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Food/Nutrition Columnist Author: Jo-Ann Heslin, MA, RD, CDN - Food and Nutrition Columnist - Last Updated: Jul 7, 2016 - 5:36:25 PM

At Risk For Diabetes – See A Registered Dietitian or Certified Diabetes Educator

By Jo-Ann Heslin, MA, RD, CDN - Food and Nutrition Columnist -
Aug 25, 2014 - 12:03:14 AM

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( - Getting a diagnosis of diabetes is life altering. Suddenly you have to consider everything you eat. You are urged to begin exercising, lose weight and are prescribed drugs. For most it is overwhelming and there are many unanswered questions after you leave the doctor's office. The next step for anyone in this situation is to ask for a referral to a registered dietitian (RD) or a certified diabetes educator (CDE). In some cases this health care professional may be one in the same. The unique aspect of this care is that this health professional will spend time with you and help to individualize your diabetic care routine which is essential to your health.

A new study ( by researchers at the Centers for Disease Control and Prevention has estimated that 40%, 4 out of every 10 adults in the US are at risk of developing diabetes at some point in their life. And, the US rate of increase may be only the tip of the iceberg. According to Lorraine L. Lipscombe, MD from the University of Toronto ( because of aging populations, rising obesity rates, unhealthy eating habits, and lack of exercise the prevalence of diabetes is increasing at an unprecedented rate worldwide.

Every person with diabetes, especially type 2 diabetes, is different. A one-size-fits-all treatment plan simply won't work. It is all about YOU - what you can do and what you are willing to do. Personalization has to be the cornerstone of an effective treatment plan. The American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) are both advocating an individualized patient-centered approach to diabetes care. It is a chronic condition with many individual variables.

Patient-centered care is responsive to what the person wants, their values, and to some degree what medications they are willing to use. You will take into consideration:

  • Your life circumstances
  • Your culture
  • Your heritage
  • Your food likes and dislikes
  • Your willingness to make changes

This approach may seem like you are receiving less than effective treatment, but even the best instructions are useless if they are not followed. Treatment options that you agree to and are willing to follow, even when not optimum, will provide better results.

All health professionals agree that diet instruction is one of the key foundations to diabetes control and will help to prevent complications in the future. The evidence is strong, showing that those who get counseling from a certified diabetes educator (CDE) or a registered dietitian (RD) are more capable of managing their diabetes. These services are often covered by insurance and always covered by Medicare.

You will benefit from this help.

The first question everyone asks is, "What can I eat now that I have diabetes?" The simple answer is "everything." No foods are off limits. It's when you eat and how much you eat that you need to watch.

At first the idea of planning all of your meals and snacks can be stressful.  It isn't that hard. First, become accustomed to regular serving sizes, which are probably smaller than what you now eat.  Stick with the smaller, regular sizes as often as you can. Next, work on spacing meals and snacks throughout the day and try to keep to this schedule each day. Then work on making the best selections each time you eat.

Meal Planning Hints


  • Eat regular meals and aim for the same amount of food at about the same time each day
  • Choose regular serving sizes
  • Eat moderately sized meals
  • Choose foods with carbohydrate and fiber at each meal and each snack
  • Include a good source of protein at each meal
  • Choose foods low in fat
  • Bring food with you so you don't miss a meal or snack

Go easy:

  • On foods containing sugar
  • On foods containing saturated fat
  • On alcohol


  • Skip meals or snacks
  • Overeat

When it comes to diabetes management, only you know how you feel. You will be the first to notice any problems. And, you will set the pace for what you are willing and able to do. The rest of your health care team depends on you. Take good care of yourself.

To learn more about managing diabetes take a look at one of my latest books The Diabetes Counter, 5th ed. (Pocket Books, 2014).

© NRH Nutrition Consultants, Inc.
Jo-Ann Heslin, MA, RD, CDN is a registered dietitian and the author of the nutrition counter series for Pocket Books with sales of more than 8.5 million books.

Look for:

The Diabetes Counter, 5th Ed., 2014

The Fat and Cholesterol Counter, 2014

The Most Complete Food Counter, 3rd ed., 2013

The Calorie Counter, 6th Ed., 2013

The Complete Food Counter, 4th ed., 2012

The Protein Counter, 3rd Ed., 2011

The Ultimate Carbohydrate Counter, 3rd Ed., 2010

The Healthy Wholefoods Counter, 2008

Your Complete Food Counter App:

For more information on Jo-Ann and her books, go to:


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