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  • Anne Mullens

Study: more training needed for dietitians to recommend carb reduction for diabetes

Updated: May 3, 2023

Diabetes Canada and the American Diabetes Association now recognize that reducing overall carbohydrate intake has the most evidence for reducing blood sugar in people living with type 2 diabetes.

However, a Canadian survey has found most dietitians want and need more advanced training to confidently recommend therapeutic carb reduction, or TCR, to their patients. Fortunately, the IPTN has developed such training.

The qualitative study, which was published in the February 2023 BMJ Nutrition, Prevention and Health, invited 6640 registered dietitians practising in Canada to participate in a semi-structured online survey exploring their knowledge and experience of using TCR.

Of those invited, 274 completed the survey, but only 45 had regularly prescribed TCR to their patients. The study authors note the responses “highlighted a desire for evidence-based educational materials and greater discussion within the diabetes nutrition community on this topic.”

Viljoen A, Yu K, Witchell E, et al. Prescribing diabetes nutrition therapy: a qualitative study of dietitians’ experiences of carbohydrate restriction in Canada. BMJ Nutrition, Prevention & Health 2023;e000532. doi: 10.1136

The study notes that growing research suggests that some patients living with diabetes may benefit from “therapeutic use of carbohydrate restriction but clinical practice guidelines have previously not accepted this dietary approach.”

The authors wrote:

Results showed a need in the RD community for accessible, trustworthy, and evidence-based educational materials on the benefits, drawbacks, and appropriateness of carbohydrate-restricted diets for relevant populations. Additionally, dietitians reported a desire for greater discussion on this topic, without fear of reprimand or judgement.

The study concludes that more training and professional support are needed for dietitians to feel comfortable in recommending TCR safely and effectively.

“The study confirms what the IPTN has anticipated: advanced training for dietitians is a critical next step to enable more patients to get the support and encouragement they need to try therapeutic nutrition for the remission of diabetes,” said Sean McKelvey, CEO and co-founder of the IPTN, which is a registered Canadian charity.

The IPTN funded the survey development but had no other influence on the study. One of the study’s four authors, Eliana Witchell, was on contract with the IPTN as Chief Dietitian when the survey started.

To better meet this educational need, the IPTN, has now devoted considerable resources to developing training and certification programs for dietitians and health care practitioners.

IPTN’s “Foundations in Therapeutic Nutrition” (level 1) and “Skill Building Workshops in Therapeutic Nutrition (level 2) are now available to dietitians, pharmacists, physicians, and nurses.

While the overall structure and core content of “Foundations” is interdisciplinary, separate versions of this course and the workshops were created to address discipline-specific implications for clinical practice.

To learn more about this training, or to sign up, visit:

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