Diabetes Dietitian
Pre-Diabetes
Sometimes patients get told they have “prediabetes” or a “high risk” of developing type 2 diabetes. This can be very scary and confusing. Prediabetes basically means that a person’s blood sugar is higher than normal but not high enough to be officially “type 2 diabetes”. In the UK, typically an HbA1C test is used and if it is 42-47mmol/mol, this is considered prediabetes.
Firstly, it’s worth mentioning that the term “prediabetes” is a pretty controversial one in the diabetes world. This is because the name suggests that people with prediabetes will go on to develop type 2 diabetes fairly imminently. This isn’t true.
Statistics show that of 100 people with prediabetes, over the course of a year, one third will develop type 2 diabetes, one third will stay in the prediabetes range, and a third which actually go back to normal blood glucose levels.
Secondly, prediabetes actually describes different conditions. A person’s blood sugar can be high in the fasting state, or high after a meal or both. Unfortunately, the HbA1c that is used by a GP practices to identify prediabetes cannot discriminate between these conditions.
This information is really important to know, because you may have been given the impression you need to “lose weight to prevent type 2 diabetes”, however, this is not always the case.
Type 2 Diabetes Remission
Type 2 diabetes develops mainly because of two separate problems: the first is that the pancreas does not make enough insulin, and the second is that there is in insulin resistance (this mean that insulin does not work very well). There are also other changes which are important which include an impaired ability to oxidise fat - might lead to fat building up in places it shouldn’t (like the liver or pancreas).
We have moved from “managing” the condition lifelong to putting the condition into remission. Remission in this context means that a patient has normal blood sugar levels and no longer needs their sugar-lowering medications. We use the term remission and not reversal here. This is deliberate as “reversal” misrepresents what is happening, and might give patients false hope.
We know that people can achieve normalisation of blood sugar levels, and can come off their sugar-lowering medications. For many people this can last for years. But we also know that some people can achieve normal blood sugar levels for a short period of time, but for reasons we don’t understand, their blood sugar creeps up again. Remission helps medical professionals and the patient understand that this is something to keep an eye on, so we can work together to help prevent any complications from developing.
How We Can Help: Meet Our Specialist Dietitian
Ellouise Simpson
Ellouise takes a holistic and realistic approach to help clients manage a wide range of health concerns such as diabetes, weight management, family nutrition, high blood pressure and cholesterol.
What to Expect From Your Pre-Diabetes Consultation
If you have been diagnosed with pre-diabetes, Ellouise will use a full clinical picture to assess your risk of type 2 diabetes and put your test results into context for you. There are ways to improve your blood sugars and reduce your risk of cardiovascular disease which do not necessarily rely on losing weight. Therefore, if you are worried about losing too much weight, we look at ways of lowering blood sugar without needing weight loss.
We will take time to thoroughly understand your medical history and will assess your diet. We will work with you to find a diet that will reduce your risk factors while promoting good long term health.
Typically, this will involve three sessions, for example:
Session 1: Assessment and dietary modifications
Session 2: Assessment of progress and consideration of next steps
Session 3: Long term nutritional management and prevention
If further tests or treatments are needed, we will liaise with your consultant or GP.
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Pricing
For people with prediabetes, we offer three appointments for £300, saving £30.
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What to Expect From Your Diabetes Remission Consultation
At your consultation, Ellouise will take time to thoroughly understand your medical history and will assess your diet. We will work with you to find the best pathway to attempt to instigate the remission of your diabetes.
Typically, this will involve six sessions, for example:
Session 1: Assessment, education and dietary treatment
Session 2: Assessment of progress and escalation of treatment
Session 3+4: Assessment of progress, accountability and next steps
Sessions 5+6: Transitioning to long term maintenance of behaviour change
If further tests or treatments are needed, we will liaise with your consultant or GP.
Sessions may be more frequent in the first two months (e.g. alternate weeks) followed by monthly sessions but this will be arranged on an individual basis.
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Pricing
For type two diabetes remission, we offer six appointment at £510 saving you £90.
Testimonials
"I was very impressed by the service in general. From the speedy reply to my initial request for an appointment to the professionality and proactiveness in understanding my issues. I felt understood and guided to a solution to my problem. Would definitely recommend."
"Very efficient service, excellent advice, good follow up from consultation. I was given time to go through the various issues I wished to discuss and these were all considered by the Dietitian and addressed. I am very pleased with the service."