Diabetes is a concern both globally and within Canada (1-4). Here, at home, nearly 1 in 10 Canadians aged 20 years old and over live with a diabetes diagnosis (3). Type 2 diabetes, which can cause a variety of complications including vision loss, nerve damage, heart disease, and premature death, accounts for 90-95% of these cases (2;5).
When we consider the prevalence of diabetes and its potential health impacts, it’s easy to understand why talk of type 2 diabetes prevention is widespread. Be it through discussions with health professionals about factors that increase our risk of developing type 2 diabetes or advice received through educational campaigns and loved ones with lived experience; there’s no shortage of information (1;2). “Knowledge is power”! And we can use that power to make informed decisions about our health. With so much out there, let’s focus on one risk factor and one type of health professional that may be well positioned to help tackle it—prediabetes and registered dietitians (6).
Prediabetes is characterized by elevated blood sugar levels that are higher than normal but still too low for a type 2 diabetes diagnosis. However, this can eventually change if prediabetes isn’t controlled properly. Paying attention to our diet is one way to manage prediabetes. Registered dietitians deliver medical nutrition therapy, a form of tailored nutrition care that encourages healthy eating patterns and behaviours (6;7). Let’s dive into its effectiveness in adults with prediabetes with the help of a systematic review (6).
What the research tells us
The review, which compares medical nutrition therapy to standard care, highlights several positive outcomes but with varying degrees of certainty.
First, it appears that medical nutrition therapy delivered by a registered dietitian likely reduces fasting blood sugar, weight, waist circumference, total cholesterol, and blood pressure in adults with prediabetes. We can be moderately sure about these findings. The benefits don’t stop there! Medical nutrition therapy may also have the potential to reduce average blood sugar levels, body mass index , and LDL “bad” cholesterol, while increasing HDL “good” cholesterol. But it should be noted that we have low certainty in this set of findings, meaning they can change as more evidence emerges. Though improvements in different types of fat found in the blood can be seen, medical nutrition therapy likely doesn’t reduce the most common type—triglycerides.
The big question around whether medical nutrition therapy reduces the occurrence of type 2 diabetes in people with prediabetes remains uncertain and requires more research. That said, its impact on various risk factors that can negatively affect our health is promising (6).
Interested in connecting with a dietitian? In Canada, people can access both free and paid dietitian services. Paid services in private practice settings are sometimes covered by private health insurance plans, so those interested should review their coverage. On the other hand, free dietitian services are offered by many provinces (through provincial hotlines and websites/online resources), local public health units, community health centres, and Family Health Teams.
