Sarah Howard
Sarah Howard has worked in the diabetes research field ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange.
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Aside from the first year after your diagnosis, have you seen a registered dietitian for help managing nutrition and T1D? Cancel reply
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I’m not actually sure when I last saw a registered dietitian since completing DAfNE in 2006 but I know the last dietitian I saw isn’t working there anymore
I’ve been a T1 diabetic for 46 years. I saw a registered dietitian several times during my time with diabetes. But, I don’t recall seeing a dietitian for the last 20 or 30 years.
I saw one after diagnosis and again about 5 years later and a third time after 12 years because of my frustration with the way my blood sugar was going. Neither time did I really get the help I needed. I received the same information that a type2 diabetic would receive after being a type1 for ten years.—It’s not the same!!
I said yes, but maybe I should have said no? Never saw an RDE when first diagnosed in 1974. I now have a nutritionist for sports and diabetes, and kidney disease.
in 20 years, I have never seen a dietitian
As part of a food study I was in last year, I met with a registered dietitian weekly for 3 months. It was incredibly beneficial. She got to know me and helped me develop my own cooking and eating style that’s tasty, healthy, and doable. I’ll add access to a registered dietitian as another benefit of being T1D. (Take the win where we can.)
I was a Registered Dietitian and Certified Diabetes Educator, but I saw dietitians when first diagnosed in 1955 quite a lot. Later saw a dietitian at the UW when doing a research study. Went to conferences with many dietitians and many conferences about diabetes. I found it really helped the more I knew about diabetes.
Saw one, recently out of school, when I was first diagnosed ten years ago. She insisted I needed 150 grams of carbs per day minimum and handed me a sheet with meal plans. She explained that I needed those carbs to keep my brain functioning properly. GEEZ. I can only hope she’s learned a thing or two since then.
Yes, I speak with one every 6 weeks or so on the phone. She’s very helpful!
Yes. I was told to eat whatever I want and take insulin accordingly and I’m now reaping the results of this terrible advice.
Not sure if the person was registered but I received great advice. Part of the advice was not new- eat plants, avoid processed foods, fast food, sugar drinks,etc.
When I was put on insulin, the first dietitian I payed to see said I could eat whatever I wanted as long as I followed the set number of macros (carbs, protein, fats). The stupid diet had my blood sugars all over the map. She didn’t care/listen when I told her milk, bread/pasta made me feel really sick. She said because I was on insulin I need to eat a high carb, low protein and low fat diet. What bad advice!
Thankfully, I came to my senses and starting reading the experiences of other T1D’s who were following the The Bernstein diet.
Every dietitian I have seen since knows I only eat fresh fruits and vegetables as my carbs and a good amount low iron protein and fat. I won’t/don’t eat junk and chase it down with insulin.
I said “NO”, but for me, even INCLUDING the first year after my diagnosis, I have never seen a registered dietitian for help managing nutrition and T1D!!!
when diagnosed back in 1962, I was given a pamphlet explaining the ADA exchange lists. I was appalled at the huge amount of food I would be required to eat: 1800 calories for a very skinny ten year old girl.
Same here 1962 carb overload I couldn’t eat that much. Things have changed drastically but i received no help at all from dieticians. I did get help from a nutritionist. I read everything I can to keep up. Not much out there to help with weight loss.
but mainly for the gastroparesis and T1D , for nutrition and bs
I spoke with a dietitian for the second time 25 years after my diabetes diagnosis. I decided to do it because I was diagnosed with MS at that time.
Don’t know if there was anyone that was only a dietician I’m sure there was but after 59 years how could I recall that?
I had no need to. My wife went to school for food and new & nutrition. Shee was a few credits shy of a dietitian. She has been very helpful with the carb counting game.
Saw the dietician several times through the decade going to the pediatric hospital endocrinology clinic. Again when I switched from “exchanges” to carb counting, when I was having trouble with cholesterol and again when I was pregnant.
Although I have seen a dietician at least 3 times, it has been many years since doing so. Right now, I need advice on how to lose weight without frequent low BG’s.
I’m sure there were registered dietitians at Joslin 70 years ago, but that’s a little hazy. I did get halfway through a Masters in Biochem, and that has always been immensely helpful in understanding the nutritional side of things. Might even have a bearing on this old lady’s longevity!
Yes, far more often recently than before carb counting became essential knowledge, Since my chronic kidney disease diagnosis 4 years ago I’ve been seeing my CDE every 6 months. Among her many academic credentials she has a doctorate in nutrition. She’s been very helpful.
