Survey of dietetic provision for patients with diabetes

Nelson, M.; Lean, Mej; Connor, Henry; Thomas, Briony; Lord, Katherine; Hartland, Beth; Waldron, Sheridan; McGough, Norma; Walker, Laura Osornio; Ryan, Allan J.; Start, Kathryn

doi:10.1046/j.1464-5491.2000.00337.x

Cited by 16 publications

(27 citation statements)

References 14 publications

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“…Most dietitians in the UK use a combination of methods when advising patients how to regulate their carbohydrate consumption. The most common methods are qualitative advice which is used, according to circumstances, by 87% and semi‐quantitative (portions) by 59%; only 17% use ‘exchanges’ and all of them combine this method with other approaches (Nelson et al. , 2000).…”

Section: Quantity Of Carbohydratementioning

confidence: 99%

“…The smaller percentage in primary care reflects the lesser availability of dietetic expertise in primary care but may also be influenced by where the dietetic clinics are held; uptake of dietetic advice is greater if the dietitian works in the general practice diabetic clinic than if the service is provided separately on a central site (Bradshaw, 1994). In a survey of dietitians known to be engaged in the provision of diabetes care in the UK in 1997 only 69% reported that they were able to see more than half of newly diagnosed adult patients within 4 weeks and less than 50% were able to offer half or more of their patients an annual review (Nelson et al. , 2000).…”

Section: Access To Dietetic Services – the Current Positionmentioning

confidence: 99%

“…, 2000). Dietetic provision for diabetes was greater in secondary than in primary care (median 9.1 v 4.4 h per 100 000 general population per week), and was also greater in those districts in which a dietitian was designated as co‐ordinator for the dietetic service than in those where the co‐ordinator was not a dietitian or where there was no co‐ordinator (Nelson et al. , 2000).…”

Section: Access To Dietetic Services – the Current Positionmentioning

confidence: 99%

“…In 1997, only 69% of dietitians were able to meet the first of the CSAG Standards and fewer than half could meet the second (Nelson et al. , 2000), and therefore Diabetes UK increased its recommended provision of dietetic staffing time for diabetes care to 22.5 h per 100 000 general population (Nelson et al. , 2000).…”

Section: Staffing For a District Diabetic Dietetic Servicementioning

confidence: 99%

“…This was to be regarded as an overall target and one which would be inadequate in areas with a higher than average prevalence of diabetes as, for example, in those districts with a large Asian population. In 1997, only 15% of areas met this recommendation (Nelson et al. , 2000), which is for the clinical management of known cases of diabetes and does not take account of the requirement for prevention.…”

Section: Staffing For a District Diabetic Dietetic Servicementioning

confidence: 99%

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The dietitians challenge: the implementation of nutritional advice for people with diabetes*

Connor¹

2003

J Human Nutrition Diet

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The evidence base for current nutritional recommendations has been extensively reviewed on behalf of the European Association for the Study of Diabetes (EASD) 1998 and the American Diabetes Association (ADA) 2002. The nutrition Sub-Committee of Diabetes UK is in general agreement with those recommendations. This paper provides consensus-based recommendations that emphasize the practical implementation of nutritional advice for people with diabetes, and describe the provision of dietetic services required to provide the information. Important changes from previous Diabetes UK (previously British Diabetic Association Diabet. Med. 9, 189) recommendations include greater flexibility in the proportions of energy derived from carbohydrate and monounsaturated fat, further liberalization in the consumption of sucrose, more active promotion of foods with a low glycaemic index, and greater emphasis on the provision of nutritional advice in the context of wider lifestyle changes, particularly physical activity. Monounsaturated fats are now promoted as the main source of dietary fat because of their lower susceptibility to lipid peroxidation--and consequent lower atherogenic potential. Consumption of sucrose for patients who are not overweight can be increased up to 10% of daily energy derived from carbohydrate provided that this is eaten in the context of a healthy diet and distributed throughout the day. The role of the dietitian is outlined in facilitating lifestyle changes and evidence is presented for the effectiveness of advice provided by trained dietitians. The increasing evidence for the importance of good metabolic control and the growing requirement for measures to prevent Type 2 diabetes in an increasingly obese population will require major expansion of dietetic services if the standards in National Service Frameworks are to be successfully implemented at local level.

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Section: Quantity Of Carbohydratementioning

confidence: 99%

Section: Access To Dietetic Services – the Current Positionmentioning

confidence: 99%

Section: Access To Dietetic Services – the Current Positionmentioning

confidence: 99%

Section: Staffing For a District Diabetic Dietetic Servicementioning

confidence: 99%

Section: Staffing For a District Diabetic Dietetic Servicementioning

confidence: 99%

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The dietitians challenge: the implementation of nutritional advice for people with diabetes*

Connor¹

2003

J Human Nutrition Diet

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Current Awareness

2001

Diabetes Metab. Res. Rev.

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of diabetes/metabolism. Each bibliography is divided into 17 sections: 1 Books, Reviews & Symposia; 2 General; 3 Genetics; 4 Epidemiology; 5 Immunology; 6 Prediction; 7 Prevention; 8 Intervention: a) General; b) Pharmacology; 9 Pathology: a) General; b) Cardiovascular; c) Neurological; d) Renal; 10 Endocrinology & Metabolism; 11 Nutrition; 12 Animal Studies; 13 Techniques. Within each section, articles are listed in alphabetical order with respect to author (11 Weeks journals ‐ Search completed at 15th Nov. 2000)

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Ensuring the quality of diabetes care: Use of the QUAD‐CAT model and Alphabet Strategy in clinical practice

Goenka¹,

Panja

James

et al. 2003

Pract Diab Int

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There are wide regional variations in the quality and provision of diabetes care. The pressure is on health care providers to deliver care of the highest quality. The Quality of Care Diabetes Assessment Tool (QUAD‐CAT) was developed to benchmark the care provided in primary and secondary care, based on the American Diabetes Association (ADA) model.We studied data from a random selection of 25 diabetic patients from 10 primary care centres and 100 diabetic patients from George Eliot Hospital diabetes clinic. Data were collected based on the template of the Alphabet Strategy for managing diabetes, for various parameters, including HbA1c, blood pressure, eye and foot examination, nephropathy assessment, lipid profile and aspirin use. A patient questionnaire was included to assess the subjective quality of service.Points were allocated based on the ADA scoring system. In order for a centre to be accredited, 80 out of 110 points were required. The overall points range was 40–95, with three practices accredited. There was a wide variation in performance in the key measures assessed between the practices.In conclusion, QUAD‐CAT provides an easily conducted and well‐accepted tool to evaluate the quality of clinical care and patient's perception of diabetes services Copyright © 2003 John Wiley & Sons, Ltd.

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Survey of dietetic provision for patients with diabetes

Abstract: Given the proven value of dietetic input in diabetes management, there would be advantages to correcting the regional inequalities in dietetic provision for diabetes care in the UK.

Cited by 16 publications

References 14 publications

The dietitians challenge: the implementation of nutritional advice for people with diabetes*

The dietitians challenge: the implementation of nutritional advice for people with diabetes*

Current Awareness

Ensuring the quality of diabetes care: Use of the QUAD‐CAT model and Alphabet Strategy in clinical practice

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