Exploring dietitians’ practice and views of giving advice on dietary patterns to patients with type 2 diabetes mellitus: a qualitative study

Konstantina E Moutou, Clare Y England, Callum Gutteridge, Zoi Toumpakari, Paul D McArdle, Angeliki Papadaki*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

7 Citations (Scopus)
204 Downloads (Pure)

Abstract

Background
Dietary guidelines for type 2 diabetes mellitus (T2DM) emphasise weight management and individualised total carbohydrate intake. Evidence on the most effective dietary patterns (DPs) for T2DM management is mixed, potentially leading to variations in the advice that dietitians provide. The present study aimed to explore dietitians' practice of DP advice provision to adults with T2DM, as well as understand their views when advising their patients on the DPs deemed effective for glycaemic management or recommended by current guidelines.

Methods
Semi-structured interviews were conducted with 12 UK-registered dietitians, with experience in consulting adults with T2DM. Dietitians were asked for their views on five DPs recommended for glycaemic management of T2DM. Interview transcripts were analysed using deductive and inductive thematic analysis.

Results
Nine themes were identified that draw attention to DP advice provision practices, the five DPs (low-carbohydrate, low-fat, low-glycaemic index, Mediterranean diet and Dietary Approaches to Stop Hypertension diet), other DPs, the barriers and facilitators to DP advice provision and following this advice, and the factors affecting the provision of DP advice. Participants' current practice of DP advice provision to patients with T2DM was perceived to be individualised and patient-centred. Participants discussed their current practice and perceptions of available evidence and how patients respond to advice on the DPs shown to be effective for glycaemic management. Several barriers to providing advice on specific DPs, including safety and compliance challenges, were identified. Participants also highlighted factors that would facilitate the provision of advice on specific DPs and would help patients to follow this advice, including social support, educational resources and more robust scientific evidence.

Conclusions
The findings of the present study provide important insights regarding dietitians' views of promoting whole DPs to patients with T2DM. Emerged barriers and facilitators should be considered when developing future guidance for dietetic practice to support patients with following whole DPs for T2DM management.
Original languageEnglish
Pages (from-to)179-190
Number of pages12
JournalJournal of Human Nutrition and Dietetics
Volume35
Issue number1
Early online date9 Aug 2021
DOIs
Publication statusPublished - Feb 2022

Bibliographical note

Funding Information:
We thank the registered dietitians who participated in this study. No financial support was received for this work. The study was supported by the National Institute for Health Research (NIHR) Bristol Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol.

Publisher Copyright:
© 2021 The British Dietetic Association.

Research Groups and Themes

  • SPS Exercise, Nutrition and Health Sciences

Keywords

  • barriers and facilitators
  • dietary patterns
  • dietetic practice
  • dietitians
  • glycaemic management
  • qualitative research
  • type 2 diabetes

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