Do you visit an RD/ Nutritionist regularly?


#21

I saw a dietician once after my initial diagnosis. It was a fairly useless meeting. Shortly after that, the funds for the diabetes education program at our local hospital ended, so I didn’t have to deal with it.

I have a degree in home economics and for years taught foods and nutrition classes among other subjects at the high school level. While I don’t pretend to have the nutrition background a dietician has, I have enough background to read and make sense of the literature I need to handle my diabetes. I simply feel no need for a dietician.


#22

I don’t “regularly”. But I do every 7 or 8 years, just for a fresher. The RD in my health system is also a CDE and a type 1, so she knows her stuff. Everyone I deal with is very helpful with whatever I want to try. And while I am not a low carb person, we have talked about ways to make some of those carb choices better for better post meal results.


#23

I used to visit one a lot when I was a teen. She only saw diabetics and had a lot of practical experience with diabetes, so she didn’t act in the conventional way their education prescribes. Mind you, I originally come from the Faroe Islands (live in Denmark now), so their education is probably a lot different from the ones in the US. She acted like a second doctor for me, because she almost always had time for me, while there was a shortage of endocrinologists in the hospital I was treated at, so I only got 2 appointments each year with the endo.
Initially she gave me pointers about what to eat, and then told me to make a food journal, count carbs and write all BG results down next to the meals I had eaten. She then helped me with insulin adjustments etc. She wasn’t really focused on the amount of carbs one was eating, but rather good glycemic control. If I could have a normal blood sugar eating 100 grams of carbs a day, then she didn’t object, if I couldn’t then I had to cut down on the carbs. I had great glycemic control under her watch, and I’m very grateful to her.


#24

I went once after doing a lot of reading and research on my own. I subscribe to a low carb diet and teat often to see what foods spike my numbers and avoid them .She wanted me to eat 45 carbs per meal and suggested foods I told her spike my blood sugars. I continue to eat only 60 carbs per day which works for me.


#25

I was diagnosed with T2DM in Aug 2017 with a BG of 594. After 6 weeks of failed diet from the ADA, suggesting 140~180 grams of carbs a day (BG levels for six weeks avg 250 a day), I decided to go on my own. Best decision I ever made.

Two days later my BG control was great. Daily avg about 80, and seldom ever above 100 (there were scary times when I ate something I didnt check out first, had lots of sugar in it, and my BG shot up to 160. Took me 30 minutes on my bike to work that out back down to the 80’s).

I went full on CARB FREE. Zero carb, carbo non grata! Took a couple of weeks to become fat adapted. First two weeks of zero carb I lost 40 pounds. To date, thats now up to 59 pounds since Oct '17. And it keeps on melting off.

Dont let the charlatons tell you carbs are essential. They are not. Dont listen to them when they tell you fat, saturated fat, is bad for you. It is not. I replaced ALL my carbs with fat and I’m feeling so much better. Reversed my diabetes. My A1C went from 11.8% to 5.8% in four months. Cant wait to rub it into the doctors faces at the V.A. who said this diet of mine was not sustainable! Hell, I get healthier, and save money. Oh, and did I mention all of my blood work improved. Including my Cholesterol! Almost everything blood wise was in the little high to pretty bad areas. Now the worst of the worst is my LDL’s on the high side of normal (and they want me to take statins for that! BAH!!) and my HDL’s are at 62 (ooohhhh yeeeeaaaaahhhhhh).


#26

My endocrinologist referred me to a dietitian at a hospital-based diabetes clinic because I wanted to know how many calories I should eat per day to lose weight.

She couldn’t (or wouldn’t) answer my question, even though that’s the only question I came in with. She just kept repeating that “we don’t count calories anymore, we count carbohydrates.” She told me to eat 40-60 grams of carbohydrates per meal, which was more than I was already eating. I told her I knew about and used carbohydrate counting but wanted to lose weight. She told me to download MyFitnessPal and the app would tell me. I also showed her a mini pocket scale I use to count carbohydrates while on the go (using factors) and she totally brushed it off and suggested I get one with a built-in nutritional database. She didn’t seem to know what carbohydrate factors were. I left with a handout listing carbohydrate counts for standard serving sizes that basically looked like the old exchange lists I used to use, and promptly put it in the recycling when I got home.

