DIABETES WEEK: Being a diabetes dietitian during Covid-19: Naomi’s story

I became a diabetes dietitian because I’ve had a passion for food from quite a young age and I’ve always enjoyed cooking and making family meals. And I was aware of diabetes in the family. 

I work across three hospitals in Birmingham. I do one-to-one consultations with patients to try to help them improve their diet. This will help them control their blood sugar and meet other diabetes related goals like reaching a body weight say, or looking after their cholesterol.

Life during the pandemic

It has been a bit strange during the pandemic. We’ve still been going into work, but clinics were running at reduced capacity so there wasn’t the same buzz and busyness.

It was hard for all staff to adapt initially. There was a lot of uncertainty about what we can and can’t do. How many patients we can bring in physically to the clinic. 

But as a team we’ve pulled together: the dietitians have supported nurses. And nurses have supported dietitians and doctors.

Feeling isolated

We’d be spread across different rooms and stay isolated from one another. So I’d go to work and go through my clinic list for the day. And it took away the educational work I do in patient groups which I enjoy – which was a big change.

I’d be speaking to my patients on the phone but less speaking to people around me. It has been a little bit lonely I have to say.

I was lucky that going into work helped me maintain some degree of normality. And I’m very lucky that I live with my partner who has been a rock.  If you’re feeling quite isolated at work, to have to come home to be on your own would have been very difficult. I wouldn’t have coped so well. 

I am quite an active person, but I managed to get more into my running outdoors and my walks. That was quite an enjoyable side of things for me.

Telephone clinics

It was quite a hard transition for patients who still wanted to see us face to face to move to a phone consultation. There's more trust on the patient side when they're speaking to us in person - as they can't see us on the phone. And we probably don't get to know them as well. 

And one of the other downsides was that patients can't come along to group sessions and meet each other. 

But everyone was at home, so they were all picking up the telephone. And we're spending more time writing letters and sending out pictures. We can still offer the same information – but not always in that initial telephone appointment. 

Many patients started off quite well at the start of the pandemic as they were motivated to lose weight. But then their lifestyles changed through working at home and gyms being shut.

The change in daily routine has been a struggle for some. They found it not so easy to keep up with blood sugar control or weight loss when their energy levels changed. 

One trend we noticed is that initial availability of foods changed. People weren’t doing their shopping as regularly as before. So we've been helping people decide how to make a balanced meal using things in the freezer and cupboards. 

Recipe competition

One thing I'm excited about is a recipe competition I’ve started. It's for our pregnant ladies coming through the diabetes clinic. And it's to celebrate the diversity we have in the community around our hospitals. 

When advising what to eat, we want to suggest things that different communities want to eat and like to eat. It's good to involve our patients in sharing good practice to help other women who are struggling. 

So we've asked women who have found a meal or snack they're prepared to share that recipe. It needs to have kept their blood sugar levels within a tight range. We want them to tell us what the inspiration is behind it and what culture it belongs to. 

Joy of food

We’re hoping we can build up a lovely collection of different foods and meals for our patients to try that fit in with our healthy eating guidelines.

Food should be an enjoyment - and I quite often say to patients - I want you to enjoy your food. It's important. 

My partner and I have tried a few new recipes during lockdown. It’s having more time. We couldn't get out to our usual places at the weekend or do our hobbies or eat out. At the start I was using more long-lasting vegetables and more tinned products. And trying out different casseroles and curries. 

Things I’m looking forward to

I'm been looking forward to going out to dinner and being able to see family and friends a lot more. 

I was going to say I was looking forward to going to the gym, but I haven’t been since it re-opened. That’s a big change for me. I find I enjoy being outdoors a lot more now.

And I’m excited about running group education again. It’s so nice to talk to more than one patient at a time and get conversation going. Patients enjoy it too. Another patient might ask a question they hadn’t wanted to ask or hadn’t thought of.