When you really start thinking about it, though, nutrition is a very important component of our patients’ health, and we should involve our RDN colleagues more often.

Let’s take this from the most obvious standpoint first: a very large number of our patients are obese. You may then think, “That’s true, but that means these patients are over-nourished, not under-nourished.” In fact, that would be false. When you consider the details of nutrition, it becomes clear that many of these obese patients are protein-calorie malnourished. They may have excessive levels of carbohydrates, but lack proteins and other integral parts of a healthy diet.

How often do you council your patients on appropriate diet? It seems like I council most of mine, since I see so many diabetics. What do you tell them? If you’re like me, you’ll describe some generalities about eating fruits and vegetables, staying away from carbs, processed foods, eating grains, drinking plenty of water, avoiding soda and junk food, etc. Let’s be honest here. Although this advice may be true, it’s as ridiculous as a primary care doctor telling a patient with plantar fasciitis to go buy the correct shoes. It’s ridiculous for its lack of detail.

Just as there are many other components to the “correct shoe” for plantar fasciitis (beside all of the other parts of appropriate treatment), so are there many other details to “appropriate diet.” These details, of course, are best understood and appreciated by none other than our RDN colleagues.

For those of you who need a little hard data to prove the importance of RDNs, Gaetke and colleagues performed a retrospective review of 175 patients’ charts to see if a single counseling session with a nutritionist improved outcomes. Patients who agreed to the counseling were compared with those who did not accept counseling. The investigators measured various patient health measures between the groups before and at three months after counseling and found significant improvement in fasting glucose, hemoglobin A1c, total cholesterol, LDL, triglycerides and BMI.¹

Similarly, Lemon and colleagues found improvements in weight loss, hemoglobin A1c, triglycerides and BMI after nutrition counseling when they performed a prospective study of 244 diabetic patients. Additionally, increased time and number of counseling sessions further improved these outcomes.²

With the numbers of patients with diabetes and increasing obesity, along with the very poor education physicians receive about nutrition, it is clear that RDNs are an integral, effective and highly important part of the healthcare team, so don’t forget to consult your local RDN whenever possible.

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