I got the impression that she’s used to dealing with people who don’t know anything and are just learning the basics and have minimal to no calculation/mathematical skills. Which is fine. But a good teacher (and maybe I’m biased since I’m a teacher, but in my opnion anyone working in this type of role needs to be a good teacher) should be able to convey the basics to people who need that but also know enough advanced knowledge to be able to challenge those who are ready. And be willing to learn from their clients/patients/students (such as my mini scale or carbohydrate factors).

I’m hoping I just got a one-off bad experience, but it certainly doesn’t encourage me to ever ask for another referral.


#27

Jen,
For weight loss, I have now found the ketogains approach (www.ketogains(dot)com). It actually is working for me, who thought I was a mutant as I continued to gain despite sticking to keto diet. It is ketogenic, low carb, higher protein, and fat as required. The key for me was I think increasing the protein (protein is essential for every body function), reducing the fat, and keeping the carbs low.

Ah, I also found that I am sensitive to dairy. :frowning: After being off dairy for two months, I now find I gain up to 2 kg in the days following consuming any significant dairy, and then lose them again in the following few days, staying off dairy. So food sensitivities can have a big impact.


#28

Thanks. I’ll look into this! I think for me the key is that I need to not only eat low-carb but also exercise quite a bit. I’m trying to work more exercise into my daily schedule, but as it is now my schedule sometimes has exercise (20,000+ step a day) and is sometimes sedentary. I’m hoping to make weight loss a summer project of mine. But the good news is that eating low-carb I’ve lost about 20 pounds in the past year and haven’t gained any of it back, though at the moment my weight is just holding steady (and it’s not because I’ve lost everything I need to lose).

I have many food allergies (anaphylaxis, eosinophilic esophagitis, oral allergy syndrome) so in combination with low-carb I eat a fairly restricted diet. I’m very reluctant to eliminate anything else unless I’m advised to by a doctor. But I’m glad eliminating dary has helped you. :slight_smile:


#29

Amen Terry, Them, the professional medical establishment and the ADA can all get in line to kiss my A$$. At best their lack of progressive leadership on the issue is negligent and at worst criminal.

I cannot believe the modern medical training that makes it way to us as the afflicted. I have a hard time with gaining my Nurse Practitioner Wife’s acceptance of a LoCarb approach to managing my diabetes.

When I talk to most medical professionals about it I feel like I am living the modern version of the old stories I hear about OB/GYNs smoking in their office as the spoke to pregnant women. Most look at me as if I am practicing witchcraft or some such unprovable faith based healing. Even the most progressive look at me and ask “yes it works but is it sustainable?” To which I retort how sustainable is an A1C over 5.5?

There are days I want USDA, Medical Schools and the ADA totally un-funded. Then I want some non-profit to start manufacturing insulin and delivery systems so I don’t have big pharma pushing me or the associated markets around me to situations that increase my dosage requirements.

Yeah, ask me how I really feel about this: we are all being shammed by the so called authorities and poisoned by food choices. Worst of all our insurance and tax dollars support this in perpetuity…

Save yourself through education and personal experimentation. I am healthier as a diabetic than I was the first 44 years I lived prior to being diagnosed!


#30

You never know what you might learn, but then again that depends on who you talk to.


#31

Low carb and low fat means low calorie, because forbid that anyone eats lots of protein.
Starvation diets don’t work very effectively for very long because their adherents get hungry.


#32

Yes, I did this for a while and lost the 10 lbs I wanted to lose, but an overnight hospital stay and their white bread sandwiches put it all back on! Never tried it again. As well as being starvation mode, low fat is tasteless and the manufactured type of food they tell us to avoid.


#33

The few times I have gone I was declaimed at by an aggressive, ignorant, and just plain stupid person reciting a rote speech.

I don’t have that much energy, and I see no reason to waste it on going to the other side of town to be insulted and bored.


#34

I’ve seen a dietician twice in my life, The first was twenty five years ago when first diagnosed with Type 2. That visit was pretty useless because I did not listen, the only thing I remember from that meeting was that I needed to eat carbs instead of fat and that I must de-fat my taste buds.

My second visit was because I requested it. I had just been prescribed MDI and I knew I needed to learn carb counting. It was a good visit, she taught me the basics. I continued my education with the good people on this forum, I have not seen a reason to go back.


#35

I had five or six visits with a RD when I was first diagnosed, since I was following directions (diabetes education at the hospital). Quickly realized the lady either didn’t really know what she was talking about, or was constrained by licensing guidelines to the point where her advice was mostly useless. I learned a couple of things from the experience:

  • Testing often was OK (good), even when not on insulin therapy.

