Recommendations of Dietitians for Overcoming Barriers to Dietary Adherence in Individuals With Diabetes

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Abstract
PURPOSE The purposes of this research were to (1) identify factors that contribute to the barriers to dietary adherence in individuals with diabetes identified in a 1998 study and (2) obtain recommendations from registered dietitians for strategies to overcome these barriers. METHODS A 10-item, open-ended telephone questionnaire was used to obtain information. The sample included 75 registered dietitians who participated in a previous survey to identify barriers and agreed to a follow-up telephone interview. RESULTS Of the 75 participants, 28% reported spending 5 hours or less per week counseling individuals with diabetes, 64% spent between 6 and 30 hours, and 8% spent more than 31 hours per week. Almost half of the participants (47%) were certified diabetes educators. Factors identified as the greatest contributors to the barriers being evaluated included lack of time, lack of symptoms, lack of education (including follow-up), poor self-esteem/lack of empowerment, and misinformation from family/peers/others with diabetes. The primary recommendations for overcoming each of these barriers included individualizing meal plans and planning ahead, teaching about complications, and setting obtainable goals. CONCLUSIONS The registered dietitians who were surveyed emphasized the importance of individualizing dietary counseling.