Dietary management of older people with diabetes

Diabetes UK's revised nutrition guidelines for the prevention and management of diabetes, published recently, encourage education in self-management and include additional guidance for older people with diabetes. The incidence of diabetes in older people is increasing. Many older people with diabetes are healthy and mobile, and live in the community, but a number are frail and living in care homes. Those who are frail are at increased risk of malnutrition from a range of causes. Older people with diabetes should be assessed for malnutrition risk and referred to a dietitian if required. Management of these patients focuses on foods that are high in protein and energy foods. A case study gives an example of how a community nurse may be involved.Peer reviewedFinal Accepted Versio

An Investigation into Patient Adherence to Dietary Advice for Type 2 Diabetes Mellitus

© 2014 Griffiths and McClinchy; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly citedPeer reviewedFinal Published versio

Identifying Dietitian’s Experiences and Views of Other Health Professionals (HCPS) Giving Nutritional Advice

© 2014 Gee and McClinchy; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly citedPeer reviewedFinal Published versio

Dining out with Coeliac Disease : An Analysis of online Message Board Postings on the Social Implications and the Challenges to Live A Normal Life

© 2014 Solomon and McClinchy; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly citedStrict adherence to a gluten free diet is the only treatment for coeliac disease. Over the past two decades, there has been a societal shift into less home cooking and eating at restaurants has become an important means of social participation creating significant difficulties for people with coeliac disease. This research aimed to explore the issues that people with coeliac disease need to contend with when dining out, their coping mechanisms and the key aspects that facilitate a normal social life through the analysis of online message board postingsPeer reviewe

An exploration of individuals’ experiences of dietary changes made as a result of a head and neck cancer diagnosis

There has been much research concentrated on the physical aspects associated with head and neck cancer such as weight loss and dysphagia (Kubrak et al, 2010). However, there is little published research exploring patients’ reactions to these issues and possible alterations to their diet. Therefore the aim of the study was to explore these experiences of dietary changes as a result of a diagnosis of head and neck cancer (HNC)Peer reviewedFinal Accepted Versio

Reliable Indicators of Cancer Related Malnutrition for an Outpatient Oncology Nutritional Screening Tool Identified Through a Systematic Review

© 2014 Humphreys et al.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly citedPeer reviewedFinal Published versio

‘Feta is obviously very dangerous stuff looking at all those reds’: Can nutrition labelling help people living with type 2 diabetes to self‐manage their condition?

© 2023 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association. This is an open access article under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License. https://creativecommons.org/licenses/by-nc-nd/4.0/.Background to the study The consumption of a healthy balanced diet is the cornerstone of treatment for people living with type 2 diabetes (PLWT2DM). The UK recommends a standardised voluntary front of pack food labelling system which uses the green-amber-red colour coding to indicate the presence of nutrients in a food item. Research with PLWT2DM suggests they may find it challenging to interpret the information on food labels. This paper draws from a larger study exploring nutrition information practices for PLWT2DM. The aim of this paper is to explore the experiences of using nutrition information found on food labels amongst PLWT2DM and their partners/carers. Methodology The study used a qualitative and mixed methods design, using a solicited 4 week unstructured diary followed by a qualitative interview with each participant. The theoretical framework drew on practice theory. Data were analysed using thematic analysis. Results 19 PLWT2DM and one partner took part. Data consisted of 19 diaries and interviews. Almost all participants used food labels to help manage their condition, however the colour coding link with traffic lights appeared to overemphasise the need to avoid foods with red labels. Participants’ beliefs about sugar influenced their food choices which in turn could impact on their nutritional intake. Highly developed mathematical skills were needed in order to interpret information about portion sizes. Principal conclusions Healthcare professionals and patient support groups should focus more on educating PLWT2DM about how to interpret food labels so that they are able to apply these to their own food choices. Future research and development of subsequent versions of the food labelling system should include PLWT2DM to ensure that labels are both clear and relevant to them.Peer reviewe

Developing the Diary-Interview Approach to Study the Embodied, Tacit and Mundane Nutrition Information Behaviours of People with Type 2 Diabetes

