Diabetes education and nutrition

I have always absolutely hated seeing the nutritionist, but I know it is about time I see someone. I want to see them to discuss meal planning at college. I am stubborn and with my college having nutritionists that help students with all kinds of food concerns. I would only want to see a nutritionist in office once every couple of years. My office referred me to their diabetes educator and nutritionist (she does both) but they want to do a like pre-class. Which I wouldn’t mind if it wasnt another hour of time spent plus the hour and a half to get there. I know that sounds stupid because I want to take care of myself and I have all these resources to do so. Should I tell then that I only want to see them once in a while? Would it be welcomed or come as an insult. I know it depends on the office, but I was wondering how often people saw their nutritionist and if they only saw them once in a while how do you express that to the provider?

I’ve had Type1 nearly 60 years and my doctor occasionally sends me for a refresher if she suspects I’ve fallen off the “carb counting” wagon. Heck, sometimes it’s good to see someone Judi to refresh your memory. I might see one also if I want to lose weight or try a new eating regimen (I prefer that term to “diet”) to make sure I’m getting my nutrients.
Since it’s such a distance for you would a video appointment be an option? You’re already experienced so don’t need the in-person hand holding a brand new patient would, and offices may still be doing online appointments in consideration of COVID.

How are studies coming😊?

My doctor told me they would do video visits and when I signed up on the website as instructed there was no option for that. I have been in contact and am waiting for a reply. I am hopeful that a video visit would be available as initially said. My office said that video visits were going to continue. They want to do something called a pre-class. No explanation of what that was on their website. So, still waiting for an answer on that.

Studies are good, thanks for asking. Lots of studying to do and am planning on changing my major, but have decided to take an exploratory semester in the fall to see what I want to do. So, I have had a bunch of meetings with different people to discuss. It’s been a crazy busy week with everything, but trying to keep on studying.

The pre-class might be a formality for new patients. You might call for details as to exactly what it is. When I start with a nutritionist they always send me home with an assignment to keep a log of my meals, insulin, etc. so it could be that - instructing on what they want you to collect. Now that I use an app for tracking we can pretty much dive right in at the first session! That may not be what your office has in mind but it won’t hurt to ask - and if you already keep logs maybe you could go ahead and submit them.

Danielle @fieldiez , how often you see a dietitian or nutritionist should be up to you, just as how often you pay a visit to a doctor is up to you. Of course, a doctor or dietitian may advise you to return mor frequently, bu ultimately you make the decision - hopefully a wise decision.

I can understand the pre-class visit as being long, just as a first time with a physician can be an hour experience while the new doctor does a complete evaluation. As Dorie @wadawabbit suggests, try not to think of your food-education as being “put on a diet”, but rather as an enrichment education to guide you in making wise choices with all-important eating. Keep im mind about eating, that your body needs are not limited to counting calories, carbohydrates, fats, proteins, sodium, etc., but rather but rather nutrition which includes how different foods react with each other.

Living and eating meals while away at college will bring a whole new set of challenges. At home when you are purchasing, preparing and “serving” meals, you had choice of ingredients, method for preparing [deep-fry or bake that skinless breast of chicken], and portion size - at college, your choices could be limited to “take-it or leave-it”. That should be a good reason to get some tips from the college expert during your first month; the education you get now from a diabetes-care nutritionist will provide you with a strong base.

Hi Danielle, I understand that school has its own challenges, schedules changes, and possibly set meal times? If you don’t already have a mini refrigerator in your dorm room if you’re staying in one it could be very helpful to store your snacks and go to when low foods. I hope you can find a nutritionist that might also have T1D as well as that can be very helpful. If you’re interested in going low carb that may be an option to talk with a nutritionist about rather than a complete review of your current meal plan. Good luck!

We had a kitchen in one of the dorm lounges and one of the residents marked her food and left notes to leave it alone as she was not on the meal plan - I don’t know why. Depending on how things are in your dorm and on your campus that might be an option for you; although it would probably be more practical to study the nutrition info (which may be more or less accurate) and use your CGM to gauge your response.
If it helps any we didn’t even have pain is BG meters for fingersticks, much less CGMS, and we got through.