I saw one with my husband a few months after he was diagnosed. We ended up in a polite argument because she insisted that he needed whole grains and wanted him to eat whole wheat bread, quinoa, wild rice and other “heathy grains” all of which is still high carb and would make it even harder to control his BG. I felt that I was doing a better job on my own, left in disgust and never went back. Unfortunately, that was only about four years ago so not much has changed.
Whole grains have fiber content which makes them release slowly and more evenly digestible for better BG spike control than processed (white) grains that have been stripped of fiber. Thus whole grains do make a beneficial difference.
Consult with the RD is included with endo visit, they don’t tell us anything new
After my initial diagnosis in 1962, the only other useful time I saw a registered dietician (RD) was when I was enrolled in the pregnancy and diabetes arm of the DCCT from 1981 to 1885. I met with a wonderful RD, CDE who brought me up to speed by teaching me about practical healthy eating food choices and carb counting, along with MDI guidance from a top notch endocrine MD and her team of RN, CDEs. I had long before abandoned the standardized ADA exchange program I was taught in the 1960s – way too much unappealing food choices and way too much ineffective and irregular insulin (NPH) once or twice a day for a petite boned short stature physically active adolescent and young adult female.
The other few dietitians that I had occasion to meet over the years were way too regimented and boxed in with hospital based clinical training. They lacked any creativity, comprehension, or insightful understanding of my personal life style needs,, interests, choices, or concerns … at least that has been my personal experience. Thus, through personal experience, I have found my own way.
However, nowadays some, if not many, registered dietitians and clinical nutritionists who are certified as CDCES (Certified Diabetes Care and Education Specialists) seemed to be better trained and more versatile to address various lifestyle and weight management concerns.
Only when insurance requires it for a new Dexcom. My a1c is right at/below 6.0 so they just say they did it for insurance purposes.
My CDE is also a Registered Dietitian.
Diagnosed in 1987. Soon after getting my first pump in 2005 the nurse practitioner kept asking me to meet with the dietitian. I finally agreed and had to listen to her standard ADA Type 2 recommendations (I’m Type 1). She was talking about exchanges! My one meeting with a dietitian soon after diagnosis was equally useless.
I’ve noticed they all have their own bias. It’s hard to sift through and determine what would work for me.
yes, I found a really great one, I see her anytime i get a new diagnosis (several auto-immunes). She helps me gear my food choices to not cause as many flair ups. She also helped me figure out bolusing for protein and how to slow down the spikes if i eat fruit. also, how to adjust my insulin for exercise. To be honest, she knew more then any of my endo’s about how much food affects blood sugar
I’ve “seen” a nutritionist AND a dietician by telephone appointment in past year. Shouldn’t they be able to look at my diet and be able to advise me if I’m getting all the RDA of vitamins and minerals, etc? And to inform me what if any supplementation is necessary? That’s what I was expecting, but it turned out my endo referred me to them only to urge me to eat more carbs. I was disappointed. I learned as usual that I’m as well informed about eating a healthy diet as they are.
I was also referred because I was diagnosed with celiac disease. I already knew that meant excluding gluten such as in grains (whether high fiber or not), and beer and many hard liquors which are often made from grains or blends of alcohol from grain. Unless a a label or an internet search or a smart liquor clerk, shows otherwise, assume that alcoholic drink is derived, as least partially, from a gluten containing source. The smart clerk found JUST ONE pricey vodka brand derived from 100% gluten free sources. And unless your tequila or mescal is labeled 100% from cactus (also pricey), assume the worst. Wines look OK, but lookout for sulfites. Sheesh, it’s enough to drive me to total sobriety! 😫
I’ve found that they are generally less informed than I am about T1D. It’s frustrating & unfortunate.
I wanted to make sure my diet was as good as it could be. She first wanted me to join a group. I said no. We proceeded to talk and she said at the end I could teach a group and she agreed it would not teach me anything. I did learn about a nifty balsamic and olive oil store called The Vine and Grind in Treasure Island near my home from her. My husband became quite the cook during the pandemic and now we only buy what we eat up and everything is fresh. Try to keep processed foods to a minimum. The result is sugar now gives me a headache. Much healthier without it.
The D nutrition fundamentals have had ZERO meaningful changes of any significance in nearly fifty years.
Once I reached adulthood and moved away from home, I switched from an Internal Medicine physician to an endo specializing in diabetes. I went to the dietician at his request. My mother always prepared very balanced meals so the dietician didn’t really have anything helpful to tell me. Her comment was ‘just keeping eating as you do now. Wish all my diabetics ate like this’. Note, I eat a LOT, but I’ve always been very active and burn off a lot of calories just sitting.