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I must strongly respond to the comment that "unless the dietician is also a
CDE they don't have a clue about diabetes". I felt that comment was
inappropriate and rather sweeping of the profession in general.
We have had dieticians that are knowledgeable about older type 1's and yet
another that are reciting literature two decades out of date and she was
utterly useless. We also have one now that is a whiz and has insights into
diabetic diets and the effects on insulin basal rates that have not been
alluded to on this site. This dietician is wonderful and has been a great help
to Sara. She has individualized a plan for Sara that meets with her three main
requirements, Diabetes, teen and athlete.
But, I had to find her. It was my responsibility to locate someone that fit
our needs and to tell our MD that the one assigned by the hospital did not
The dieticians at the hospital are of course inclined to treat the diabetics
they see most often, Type 2 who are middle aged or senior citizens. This is
the largest population of Diabetic patients in the country. The ADA in our
area was better, but still the ratio of pump patients to MDI and Type 2 was
very low. So where would I expect the dieticians to invest their time?
Investigating the best means of advising those individuals they are most in
contact with. How many female teen, type 1 that swim 18 hours per week with
weight training three times per week on an insulin pump do dieticians see? I
can tell you in the Akron/Cleveland area not many, if any others. We have yet
to see another insulin pump on any competitive pool deck. But, I found a
dietician that had expertise in these areas.
Believe it or not there are still many diabetics doing exchanges. To us it
seems outdated, especially when we are using a pump, the most up to date
technology. But for some senior citizens counting the exchanges they need to
eat at each meal is much simpler and less prone to errors. Therefore the
patient compliance increases dramatically with the expected, and hopefully
It is very frustrating to need the support of these specialties and not
receive the level of expertise required. But, to slam the whole group because
this session was a bust for you is counterproductive. You just need to connect
with a dietician that fits with your needs. This one did not, but the
dietician may have been wonderful for others in the group. Your real complaint
is that you wasted an evening of your time and got nothing. And you had every
right to complain about that. It is too bad the dietician did not have the
insight to explain that her focus was not on insulin pump therapy and provide
advise for you to find the information you were interested in acquiring.
The American Dieticians WEB site has a "find a dietician" search incorporated.
You can choose three requirements and limit the geographic area of the search.
You can then call and interview the dieticians from your specific search
results. I have provided the address below.
This is a much better way to use your time and energy then running randomly to
nutrition lectures hoping that this one is for pre-pubescent pump people.
Pam, mom to Sara
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