I suppose that is what I was thinking was that the college expert would be more valuable for meals on campus. I have never been on to really restrict myself to low carb or anything. I definitely watch my diet and fill up on veggies, but I tried low carb for a while and I found it less than sustainable for me. I was diagnosed at 15 and I feel like a lot of my eating patterns were set. I used to see a nutritionist every few months in the beginning and I still refer to her notes. I do think that maybe that strong base might have changed since then. (Been maybe 2 years since I have seen one) Our college is really great about clean eating and accommodating food to students which is one of the many reasons I chose to go there. I just think finding the best options with someone there would be great. I want to take care of myself and see my doctor whenever they schedule for (every 3-4 months) I definitely want to use these recourses, but I also live in the middle of nowhere and so getting to these places can be inaccessible at times. I guess what I am saying is I would be more open to the idea of a video visit.

Also, the mini-fridge is a check. I am a freshman now, but because of covid, I ended up being at home this year all virtual. I will be a sophomore next semester, but I already bought all of the essentials. @Janine83965 I also hope to have a nutritionist with type one, but most don’t share that on their professional pages, so it is kind of hit or miss. I know if is different for everyone, but I low carb didn’t work for me and my old nutritionist recommended I didn’t do that, so I guess I just watch carbs.

@wadawabbit Unfortunately our college requires most students to be on the meal plan. As I said before though, they are really focused on having variety for their clean eaters and people with dietary restrictions. I have eaten there before on visits and I liked a lot of the options I saw in certain dining halls. I think my struggle will be if my day isn’t working out (woke up late, lost track of time, office hours, etc.) and I want to utilize their more grab-and-go options. They have almost like student convenience stores set up on campus (sandwiches, salads, drinks, etc.) That was one of the reasons why I did want a cgm before being on campus.

Sorry for the long post.

If you feel like you’d benefit from seeing a nutritionist, see a nutritionist. If you don’t feel like you need more than one visit or more than an occasional refresher and check-in, that’s fine. As long as you’re comfortable with your level of care and you and your doctor are satisfied that you’re getting the nutrition you need and your blood sugars and everything are under good control, you’re fine.

I’m not a fan of low carb diets, myself. Every cell in your body is designed to run on carbs, and digesting fat and protein for energy produces toxic byproducts that your kidneys have to deal with. That should have been covered in high school biology class. A balanced diet with an appropriate amount of carbs for your individual metabolism and activity level, which also takes into account your need for protein, vegetables, etc. (and differentiates between simple sugars and complex carbs) may take a little more thought and training, but it’s a healthy and sustainable way of life. A good nutritionist can help you with that.

I hope you can get the appointment you need, and that it gets you on track.

Meal plans probably are required - and they are a more “real world” Orin than preparing everything yourself. Some grab and go options aren’t bad - I’m sure you’ve figured out you go with the info on the label and adjust afterwards. And perhaps you can keep a small pantry in your dorm room if you just don’t feel like going out to pick up something.

I will definitely have a small pantry and a fridge in my room stocked with things for lows and also some healthy snacks. Especially because I am sure I will be having so late-night study sessions and want to keep healthy snacks around so I don’t snack on unhealthy ones.

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Yes. I took a lot of biology in high school, regular, A.P, etc. so I definitely know about ho we need carbs. Of course to each their own with their food choices, but it never worked for me. My doctor said he would only send me if I wanted if because we talk about my food choices on a regular day and he said he though my diet was healthy and realistic. Depending on the meal I eat any where from 20-60 grams of carbs. (Usually not many at breakfast or dinner, but more at lunch) I was told by my last nutritionist that eating too low carb is going to make me tired and she was right. I generally try to eat lower glycemic index. (More whole foods than highly processed ones and more fiber)
I am hopeful for a good appointment

