Meeting the nutrition education needs of people with Type 2 Diabetes

The clinical and cost effectiveness of dietary and lifestyle modification as a treatment for type 2 diabetes (T2D) is well described (1). This is reflected in the Diabetes in Adults NICE Quality Standards which includes the Quality Statement: People with diabetes should receive personalised advice on nutrition and physical activity from an appropriately trained health care professional (defined as one with specific expertise and competencies in nutrition) (2). However, over the past 20 years a number of factors have led to changes in the provision of nutrition education which are impacted on meeting this standard. There is now strong evidence for the benefits of structured group education (of which nutrition is one component) and as such availability has increased but referral rates from primary care remain too low. Face to face consultations for non-complex patients, once provided by dietitians are now more frequently done by practice nurses. These interventions should provide basic introductory information and support; discuss referral for more detailed and complex advice; and then provide on-going support and reinforcement. However, the findings of study by the project lead found that in practice, referral rates by practice nurses to other sources of nutrition education are low. Nutrition education is being provided largely in general practice by staff working beyond their professional roles, who lack the time and in some cases the competencies to provide this and are isolated from professional support and guidance (3). 

This GRIP project considered the current knowledge regarding the provision of nutrition education in primary care for people with T2D at a national and local level and sought to use this to find ways of improving access to high quality, timely nutritional education to better meet the needs of people with T2D in Sheffield and meet national recommendations for diabetes care.

The following sources of knowledge were considered:
  • The practice and the service knowledge of health care providers across the city regarding diabetes care.
  • Research evidence including NICE guidelines and standards.
  • Findings from a study ‘Exploring the provision of diabetes nutrition education by Practice Nurses.’ (3).
Please find the full report here.