A SURVEY OF THE DIETARY-MANAGEMENT OF CHILDRENS DIABETES

A cross-sectional survey of dietitians using a structured postal quest ionnaire was sent to 148 dietitians who provided a service to children with diabetes. One hundred and twenty-two (82 %) replied, of whom 50 were paediatric dietitians (4 paediatric diabetes dietitians) and 72 w ere other grades. One hundred and eighteen (97 %) dietitians reviewed newly diagnosed children within 24-48 hours of diagnosis but only 81 ( 66 %) used literature specifically designed for children. The majority 116 (95 %) felt they worked within a multidisciplinary team. Only 15 (12 %) of dietitians used purely qualitative carbohydrate dietary educ ation; the remainder used quantitative methods, e.g. 10 g exchange sys tem. Ninety-one (75 %) used carbohydrate exchange lists. High fibre fo ods were suggested but dietitians felt only a moderate intake was achi evable. One hundred and twelve (92 %) recommended a reduced fat intake but guidance was not as unanimous can reducing specific fatty acids. Objective assessment of dietary outcomes was limited. Paediatric dieti tians compared with other grades were more likely to use innovative me thods of education but no other differences in dietary practice existe d, A minority of dietitians 17 (18 %) felt families would find impleme nting the diet easy. The survey confirmed national inconsistencies in dietary messages and poor evaluation elf patient compliance. Research is required into effective dietary counselling to support evidence-bas ed practice. (C) 1997 by John Wiley & Sons, Ltd.