The most recent Nutritional Guideline from Diabetes UK 1 recommends that:
· Everyone with diabetes should receive individual, on-going nutritional advice from a Registered Dietitian.
· All people with diabetes and/or their carer should be offered structured education at the time of diagnosis with an annual follow-up.
Type 1 Diabetes
All patients newly diagnosed with Type 1 Diabetes should be referred for an individual appointment with 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.
Carbohydrate awareness course
Alongside this individualised education all adults with newly diagnosed Type 1 Diabetes are offered a half day carbohydrate awareness course.
This is jointly delivered by a Diabetes Specialist Dietitian and Diabetes Specialist Nurse and has been developed to meet the recently published NICE guidance Type 1 Diabetes in adults: diagnosis and management https://www.nice.org.uk/guidance/ng17which recommends referral to a structured education programme 6-12 months after diagnosis. Referral to this course is via the Diabetes Specialist Nurses.
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 locally delivered by Diabetes Specialist Dietitians and Diabetes Specialist Nurses over 2 half days and are evidence-based.
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 newly diagnosed with Type 2 Diabetes should be provided with individualised and ongoing nutritional advice from a healthcare professional with specific expertise and competencies in nutrition. https://www.nice.org.uk/guidance/ng28
All people newly diagnosed with Type 2 Diabetes should be given a copy of the Cornwall Diabetes Centre yellow book “Understanding Diabetes” at diagnosis and understanding checked at each subsequent review.
Registered Dietitians deliver group education sessions for people newly diagnosed with Type 2 Diabetes at various locations throughout the county -
Consider an individual referral to the dietitian if:
· The patient is unable / unwilling to attend group education
· Following group education additional advice / support is required
· The patient is struggling with implementing advice/ motivation
· The patient has an additional medical condition / nutritional concern