© The Author(s) 2022. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/)This article discusses the development and use of the solicited unstructured diary-interview method to explore the everyday tacit and mundane nutrition information activities (NIA) of people who have type 2 diabetes. Diary completion was followed by individual qualitative interviews with individuals (n = 18) and one couple. Diary entry styles ranged from succinct daily logs of their NIA to extensive prose reflecting on the nutrition information they used and associated practices. Development of the method incorporated piloting and advice from lay groups who checked acceptability and understanding of the research tools, and highlighted the need for regular contact between the researcher and participants throughout the diary completion phase. Participants engaged positively with the diary approach. The findings highlight the extent to which the everyday NIA is mundane and thus unavailable for academic exploration. The diary-interview method exposed these practices to both the researcher and participant, and supported them to reflect on the practices they engage in every day in order to self-manage their type 2 diabetes. Although this article draws on an example from health, the article demonstrates how the diary-interview method has utility for researchers exploring other everyday tacit and mundane experiences.Peer reviewedFinal Published versio

WHAT NUTRITION INFORMATION ARE DIETITIANS USING WITH THEIR PATIENTS WHO HAVE TYPE 2 DIABETES?

Introduction Dietitians offer specialist evidence-based dietary advice to their patients. Dietary advice for people with type 2 diabetes (T2DM) including written nutrition information (NI) is a key component of the management plan. The aim of the project was to investigate the NI used by dietitians with people with T2DM. Methods An online ad hoc questionnaire exploring whether dietitians produced NI, whether they have had training in the production, any patient involvement in the production, other sources of NIs, factors affecting choice of NIs used and the provision of NIs to other healthcare professionals (HCPs) was developed and pre-piloted. Individual dietitians and departments with dietitians who were working with people with T2DM across England were emailed a link to an online questionnaire. Data were analysed using descriptive statistics and thematic analysis. Ethics approval was obtained from the University of Hertfordshire. Results All 93 respondents used NIs in their consultations. The main sources were a national diabetes charity and a national provider of nutrition information. The main reason given for their use was that the information met the needs of patients. Two thirds of respondents also used NIs produced by their own departments. However almost 40% reported not having any training in the production of NIs and only 10% involved patients in their development. Over 80% of respondents also supplied HCPs with information; nurses and GPs being the main recipients. Conclusions, discussion and/or practical application Dietitians are using evidence-based information and in ensuring HCPs who work with people with T2DM have access to appropriate resources. However their lack of access to training in the development of NIs and in involving patients may limit the effectiveness of resources developed by their own departments. Dietitians could benefit from training in the development of NIs and should be encouraged to involve patients in the development process.Peer reviewe

Dietary advice and collaborative working : Do health care professionals have a role?

Introduction: Long term health conditions either wholly or partly diet-related continue to increase both nationally and internationally. Health care professionals (HCPs) have a key role to play in the management of patients with long term conditions (AHPF 2008). There is limited research exploring whether HCPs other than dietitians are important in the delivery of dietary advice although in the UK, community pharmacists are now expected to undertake public health activities and have been identified in the pathway for the provision of oral nutritional supplements (www.malnutritionpathway.co.uk no date). This research aimed to explore the views of HCPs other than dietitians regarding the provision of dietary advice that is, or could be, given to their patients. Method: The study adopted a generic qualitative approach (Williams 2012) using focus groups to generate group views. A total of 23 participants took part in five uni-professional focus groups. Each focus group was recorded and transcribed verbatim, analysed using an interpretivist approach and the data and the management and retrieval of the qualitative data was supported by the use of a computer programme, NVivo8® (QSR 2008). The themes and codes emerging from each focus group were discussed within the research team and main themes were identified. Results: The topics covered across the different professions varied and reflected the range of specialisms present within the groups and the type of role each professional group has within healthcare. Despite this variation in roles all groups considered the provision of dietary advice in the context of their own professional roles, discussed issues relating to referral to the dietitian for specialist advice and discussed the need for written information. Conclusion: The findings suggest that HCPs perceive that they have a role in the delivery of dietary advice, that they are aware that there are times when specialist dietary advice provided by a dietitian is required and understand the value of dietary advice provided in the written form. These results seem to suggest that HCPs are not always able to utilise specialist expertise and highlight the importance of maximising the role of all HCPs in the delivery of health promotion advice including dietary advice (Midlands and East NHS (2013). With the need for HCPs to work more collaboratively and flexibly (AHPF 2008, Needle et al. 2011) these findings relating to role, referral pathway and written information could equally be relevant to other HCPs and other aspects of caring for patients with long term conditions.Peer reviewe