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I’m the cynic. 44 years with type 1 in June. I’ve generally found nutritionists and dietitians diabetic related to be useless. They gave bad advice that I followed and it didn’t help and it did harm. Hopefully they’re more aware now but the Ada diet followed many years really caused a lot of problems. I find it useful to explore on my own and I’m looking at a very plant-based and I hope that will bring better results. And you have to figure out your own path. I’d go see them if it was not a burden and maybe they’re all updated with new and snazzy information and actual evidence. You also are ultimately your own doctor of sorts and maybe they can give you some ideas to help you figure out what you need for your health. If they are not allowing for a video appointment given how high risk it is for type 1 diabetics to get covid-19 and other conditions oh, I would never see you then. It would be extremely disrespectful and potentially life-threatening to go to that clinic and that would be a solid Mark against them to begin with. I wouldn’t even go. By the way all the people telling us that type 1 diabetics do fine with the vaccine like type 2, well they never tested us so we don’t even know effectiveness. They left us with type 2 and we are two different diseases and two different disease processes. I consider it gaslighting by public health they’re also told us asymptomatic people are safe and don’t wear masks way back when last year. There are n95 masks available for the public and there is actually no shortage so you can go to companies to get us made ones with niosh approval if you do have to be face-to-face with anyone in a medical setting. In my state they are not updating to the CDC guidelines which is universal double masking indoors or n 95. Kaiser health Permanente did a report on how dangerous single masks single surgical masks are published through CNN on March 12th. You can search the keywords cough is more dangerous than intubation. They basically said that coughing, talking and breathing are the highest risk factors for covid-19 infection. With variance I wouldn’t go in anywhere knowing the healthcare system is probably not compliant with the upgraded guidelines. It depends on your state and the medical setting now. I would caution anyone from going indoors anywhere until they manage the variance and really know effectiveness of vaccinations for our sub group.

Thanks for your reply. I am a little like you in that I don’t always see the benefit of seeing a nutritionist. I was in contact with my office and forgot to update you that I am seeing them for a video visit tomorrow night.

Kind of irrelevant, but when my grandfather passed away last year in October, I asked my previous doctor (not the office in this subject) if I could have a video visit and they told me they don’t do them. I thought that was unusual considering that their main focus is type one diabetes. This nutrition office is a diabetes office as well and does primarily video visits and hope to continue to do this. They said for some reason their website isn’t scheduling as video visits, but that they now have it figured out.

On the topic of the vaccine, I do agree with some about how little science there was behind it for us. We do tend to get lumped in with type 2, but I have had my first dose and am going back for my second next week. I’m not sure what your thoughts are on getting it. I am not trying to pressure you to get it. It is up to everyone what they want to do about the vaccine. I had low blood sugar the first day and elevated for two after that, but I believe there is another thread on here talking about vaccine side effects people have had. We have kind of done the studies for ourselves.

I had Covid in December and I was, fortunately, okay, with only mild symptoms, being the only type one in my house, everyone was careful, but on the topic of masks, I do believe that some masks are not as effective as others. My mother had to go to work only once since the start of the pandemic and with masks and other protective equipment, she still got it. She was sick for a couple of days before we knew for sure She got sick on Friday, so had to wait till Monday to get tested and on that Monday(in December), she came back positive. She got pretty bad out of it and still can’t taste or smell much. I however got nothing from it but allergy symptoms and some fatigue. For me, I was kind of like, well if the virus didn’t kill me how bad can the shot be. Again, I hope this doesn’t come across as me trying to pressure you. I think you should feel safe before getting it. It is a risk we take, and one that is our own decision.

Thanks for your cautioning us, I live in an area where people absolutely refuse to wear masks at all. I live in Lancaster county Pennsylvania where we have a large Mennonite and Amish community and not all, but most of them won’t wear masks. When I was working my part-time job, I was really frustrated with how many people would refuse to wear masks. Even if people don’t do it to protect themselves, I wish they would do it for other people. People like us who could potentially get far worse symptoms, their older community, immunosuppressed, etc.

Thanks for your response. I’m so sorry about your mom’s illness and the infection. There are millions of fake masks on the market so we just don’t know what we’re getting. I would encourage our people, the higher risk, to get the best possible n95 or n 100 masks from a vetted distributor or directly from the maker. The country has made it clear we’re on our own to protect ourselves and your state is no different than mine with careless people around everywhere. That’s why I’ve stayed inside I don’t even exercise outside anymore. It’s just too disappointing to see people not care let alone dangerous.Masks stack up in US warehouses as nurses reuse N95 respirators - Roll Call
This is a pretty stunning article. Every American could have won if the government caught up with the virus. This also means that in my state they haven’t updated guidelines so who knows weather medical providers and patrons are wearing proper masks, not counterfeit ones, and even if medical providers wear an n95 mask they’re not sharing it with all staff and patients universally, and making medical staff reuse n9 5 means administrators are not willing to ensure safety to my mind.

