Aims To survey dietitians involved in diabetes care regarding the provision
s for patients with diabetes.
Methods A national survey of 512 dietitians known to be engaged in provisio
n of diabetes care was conducted in 1997 and 391 (76%) responded.
Results Nationally the median provision of dietetic care for diabetes repor
ted was 10.7 h per 100 000 general population per week, bur the provision w
as uneven ranging from 2.0 to 27.6 h per 100 000. Eighty-five per cent of d
ietitians worked in areas where the provision was less than 22 h per 100 00
0 general population per week (the current recommended minimum standard). D
ietetic provision was greater in secondary care (median 9.1h per 100 000 ge
neral population per week) than in general practice, residential homes and
other locations (median 4.4 h per 100 000 general population per week). Pro
vision was greater in those areas in which a designated dietitian had respo
nsibility for co-ordinating the dietetic service for diabetes than in areas
where the co-ordinator was not a dietitian or where there was no co-ordina
tor. Over 90% of dietitians reported following British Diabetic Association
(BDA) recommendations regarding advice on carbohydrate, sugar, fat and fib
re consumption, but only one-third routinely advised on salt restriction. O
f the 17% of dietitians who continue to use carbohydrate exchanges, all com
bine this method with other approaches. Of the recommendations made by the
Clinical Standards Group, only 69% of dietitians reported seeing more than
half of newly diagnosd adult patients within four weeks, and less than 50%
reported offering half or more of their patients an annual review. Amongst
the literature in current use, 98% of dietitians use BDA literature for tea
ching patients and 90% use BDA publications in their own education. Seventy
-six per cent of dietitians believed that there was a role for commercial s
limming organizations in weight management of people with diabetes
Conclusions Given the proven value of dietetic input in diabetes management
, there would be advantages to correcting the regional inequalities in diet
etic provision for diabetes care in the UK.