Dietary management practices for type 1 diabetes mellitus by dietitians in KwaZulu-Natal

Abstract

Background: In South Africa, 5% – 15% of diabetics have type 1 diabetes mellitus (T1DM). Dietitians are an important part of the diabetes management team; however, there is a lack of published data on the dietary management practices for T1DM by dietitians.Aim: The aim of this study was to determine the dietary management practices for T1DM by dietitians in KwaZulu-Natal (KZN).Setting: This study was conducted in KZN.Methods: A cross-sectional, descriptive study was conducted using a self-administered electronic questionnaire.Results: Of the 69 dietitians who participated, 58% (n = 40) used the American Diabetes Association (ADA) guidelines to manage T1DM; just under 35% (n = 24) spent over an hour with new cases; and 87% (n = 60) used face-to-face consultations for follow-up. Dietitians used the glycaemic index, portion control using the healthy eating plate, carbohydrate counting using nutritional labels and household measures and carbohydrate awareness to manage T1DM (p 0.05). Dietitians also used the healthy eating plate (71%; n = 49) (p 0.05) and household measures (73.9%; n = 51) (p 0.05) to manage T1DM. Time constraints, the literacy level of the patient, available resources and language barriers all played a role in determining the dietary management practices used (p 0.05).Conclusion: Most dietitians in KZN used the ADA dietary guidelines to manage T1DM, which highlights the need for South African dietary guidelines for the management of T1DM. Dietitians used a variety of different dietary methods to manage T1DM in practice. This suggests that dietitians are flexible in how they manage T1DM with no one particular method being used. A variety of factors also influenced which dietary management practices were chosen.