I am fortunate to have been able to isolate going on 15 months. I’ve also been fortunate to find providers who worked with me for medical issues so I didn’t have to go face to face because I wouldn’t. Oneprovider help me drain an abscess early in the pandemic after an injection led to this the first time ever in my life to have an abscess at an injection site. They instructed me by video Telehealth how to drain it. Same thing with remote treatment of a UTI. And of course I have more kitchen accidents cooking at home and sliced my finger which needed stitches. I made do with an alternative that isn’t great but I felt it was better than going face-to-face in settings where I have been repeatedly told they are safe settings and then we find out not long after they’re absolutely not too. It’s a fast-moving virus and much smarter than I am in my early fifties and having lost my mom to this disease when she was 44. So I feel it’s an honor of her memory that I do everything I can to protect my life in addition to being grateful now, having lost a dear friend in mid February 20/20 To covid-19 I believe. They never had testing available but I believe that took her. I feel very lucky to be here and I’m glad you got through the covid-19 illness without too much bad effect. And I’m so sorry for your mom too. I’ve read about type 1 diabetics with long covid-19 and I can’t imagine that burden on top of the diabetes. Lancaster might as well be Oregon where I am. People are inconsistent and we can see that by the hospitalizations and infection rates even with the vaccine rollout concurrent. It’s a shame. I also stopped exercising outside and used to do 6 miles sometimes walking. I would never get into hypoglycemic reaction and have these people come up to me without a mask even if they felt like helping.

I I’m very vaccine hesitant without more data but I still got the first Pfizer shot three weeks ago and the second one yesterday. I’ve been sleeping most of the day with some flu-like symptoms but it’s been easier than I expected. I’m going on day 2 and think I’ve gotten through the worst, muscle ache and fatigue and a little bit of warmth not quite a flu but not feeling great. First shot was some sniffles briefly but I have no eyes didn’t feel anything. What made the difference for me was that according to Healthline. Com CDC finally acknowledged that they couldn’t guarantee the safety of the vaccines which meant they’re finally acknowledging that they didn’t study right. I was just grateful for the transparency for a change. Anyone reading this who is 60 and over with an immune-compromised condition, should know that FDA reported only 42% efficacy with Johnson & Johnson and this issue came up in a Washington Post article as well. It got even more ridiculous because they said well they can’t really trust the 42% number cuz they didn’t really have enough people in the study. So the few that they did have didn’t do as well as are there vaccines. Pfizer also had poor outcomes for first shot transplant patients. I just hope that they will really continue to collect data. I only got the vaccine in case I have to have an unavoidable medical interface. Otherwise I’m not changing my behavior with all the strains going around and the one that doesn’t do well with Pfizer. Thank you for your concern too. I was and remain hesitant without data but I went ahead and got the shots anyway. And this is funny. None of them vaccinators were double-masked so I asked for them to double mask writing on a piece of paper showing it through the window of the drive-thru, saying thank you for saving Our Lives, type 1 severe diabetic, could you kindly double masks per CDC and fauci. They agreed and I got my shot.

I had a few thoughts. I wonder if you’re going to college if you could talk with the Americans with Disabilities Act office for any special accommodation that can keep you safest. I’m not sure what that would be but you can think about what would help you the best to be successful and safe. Late in my school career I started to ask for things like extra time in a national exam so I could self care and test glucose as needed. My glucose goes up and down with this stock market so it’s hard to manage and the other choice I made was ignoring it most of my career. Anyway this helped get a little more flexibility to self care. Oh so perhaps they’ll offer a zoom option for some students and if you notice concerns about people not respecting guidelines just to have it available could be something. I don’t know if that’s something you’d want but I just offer it as a brainstorm. I don’t know if there would be options for dietary related matters but since food is medicine for us as much as it is for anyone, making sure you have whatever helps your immune system and management seems pretty important.
Well this is a lot of information. I hope it is helpful. You would have to vet and use your best judgement for any of this and you seem pretty on top of things. Just a matter of them accommodating you. I don’t know if a special accommodation request note from your doctor or even The dietitian would be at all useful. But if they ever question your need at least that would be in the back pocket useful or not.

