Not the Diet Police: The Science-Backed Benefits of Working with a Dietitian for Diabetes Management

Welcome back to another episode of the Diabetes Digital podcast.

Today we are talking about how a dietitian, which is what we are, we’re dietitians and diabetes educators, can help you manage your diabetes.

It’s interesting because so many people, including doctors, really don’t have any idea how dietitians can help with diabetes management.

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We’re always reaching out to doctors to form partnerships for referrals, and sometimes they’re like, yeah, we don’t really understand what you guys do.

Can you tell us?

So we figured if doctors don’t know, then that means probably a lot of you don’t know either.

And what better way to talk about this than on our podcast?

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And so on this episode, we are going to talk about what exactly is a dietitian, what to expect during your visits.

Because most people, especially those who work with diabetes digital, they don’t have any clue how the visits are going to go.

They think that we’re just going to tell them they can’t eat all these things and that’s not the case.

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We’re going to talk about how a dietitian can help you with a personalized approach to nutrition, how they provide support and accountability, address barriers, and also like what is the result that a dietitian can bring?

Because we don’t want to do anything that’s a waste of time, that’s not going to actually help our A1C.

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And there’s actually studies to show how dietitians can actually have meaningful impacts on A1C.

And we even have our own case studies.

We’re going to share a couple of those as well.

Welcome to the Diabetes Digital Podcast.

I’m Wendy.

And I’m Jess, and we’re best friends, registered dietitians and diabetes educators.

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Through our telehealth platform, diabetesdigital.co, we offer accessible and personalized virtual nutrition counseling for people managing diabetes and pre diabetes.

Visit diabetesdigital.co that’s Co to book your first appointment.

We accept insurance and offer affordable self pay options.

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Now let’s get into today’s episode.

Let’s first get into what a dietitian is and how a dietitian might be different from a nutritionist or a Wellness influencer.

So dietitians are regulated healthcare professionals.

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And when I say regulated, that means that there’s very specific educational and professional requirements that are regulated by different boards.

There are different state boards and then there is national boards and you have to go through a series of trainings and coursework.

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You have to pass a national exam to become a registered dietitian.

In certain states, you have to apply for licensure to even be able to see people as a dietitian, whereas a nutritionist can really be anyone who provides counseling or advice on nutrition.

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They might not have the formal training that I just went over.

That training is regulated, but they maybe they have other types of training that isn’t so regulated through like a program or certification because there’s a lot of those programs out there.

And now the issue is that with many of these programs, since they’re not regulated, we can’t really attest to whether or not they’re evidence based, meaning they’re backed by science.

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It’s like the Wawa W.

There’s just so many courses and information out there.

A lot of it is a scam, to be honest with you.

And This is why it’s important that you are getting your information from a registered dietitian because this is a person who has gone through years of coursework, who you know that the information is coming from a reliable source.

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And also many of us have experience working with different members of your healthcare team, like your primary care provider, even your therapist and other providers as well.

So it’s nice because we have that background, so we can provide that interdisciplinary care.

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And we also accept insurance, which is something that for a nutritionist who isn’t a dietitian or a Wellness influencer, that’s likely something that they’re not going to accept only because insurance for nutrition is going to cover services by a dietitian.

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And often times, like through US, that service is covered for free.

You don’t have to come out of pocket if you have insurance.

And that’s something a lot of people don’t realize.

When you’re working with a nutritionist or a Wellness influencer, often times you have to opt into like a package that you have to pay out of pocket or a program or something like that.

4:32
Dietitians have that as well.

But the difference is that if we wanted to and we do a diabetes digital, we could go through insurance and it makes it a lot more accessible for people who have that coverage.

They don’t have to come out of pocket.

Yeah.

I would say like 98% of the people we work with are using their benefits and majority of those get unlimited benefits, if not like 26 per year.

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Some people get less, like there’s a couple of plans, but we’ve figured out ways where we can help advocate for those people to get more benefits.

So so it really is a great service.

And even the doctors we talked to are shocked that we’re able to take insurance and see people for these longer visits over a more frequent period of time.

5:16
Now the biggest question people have is what goes on in a nutrition session?

I think a lot of people are scared.

They don’t know, like I said, if it’s going to be diet police.

And so let’s talk about that.

So #1, a dietitian is always going to be collaborative, supportive, and not judgmental.

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I can’t say always, but I would say most of the time, that’s how we’re trained to be supportive.

We are your partner.

You are the expert in your own life.

We might know some things about nutrition that we will share with you with permission, but we’re not going to be preaching about how you’re doing everything wrong and have to change everything overnight.

