I had a chance to talk to Abby Black, who is a cde and a registered dietitian. She had some a lot to share.
What made you decide to get into the career path of a CDE?
I have a strong family history with diabetes and ever since middle school, when I shadowed a registered dietitian providing diabetes education for patients, I wanted to not only pursue my RD, but also my CDE.
Are you connected to diabetes personally, via a family member or yourself?
I have many family members with diabetes.
You have a newly diagnosed patient with Type 2 diabetes, they are feeling a bit overwhelmed with everything and want to know what they can do to reverse it or get rid of it. How do you answer them?
I completely understand the feelings of being overwhelmed! There is a lot to understand. The key is to take it one step at a time. We will look at where the current stage of diabetes control is at the beginning and then make changes that are achievable to get diabetes under better control.
What would you tell a patient with type 1 diabetes about adjusting insulin for higher fat meals?
We will look at food logs in relation to blood glucose levels to determine when the adjustment is needed for each person’s individual needs.
Could you explain to our readers more about being prediabetic, what this means, and what they should do if their doctor tells them they are prediabetic?
If you have prediabetes, you are already at a higher risk for heart disease in comparison to someone who doesn’t have diabetes. Prediabetes is a time to work really hard with food choices and exercise to reduce your risk of developing type 2 diabetes. If you are told you have prediabetes, seek out individual nutrition counseling through a RDN, CDE or enroll in group classes so you know how to reduce your risk of developing type 2 diabetes.
You have a patient who isn’t able to afford their testing strips. They are given some expired ones from a family member and ask you about using these and their accuracy. How do you answer them and how would you guide them for getting the supplies they need?
Any time test strips are expired, they aren’t going to have the accuracy as new test strips. I would work with the patient and seek out medical companies that will help pay for these strips.
Your patient has been working to lose weight unsuccessfully, they have type 2 diabetes and come to you asking for advice and approval on starting a vegan diet. How do you answer?
If a patient is wanting to start eating a vegan lifestyle, the key I emphasize is it isn’t a diet, it is a lifestyle choice. With eating vegan, while having diabetes, you still need to count carbohydrates, but we can work with the foods to appropriately meal plan together.
Many diabetes patients both type 1 and type 2 use carbohydrate counting in their diabetes management. What about the GI Index and would this benefit both types of patients if introduced into their diabetes management plan? If so, how?
The glycemic index isn’t based on the amount of normal portions of food. A person would need to look at the glycemic load, but it can still have inaccuracies when foods of various food groups are eaten together. Carbohydrate counting is an easier method for diabetes control.
Are there any supplements/ vitamins you recommend for both type 1 and type 2 diabetes patients to take?
My goal is to individualize to the client I’m meeting with. There are certain nutrients that have been shown by research to be low, but we always need to do lab testing to verify that before starting new supplements. Also, supplements can vary as far as being reputable so that is another area to look at further.
Could you please explain to our readers the importance in protein in blood glucose control?
Protein is helpful to provide satiety in your eating regimen. You want to have a balanced meal plan of protein, carbohydrates, and fat.
Are people with diabetes at a higher risk for oral problems such as gum disease and tooth decay?
If so why is this and what can they do to reduce their chances of developing it? Yes, there is a higher risk of gum disease due to diabetes being a multisystemic disease process where it can affect many areas throughout your entire body. The key is regular dental check ups and keeping diabetes in the best control.
A patient’s adult child comes to you with concern that their parent isn’t taking their medications properly or testing as much as recommended. How would you handle this situation?
We would all work together to see what the obstacles are and how to overcome these challenges in an achievable way.
A patient with type 2 diabetes has asked you how they can avoid being put on an insulin treatment regime. How do you respond?
The best way to avoid insulin is to properly manage diabetes and get diabetes under the best control possible. Keep in mind that our body doesn’t work as well as it once used to, so even though you may need to go on insulin, that doesn’t mean you haven’t put your best effort forward with food choices and exercise regimen.
For more information or to contact Abby Black visit her website http://www.abnutritionsolutions.com/about-abby