In 1997, Diabetes UK, formerly the British Diabetic Association, investigated the provision of dietetic services in diabetes care. They carried out a postal survey to dietitians in the UK to assess level of provision and current practices including application of nutritional guidelines, audit and evaluation.
The survey showed that 85% of dietitians worked in situations where dietetic provision was less than the current recommendation of 22.5 hours per 100 000 of the population, made by Diabetes UK, in 1999. One of the outcomes of this situation is that people with diabetes may not receive dietary education from a State Registered Dietitian.
Dietary education may be part of an education package offered in general practice by the practice nurse. The evolution of the nutritional guidelines for people with diabetes to a status which is in line with healthy eating recommendations for the general population may have ‘de-mystified’ the diet in diabetes care to the extent that it was perceived as being a package that could be relayed without the expertise of a dietitian.
There is a need for a consistent approach from health care professionals. Coordination of training of all health care professionals involved in diabetes education on nutrition and diabetes as well as overall management of dietary education in diabetes care is essential to ensure a high-quality service to all people with diabetes. Continuing professional development is essential to update knowledge and skills.