Dietitians assist in many ways with diabetes management including assessing diet quality, alongside medical management of diabetes, making recommendations and monitoring effects. The evidence-based approach however in long-term care environments, may differ to what many people think.
Several relevant organisations and research bodies agree that for clients in long-term care, restricting diet is unnecessary and may increase risk of malnourishment. Additionally, most clients living in residential aged care have a life expectancy of less than 10 years, which negates the long-term impacts of diabetes and this needs to be considered alongside clients who often have multiple comorbidities, impaired cognition and/or frailty.
Treatment goals for clients in younger age groups differ greatly from this approach, however in aged care, nutrition approaches are usually a somewhat relaxed and screening for malnutrition and dehydration becomes a greater focus to prevent glycaemic extremes and potential short-term effects of diabetes.
Often residents who have lived with diabetes for several years may have been told previously to restrict certain foods, however this approach can be detrimental to maintaining lean body mass and therefore function. Some residents and families will have questions about this approach and can benefit from education on diabetes management to make informed dietary choices.
A dietitian assessment is encouraged if this is the case to ensure meals are nutritionally adequate and that the resident and or relatives are educated on current diabetes management practices to make informed dietary choices.