Specialist Nurse (DSN) Service. All adults newly diagnosed with Type 1 Diabetes are offered a half day carbohydrate awareness course (see below) as well as individual dietetic support that is delivered on a one-to-one basis.
Carbohydrate Awareness Course (Introduction to Carbohydrate Counting)
This is a nationally accredited course that is delivered by a Diabetes Specialist Dietitian and has been developed to meet the NICE guidance Type 1 Diabetes in adults: diagnosis and management Type 1 diabetes in adults: diagnosis and management (nice.org.uk) which recommends referral to a structured education programme within 6-12 months after diagnosis. Patients would usually attend this course in advance of their individual dietetic appointment/s.
Carbohydrate Counting Course
Those who wish or for whom it is appropriate are offered the opportunity to progress to a longer carbohydrate counting course. Carbohydrate counting involves matching insulin dose with the amount of carbohydrate that is eaten.
These courses are delivered by Diabetes Specialist Dietitians and Diabetes Specialist Nurses over 2 half days and are evidence-based and nationally accredited.
Referral to the course is via the Secondary Care Diabetes Team (Diabetes Dietitians / Diabetes Specialist Nurses / Diabetes Consultants).
Type 2 Diabetes
NICE recommends that all patients with Type 2 Diabetes should be provided with individualised and ongoing nutritional advice from a healthcare professional with specific expertise and competencies in nutrition. Type 2 diabetes in adults: management (nice.org.uk)
All people newly diagnosed with Type 2 Diabetes should be given a copy of the Diabetes UK Publications “Eating Well with Diabetes” and “Your Guide to Type 2 Diabetes” at diagnosis and understanding checked at each subsequent review. These leaflets are available to order / download from Diabetes UK healthcare professionals - Diabetes UK Shop
Group Education for people newly diagnosed with Type 2 diabetes
NICE recommends that adults with type 2 diabetes and/or their family members or carers (as appropriate) should be offered structured education at and around the time of diagnosis, with annual reinforcement and review.
Please see Education for Type 2 Diabetes (kernowccg.nhs.uk) for details of ‘Diabetes and You’, the locally developed and delivered model of Type 2 diabetes structured education in Cornwall.
Consider an individual referral to the dietitian for patients with Type 2 Diabetes if:
- The patient is unable / unwilling to attend group education
- Following group education additional dietetic advice / support is required
- The patient is struggling with implementing advice/ motivation
- The patient has an additional medical condition / nutritional concern – please see the referral pathway which can be accessed by the link at the top of this page.
Please see Non Diabetic Hyperglycaemia referrals to NDPP (kernowccg.nhs.uk)for details of how to refer to the National Diabetes Prevention Programme (NDPP)