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Like that’s not what we do.

We want to make sure that you have an understanding of your condition.

So in the case of Diabetes Digital, we focus on managing diabetes, pre diabetes, PCOS, metabolic syndrome.

Everybody is diagnosed in different ways.

6:10
Some people may be diagnosed and just given a handout and they don’t really know what’s going on.

So we’ll make sure you understand what are the lab values, what are your targets and goals, things like that.

We also want to focus on how we can empower you with your unique personality to make these positive changes because everybody is motivated by different things.

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Everybody has a different style that works for them.

And we kind of get a sense on how you learn best and how you’re most motivated.

And in the initial visits, we’re going to focus on exploring your eating habits and patterns, again, with no judgement.

It doesn’t matter if you had 10 pizzas last night or a salad, we don’t want to say we don’t care, but we just want the information so we can help you get to whatever goals you have.

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Also understanding your relationship with food, including any disordered eating history or emotional eating history, because that’s really part of the diabetes digital framework is focusing on diabetes and pre diabetes.

But within the context of having that healthy relationship with food.

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We’ll discuss your household situation, who cooks in your house?

Do you actually like cooking?

How much time do you want to spend on food?

And we’re going to look at your health history and identify challenges, what’s getting in the way for you.

And from there, we’re going to set some achievable goals that align with your needs and preferences.

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And then in our future visits, we’ll talk about things like meal and snack planning and ideas about meeting fiber needs, how to build a balance plate, how to make sure you’re getting enough protein, what your actual protein needs are, because everyone’s protein needs are different.

We’ll talk about reading nutrition facts, labels, hydration, which is really important for everybody, but especially people who have diabetes, how you can cope with healthy strategies, right?

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Like we might use food for coping sometimes, but we don’t want that to be our only coping mechanism.

So we’ll help you build other strategies.

And of course, we’ll talk about carb awareness, the different types of carbs.

We even get into stress and sleep hygiene because we like to take a holistic approach that looks at the whole body.

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And for certain people, they might want to get into hunger and fullness cues, meal timing, cravings.

So there’s so much that we talk about and there’s even more than that.

That’s just like a very brief list.

And it really depends on kind of what your goals are.

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And you know, how much time you have to kind of invest in these things because you might focus on one thing longer if you you don’t have less time to make these changes more quickly.

And that’s totally fine.

We’re going to go at your pace.

Exactly.

Yeah.

So it’s a lot more than just getting a meal plan, which is what a lot of people think we do.

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We can absolutely help you with meal planning, but it’s very individualized.

It’s not like we’re just giving out handouts and being like, this is what you’re gonna eat Monday through Friday, and this is breakfast, lunch and dinner.

It’s a lot more complex than that.

And we like to go deeper and explore what your relationship to food might be like.

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What are your obstacles and challenges?

And any plan that we do create is very individualized for you based on whatever information it is that you’re giving us.

And that is really like the key difference.

If it were as easy as a meal plan, then, you know so many people wouldn’t be coming back and back.

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For nutrition counseling.

It’s a lot more complex than that.

We also take into account things like age because we know that nutritional needs vary at different life stages.

So maybe your appetite has gone down now that you’re getting older or during certain points of the month.

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Or maybe you want to start a fitness routine and you want to adjust your nutrition based on that.

Also, cultural preferences is really big in our practice.

We like to honor everyone’s culture and learn about what are the foods that you grew up eating and how we can incorporate those in a nutritious way.

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We also talked about medication.

So, you know, with many medications, they might increase your appetite, they might decrease your appetite.

And so we talked about those side effects and how you can navigate those, especially for people that have diabetes or who on injectables, you almost kind of have to like plan the medication alongside food choices.

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So we help you navigate that and whatever food preferences you have, like if there’s any foods that you’re like, you know what, I really don’t like that even though it’s considered a healthy food, we explore other options that you can incorporate for people managing diabetes.

It is really important to understand versus cut out carbohydrates.

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That’s another big misconception that you should be limiting carbohydrates that you should, you know, do keto and, and things like that.

And so we support you in planning carbohydrates as part of a healthy meal, figuring out what carbs you thrive on, which ones you enjoy.

10:58
And so everything again is tailored to your preferences so that we can help stabilize your glucose and get you to your A1C goals.

And if you’re wondering like what that looks like, practically, you would be meeting with a dietitian, whether it’s weekly or bi weekly, We recommend if you’ve never worked with a dietitian, to start doing weekly just so that you can get to know your dietitian, build that trust and build some momentum.

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And then you can maintain.