One of the brilliant outcomes of this pandemic is that it opened up opportunities to participate in other diabetes groups out of town Zoom. I heard the most miraculous thing. Someone at this other group out of state said she is trying a saliva blood glucose test that is in review by the FDA in one of their trials. I think that would save a lot of lives type 1 and type 2 you if it ever gets to Market. She says it’s more accurate then Lancet Pricks and CGM. I think we’re all tired of holes in our bodies and I don’t ever trust anyone because they always promised things that don’t come out. But anyway I can hope on that anyway. She knew a doctor I contacted who said there is a blood test to check antibodies post vaccine but the doctors often order the wrong test. I don’t know if it is actually accurate but I guess they’re considering it so. So that might be something to ask about if it is considered a high quality test, to have a better sense effectiveness… knowing won’t change my behavior of avoidance but it may impact what vaccine I would choose the next round if this isn’t useful or if it is. I am voice dictating this diatribe so I apologize for any errors and I hope it’s useful.

Thanks! Type one is a growing concern or maybe condition rather among people in college. I have plans in place with my school when it comes to testing, having food in class, leaving to test or correct, and so much more. My school will add items to their menus for students who need it as well. I met with the team on my first visit there and they were the only school I visited that was actually willing to come out and really have a good discussion with me about food options on campus. They offer ‘free’ nutrition visits (I think 3 visits per semester) they have an awesome health center. I am a little worried about Covid on Campus and I do plan to be on campus next semester. Masks are required and students will be fined and suspended for not wearing them in public places. You can’t have visitors in dorms and stuff like that for the most part either. They don’t want an outbreak on campus. I am pretty proud of my school in that they have an extremely low number of reported Covid cases among their students. I think it’s only 30 out of 7000 and more than half of those were off-campus students. That being said, most students are not there. They do regular Covid testing and everyone will be required to quarantine and be tested when they arrive at campus in the fall. I don’t know if it will be enough, but they are making a good effort. Obviously, I have to be more careful, but I have never been one to party or anything like that, I care a lot about my grades, so I probably won’t be out of my dorm room much, except to go for a run or grab food. You can also get food to be delivered to your dorm from any of the dining halls on campus. (No extra charge I might add)

I am sorry you are feeling under the weather. I hope that this is the worst of it for you from the shot and you start to feel much better soon!! Thanks for your thoughts and the interesting article.

I will point out that none of these vaccines are considered FDA Approved, they are still being tested and are only considered for emergency use. There was a lot of resources, time, and money that went into these vaccines to keep us safe. I guess for me I kind of knew they wouldn’t be perfect at the first go, but I think they are a necessity to get back to normal or what I assume maybe our “new” normal someday. To me it was a no brainer. We are lucky to have these vaccines and I went and got mine, when I was able. This is a common topic of discussion in my household. Just my personal opinion. All the vaccines were rushed, to try to slow the spread, so I guess if we didn’t expect any side effects, we would be kidding ourselves. Most medications take quite a few years to be approved for use. In this case, it was a matter of months.

To be clear: The vaccines are safe and effective. FDA emergency use authorization was granted after hours of debate by a panel of the top independent (not employed by pharmaceutical companies or the government) vaccine and coronavirus experts in the world. (If you want, Here’s 8 hours of them discussing whether to approve the Pfizer vaccine. If that’s not enough, here’s another 8 hour discussion about the Moderna vaccine. They did similar panels to approve the J&J and to approve resuming it. You can find those if you want.) When there were 6 cases of a serious side effect out of millions of doses of the J&J vaccine, they put it on pause for several days to reconvene and study the situation in detail before formally deciding that the minuscule risk of a treatable blood clot disorder is much lower than the risk of getting COVID-19 and possibly having permanent lung damage from it. (Also, the flu shot, despite being well studied and developed, causes side effects in many people. Usually passes in a day or so. And much better than getting the flu.)

Yes, these vaccines were developed much faster than most. That’s due to a combination of the massive amount of resources thrown into vaccine development because the entire world was disrupted by the virus and the fact that there were already hundreds of millions of cases when the vaccines were ready for clinical trials. It’s much easier to get good data on how effective the vaccine is when you’ve got a highly transmissible virus that’s being broadly tested for in a population where there are a lot of cases.