  • Testing on a schedule to capture fasting, before and after meals, before bed, and middle of night BGs is a good idea.

  • Whoever issues nutritional guidelines in the US is trying to actively kill Type 2s and make Type 1s life a lot harder than it has to be…

On that last point, I was given very specific advice (as a healthy, slim, active 40 year old): don’t exercise too much (walking is fine); restrict calories severely (suggestions were about 800 kcal below my daily maintenance levels); reduce fat intake to zero and limit or eliminate red meat consumption; and eat more carbs. I was only eating about 100-150g of carbs a day at that point, and I was told it was dangerous and unhealthy if I wasn’t eating at least 150g a day, preferably more (as long as it was “complex carbs” and “fortified grains”).

In other words, I got all the typical BS that just doesn’t work for many (if not most or all) diabetics. Of course, I wasn’t Type 2, and weight wasn’t a problem and I was fit, but I got treated like I was an 85 year old obese patient in a nursing home. “Take it easy, don’t stress out about it, live a little, and don’t worry about complications…”

But, that RD did me one huge favor! On my last visit, she said, and I quote:

I can’t suggest you do this, but some diabetics have benefited greatly from a nutritional ketogenic diet, and you can look up what that is on the internet.

I don’t eat keto, but I’ve benefited greatly from studying up on carb restriction and reducing my intake down to the “low” level (50-80g per day, with tons of fiber).


#36

i was by 2 already and they have nothing what to say besides that i should starve


#37

Why dont I visit a RD or a Nutritionist? I did when I was first Dx with T2DM. Heck, I was terrified. I wanted to learn everything I could.

I’m retired USAF, and hence, go to the VA for my medical care. The VA nutritionist had a two hour long class all about eating as a diabetic, and selecting proper portion sizes. It was basically a point system, where the only points you count are carbs, as long as you kept it low fat. Basically a 40% protein, 50% carbs, 10% fat. :face_with_raised_eyebrow:

She kept mentioning 45~60 grams of carbs per meal. Thats upwards of 180 grams of carbs a day. Thats not low carb at all. After six weeks of trying to follow their advice, I decided to go back to Keto (I had tried it for 3 months a few years earlier, but I liked my pasta, french fries and pizza too much, so I went back to S.A.D.)

Not just Ketogenic diet, but zero carb. Cold turkey. Carbonongrata.

At my two month follow up, the nurses were ecstatic with my blood glucose control, and needed to know every detail. My PC and my Endo were both ‘meh’ got to much to do than talk to a healthy patient. Got another hundred patients behind this one to write scripts for.

Im my opinion, the nutritionist only know what they were taught. The dont think outside the box. The dont question what they learned. Thats a biggie for me.

In the USAF, I worked with aircraft weapons. We would often hear, “This is the ONLY way to do this”, so then I ask “why?” Why cant I put that explosive cartridge in my pocket? “Because its sensitive to static electricity, and that can set it off”. Then next time lead with the static safety concern, [as I lean over and ground myself at a grounding terminal, now paranoid in a good way]. Compared to “Diabetes is a BG control problem” the follow up question should be “why?” to which the answer should be “because eating carbs raises BG and they have an issue with insulin resistance”. But I think they just dont ask the “why’s” enough.


#38

I saw one for one day in my beginning weeks of diagnosis. After I was coming out of my disordered eating last year because of my diabetes, I wanted to see one but whenever I or my endo called no one would call us back. Unfortunately, it seems that there are no RD’s housed in the diabetes center. It’a shame that there is a lack of RD’s in this field since many pwd’s that are learning how to eat better don’t have the resources they need. The cookie cutter lessons on eating 3 servings of carbs every meal, etc. are outdated and no longer valuable to many pwd’s who want to be healthy without superfluous carbs.


#39

My experience with RD’s is that their approach is more applicable to T2’s. I also find their advice to be to generic, one-size-fits-all. When I was first Dx’s I was a ballet dancer, and since the hospital wouldn’t release (parole) me until I weighted what they wanted, I left 30 lbs heavier than my working weight. I had the ballet company director stop by to convince them that my 110 lb goal weight was where I needed to be. I was 95 when admitted upon initial Dx. They wouldn’t listen, and I lost my job with the ballet company. As PWD1’s we are all different, and havbe different lifestyle requirements.