Once you’ve kind of reached your goals, you could do a maintenance phase where you do bi weekly or even monthly if you don’t feel like you need that much support.

And the visits are about 15 minutes.

So that gives you a chance to really talk to someone, build rapport.

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Because you know when you go to the clinic or a hospital, those visits are usually like 20 minutes.

They’re very short.

And then you might not be able to get a follow up until the next month.

And so it’s like all the rapport, all the work that you might have done, it kind of just goes away because it’s not enough follow up, it’s not enough support.

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So with this model, it really allows you to have someone actively encouraging you and holding you accountable for your goals.

And at Diabetes Digital, what we like to do is we do, we set you for an initial visit and we kind of just secure you for a recurring slot if your schedule is pretty predictable.

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So that, that way, you know, like Fridays at 3:00 PM, I’m gonna be seeing my dietitian every week.

Now for people who are like, well, I prefer to schedule week to week ’cause I have a lot going on.

That’s more so like my situation then you could do week to week and that’s totally fine.

And then in terms of like what ongoing support looks like, so you do your initial visit where we go over medical history and we, you know, we just get to know you and get to know what your needs are.

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And then during those follow up visits, we monitor progress, we adjust the plans, we talk about maybe any new lab work that you’ve gotten and what tweaks we might have to do.

If you’re doing any kind of glucose monitoring, we also go over those numbers with you and we actually have software that integrates with your glucose monitoring system.

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So we’re able to see in lifetime what your numbers are like and that is really great because we can go through certain parts of the day and identify like, hey, what happened here?

What do you think is going on?

I’m noticing that your post dinner numbers are like consistently high.

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What have you been having for dinner or have you been taking your medication?

If you’re on medication, you know, things like that.

So it’s great because we’re really able to individualize in that way and we can help you prioritize like what’s really going to get you to your goals.

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Now, the fourth reason why it’s beneficial to work with a dietitian to help manage your diabetes is because we will help you address individual challenges and barriers.

I always say that a lot of us know what to do, but we have a really hard time doing it because there’s a lot of different challenges that come up for us, whether that’s emotional eating, whether it is societal pressures that may drive us to binging and restricting.

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We can help with those things.

And we always will set goals after each visit and then we’ll come back and say, hey, how did it go?

And sometimes there’s obstacles that we didn’t account for, right?

Maybe we had a goal, but we didn’t account for the fact that you are going to be traveling and it was going to be a little harder to reach that goal.

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So then we can pivot, re evaluate and go from there.

We’ll also offer psychological support and guidance for some of these difficult situations.

Now, we are dietitians, we’re not therapists, but a lot of food is psychological, right?

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A lot of our relationship with food also is deeply intertwined with our mental health.

And while we encourage all of our clients to work with the therapist as well, we will provide some of that emotional support around eating.

So essentially working with a dietitian to help with these challenges and barriers is really going to help ensure long term success in preventing or managing diabetes.

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And the fifth way that we as dietitians help with people with diabetes is helping to monitor blood glucose levels.

So Wendy already talked a little bit about this.

We do have a lot of systems and softwares that help us with clients permission track their blood sugars in real time.

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So we can, you know, even between visits, a lot of our dietitians will go in, they’ll comment on what’s happening, they’ll send you a message saying, hey, I’m seeing this so that you can get some of that feedback in real time.

So we’re reviewing those glucose numbers and data.

And even if it’s not happening between sessions, it definitely happens at every session.

15:32
And some of the different glucose monitoring methods that our clients use are glucometers.

We also use CGMS, continuous glucose monitors, and these two things really help us get an idea of what’s going on.

There’s benefits to each method and yeah, it will really inform your treatment plan.

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One thing we’re really excited about with Diabetes Digital is that we put everything we’ve learned in our first six months of operation into a 12 week program, which is our 12, 12 weeks to lower your A1C program.

So within this program you get one-on-one coaching with your dietitian weekly or as Wendy said, bi weekly based on your schedule.

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And all the things that we talked about are kind of packaged into different topics per week so that you make sure that you’re getting everything covered in those weekly sessions.

Now, while this does have structure, we also can personalize things.

So if you already know about physical activity and you have a routine that you love, maybe we don’t spend as much time talking about that.

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But if you have more emotional eating going on, maybe we spend more time talking about that.

So it’s really customizable, flexible, but it gives you that framework to make sure that we’re hitting all of our bases.

And I know a lot of programs out there, they require cash pay, but one of the benefits of working with a dietitian, as we said, is that we accept insurance.

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And now we accept most major insurance companies, including Aetna, Anthem Blue Cross Blue Shield, United, Cigna, pretty much all of the major ones, Medicare.