Also, the technology used to create these vaccines has led to a breakthrough in creating a promising vaccine candidate for HIV, which is amazing.

If you can get the vaccine, please do. Even if you feel under the weather for a couple of days or even a week, it’s much better than getting the virus. And, importantly, the more people who get vaccinated, the slower the virus is able to spread, and that will in turn slow down the breeding of new variants.

That Washington Post article you mentioned says that the J&J vaccine is safe and effective. “We know this vaccine prevents 85 percent of the severe disease. … It was 100 percent effective in preventing hospitalization and deaths, and that’s really what’s important." That 42% number you mentioned, in its proper context:

The vaccine’s efficacy rate was lower — 42 percent — in preventing moderate to severe illness in a subgroup of adults older than 60 who had medical risk factors. But regulators noted that the statistical significance of that finding was uncertain, and no deaths or cases requiring medical intervention were reported a month after those older adults received shots. Overall, there were seven deaths in the trial, all in the group that received a placebo.

So there were a few more cases in that high-risk subgroup who got sick, but the finding isn’t clear, and none of them needed to be hospitalized and none of them died.

It should also be noted that the J&J vaccine was tested later than the Pfizer and Moderna ones, so its slightly lower efficacy rate (85% instead of 95%) is not directly comparable because it was being tested against new variants that weren’t around when the other two were tested. Which brings me back to the point that the faster we get everyone vaccinated who safely can be, the faster we quell the rise of new variants that will require new vaccines. (Expect this to be an ongoing annual thing, like the flu shot. The flu is another, less deadly, form of coronavirus. We need a flu shot every year because the virus mutates. The flu shot is less effective than the COVID-19 vaccines - only about 50% - in part because there are more variants.) Thing is, even if you do get the virus (flu or COVID-19) after being vaccinated, your case will be less severe because your immune system was primed to handle the virus and just needs time to update for the variant you encountered.

Early in the pandemic, there were fears that a rush of people would buy N95 masks, leaving hospitals without. And, indeed, hospitals did have shortages and needed to find ways to disinfect and reuse masks, sometimes multiple times until the masks fell apart. We’re in a better place now, and we know that cloth masks can be effective (even if not quite as effective as a properly-worn N95). But an N95 needs to be carefully fitted (which requires extensive training) to be fully effective. Other information (about how the virus spreads) was updated as our understanding of the virus grew with new information and testing. It’s not transmitted through food or surface contact, but masks are very important in preventing transmission. We know that now. We didn’t know that this time last year.

Personally, even though I’m fully vaccinated, I still wear a mask. The vaccine greatly reduces the risk of my getting and transmitting the virus, but it’s not 100% and I don’t want to risk giving someone a potentially deadly infection even if it’s only a 1% chance. Besides, people don’t know that I’m vaccinated and may be uncomfortable with me being unmasked. And it helps encourage others to keep wearing theirs, too.

Also, side note: The Americans With Disabilities Act is a law, not an agency. There is no ADA office.

All that out of the way, I’ll get back on topic:

Personally, I’ve found it helpful to meet briefly with a nutritionist to go over the basics, discuss portion sizes, come up with an overall plan, etc. Some nutritionists are better than others. I’ve had the misfortune of meeting several whose knowledge and helpfulness were limited. They were there to go over the basics and keep everything in neat familiar little boxes, and that was it. But there are better ones out there. And it’s still helpful to have a good grasp of the basics, like portion sizes and nutritional needs and the effects of different types of food on your sugar level and how long they take to digest and all that.

Like I said, it’s a personal matter. If you’re just starting out, it’s a good idea to learn. If you’re having trouble, it’s a good idea to brush up. If you feel like you’re doing okay, then you’re probably doing okay.

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I guess something came across wrong in my post. There was definitely a lot of research that went into these vaccines, I just meant that if we didn’t expect some different reactions to occur, that we are not being realistic. Of course they spent hours deciding on it and it went through trials, just because of the short time span, data on it was less than that of a normal vaccine time span and data amount. I meant no insult to any company or process. My mother works for J&J, so please don’t think I am bashing them. They did the responsible thing in stopping vaccine distribution until an informed decision was made. My mom does not work with the vaccines, but… I am saying that blood clots in so few people in terms of how many got it is definitely something rare. I didn’t realize how it would come across in writing. Please don’t think I am bashing any company. I am half way vaccinated, I get my second one on Friday and I still intend to wear a mask. I was always informed that cloth masks were effective, I was just sharing how in some cases, we need to be more careful. We subconsciously touch our faces all of the time and so even with some of this PPE, we still need to be more aware. I think that we still have a lot to learn about this virus. You are definitely right that there was a lot of resources put into these vaccines, but we talk pharmaceuticals in my house a lot. Part of the reason for the efficacy of J&J’s being lower was that we had new variants, and also it being a one shot vaccine had a little bit of an effect of efficacy as well.

On to nutrition. I was just curious about how often people saw their nutritionist. I do pretty well with food, but I feel like everyone has different approaches to food and I wouldn’t mind brushing up for thinking about college food. It is going to be like eating at a restaurant everyday for a while. I just didn’t know how people went about seeing a nutritionist only when they need it. It feel like it was expected at my pediatric endocrine office to see them twice a year, which isn’t a bad thing, I just don’t know if it is as necessary now that I am older. Thanks for your input on this subject.

I think what she meant was if our school had an office that would represent its students who fall under the disability act. I have plans in place with my school to make sure that I was well represented and that the ADA (laws) were met. I have special accommodations to make sure that I get the same education as everyone else, in terms of fairness, so that Diabetes does not get in the way. It was the same in High school. In college, for example, if I am sick or having trouble with elevated blood sugar I can have an extension on my test date. Nutrition on campus also falls under this category (in a way). It is an expectation that schools accommodate students with dietary needs and so, they will help students find food on campus to meet their needs and if their isn’t enough options, they will add more to their menu to accommodate, at least at my school.

Again, sorry if anything came across wrong, probably in a face to face conversation it would have come across differently on my end. Thanks for getting back on topic. I am meeting with my diabetes educator today, to get started with them, on a video visit, they do it in terms of classes. I can take a nutrition “class” which is a one on one session with a diabetes educator and nutritionist. I was just trying to gauge how often people go see there’s, even if I am doing well, I do think it would be beneficial to see one in terms of transitioning to new conditions. Thanks for your educational and thoughtful response as always!!

As far as frequency of visits with the dietician, our pediatric endo offices (we’ve been to two in the 6 years since diagnosis) never even referred us once. So we haven’t gone.

Like you, it sounds like, we feel pretty good about the food choices in our house overall, and we’ve had plenty of training in the context of sessions held during diabetes weekends/camps/expos/etc. Plus LOTS of handholding by our CDE when our daughter was first diagnosed — that wonderful woman very quickly came to recognize my phone number, and she was always so patient and helpful! But now I digress. :slightly_smiling_face:

So, yeah: put us down as a “never.” Not opposed, and certainly lots of exposure to the information, just never had a formal, one-on-one consult with a nutritionist.

Thanks for your input!! We had a team in my pediatric endo office. Consisting of several nurses, three diabetes educators, doctors, and nutritionists. So, it was up to you who you saw and for what reason, which was very nice. I always discuss nutrition with my PCP and she always says that she thinks I have a good diet. Not meaning I am dieting, meaning my eating style. That is not to say I don’t have a comfort meal or snack once in a while. I strive to be both realistic and healthy with my meals. I loved the team at my pediatric endo. Great CDE, who was probably the only one who acknowledged that I am a teenager and that I wanted to sleep in on the weekends. She was the first person who made a difference to me in terms of nutrition in that she said that I was letting diabetes control me and not the other way around. That’s a long story for discussion some other time, she told me that I could actually eat what I want within reason of course. Like don’t eat cake and donuts every day, but she saw that I was letting my blood sugar get in the way of me eating and feeling good about myself. She felt safe to talk to about things like that in terms of I never told anyone else that there were times where I was hungry after school but would refuse to eat a snack because I didn’t want my blood sugar to be high before dinner. I don’t snack anymore, but it is because I don’t feel like I need to. I am not hungry between meals and if I am, then I make a healthy snack choice that is still satisfying. Sorry for the rant, I just wanted to express that often CDE’s can be our best friends and advocates in terms of navigating this.

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