So it’s great because you get the support, you help to lower your A1C and you don’t have to pay for it in most cases.

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And I know people are wondering, OK, because I mentioned at the beginning, I’ll talk about does this work?

Like, do dietitians really make a difference?

The answer is absolutely yes.

So there is a study that suggests dietitians with nutrition counseling within three to six months can help to lower your A1C by up to two percentage points, which is incredible.

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So that is somebody going from an A1C of 8 to an A1C of 6.

And by the way, for those who don’t know what A1C is, it’s your average blood sugar over three months and it’s the number that we look at when we’re looking at how well you’re managing diabetes or pre diabetes.

OK.

17:49
So I also wanted to share some case studies because now that we’ve been around for six months, we have some of this data on the patients we’ve been working with.

And if you go to our website, diabetesdigital.co/A1C, you can see these case studies for yourself.

But I’ll pull one patient here.

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This person had a history of pre diabetes and high cholesterol.

We work with them seven sessions over three months and the focus was on joyful movement.

It was on honoring hunger and respecting fullness, increasing carbohydrate awareness and focusing on complex carbs, mindful eating and also challenging all or nothing self talk, especially as it comes to food because often we’re like, Oh well, I quote UN quote ate bad.

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So like who cares?

I’m just going to finish this box of cookies, right?

And so that’s kind of all or nothing.

This person’s A1C went from 5.9 before working with us to 5.1, which is incredible because now they’re out of that pre diabetes range.

I’ll give another example of a patient.

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So we have another person who had type 2 diabetes, high blood pressure.

They work with us for 13 sessions over three months.

And for this person, we prioritize planning meals and balance snacks.

During busy weeks.

We added a vegetable to lunch or dinner, more fiber, also skipping less meals.

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That’s a huge issue for people improving their relationship with food and emphasizing positive and mindful eating and also increasing joyful movement and physical activity.

This person’s A1C went from 13.5% to 7.5%, which is absolutely incredible.

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And so these are the results that we’re seeing with our patients.

If you want to see more case studies, we have even more on the website.

Go to diabetesdigital.co slash A1C.

And that is how a dietitian can help you improve your diabetes.

Yeah.

So as you can see, it’s a lot more than meal planning.

19:44
We help you get your A1C down, keep your labs stable, explore your relationship to food, get personal guidance.

Like there’s just so much that we can do working together.

I think for most people, we know that our relationship to food is ongoing.

20:01
It’s ever changing.

And it really helps to get that additional support when managing diabetes.

Just like therapy is really helpful to navigate life, working with a dietitian is really helpful to navigate food, especially if you have a chronic condition like diabetes that can taint your relationship to food.

20:18
So we really encourage you to consider working with one of our expert dietitians.

They’re incredible and we have options for you to pick from based on your needs and they can really help you live a healthy life.

Whether you have pre diabetes, diabetes, PCOS, insulin resistant, our dietitians got you.

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And again, the best part is that it’s covered by insurance.

If you have any commercial plans or even if you have Medicare, you can go to diabetesdigital.co to learn and more.

And yeah, we have like a one minute quiz that you put your information into and that’s how you get started.

20:53
And if you guys have any questions after listening to this episode specifics or you’re wanting to know if we’re in your state, take our quiz because we’re in 29 states so far.

But some people also follow up with an e-mail like we just saw an e-mail this morning where someone was like, hey, when you coming to Maine.

21:09
So when we do get a lot of emails like that, we will try to take action as best we can and get license in those new states if we see a need.

So still take the quiz and submit it so that we can kind of see where we’re getting a lot of traffic from.

And once we get in your state, which happens all the time, we will then message you and let you know.

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And then you can work with our dietitian.

So thank you all for listening to this podcast.

Share with a friend, a family member who needs to work with a dietitian or you think they would benefit or they have diabetes, pre diabetes, PCOS and hopefully we can help.

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And if not us, we will refer you to a dietitian who can.

All right, y’all, thank you so much for listening and we’ll catch you next time.

Bye.

Thanks for joining us for today’s episode.

If you’re interested in nutrition counseling with one of our expert dietitians to help improve your pre diabetes or diabetes, visit us at diabetesdigital.co.

22:03
Also, if you found our conversation helpful, do us a favor and rate and review this podcast on iTunes, plus share with someone who might find this helpful.

You can also connect with us on Instagram at Diabetes Digital dot.

Co and TuneIn every Wednesday for practical, inclusive and culturally humble diabetes BD’s insights.

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We’ll catch you later.