What, when, and how much you eat can make a huge difference in your ability to control your blood sugar when you’re managing type 2 diabetes.

Your doctor may recommend working with a registered dietitian (RD) to develop a personalized food plan that takes into account your eating preferences, schedule, and nutrition requirements. Many dietitians have also completed training to become certified diabetes educators (CDEs), indicating that they are experts in diabetes management as well as planning healthy diets based on individuals’ health needs.

“Being certified in diabetes, we know the ins and outs of the disease, which gives us experience in helping you manage your diabetes,” says Angela Ginn-Meadow, RD, a certified diabetes educator at the University of Maryland Center for Diabetes and Endocrinology and a spokeswoman for the Academy of Nutrition and Dietetics.
Finding the Right Registered Dietitian for You

In the ideal world, you’ll be referred to a registered dietitian as soon as you’re diagnosed with diabetes so that you can get guidance right away about what to eat — and when — for better blood sugar control. A registered dietitian can help you set goals and then plan meals to meet them. Your diabetes and nutrition goals might include losing weight as well as lowering your cholesterol and blood pressure.

If you don’t have a specific referral, you can find a registered dietitian at the Academy of Nutrition and Dietetics web site. Your insurance company may be able to provide a list of registered dietitians who are also certified diabetes educators.

Be sure you and your dietitian are compatible. “This is a journey for the long haul,” says Ginn-Meadow. “This isn’t likely a person you see once and never see them again. They’re here to help you along on your journey and to be a partner on your health care team.”
Budgeting for Nutrition Support

If you are diagnosed with diabetes, your insurance is likely to cover your visits with a nutritionist, says Ginn-Meadow. However, if you have been diagnosed with prediabetes because your blood sugar levels are somewhat higher than normal, your visits may not be covered. Because working with an RD/CDE may prevent you from going from prediabetes to full-blown type 2 diabetes, it’s worth paying for the visit yourself, says Ginn-Meadow.

The cost for a visit with a dietitian will vary depending on where you live and what type of facility you go to — a private practice, a hospital, or a diabetes center.

You can expect to pay between $100 and $200 for the initial visit and about $50 to $150 for shorter follow-up visits. If your visits are covered by insurance, your co pays could be as little as $10 or as much as 20 percent of the cost. Check with your insurance plan ahead of time to be sure.
Meeting Your Nutrition Partner for the First Time

Expect your first meeting with your registered dietitian to last for up to an hour. You and your nutritionist will talk about your desired weight, how active you are, your medications, and your overall health goals.

“It will be general, but it shouldn’t be overwhelming,” says Ginn-Meadow. “What I like to do is get to know you and understand what your goals are. We can set small goals and discuss where to go from here.” Come prepared. “The more information you bring, the better I can help you,” says Ginn-Meadow.

To get the most out of this important first visit, bring with you:

A food diary. Record everything you eat and when you eat it for at least two or three days in a notebook or using one of the many smartphone apps. At least one of those days should be a weekend because people tend to eat differently on weekends and to have different activity schedules than during the workweek. Be sure to thoroughly log everything you consume, including snacks, beverages, and between-meal nibbles. In order to help you make improvements, your dietitian will need to get an accurate picture of what you’re currently eating. Research conducted by Kaiser Permanente found keeping a food diary kept people on track to lose more weight than they would have lost without one, in fact twice as much as anticipated than those people who didn’t keep a record. According to the American Diabetes Association being overweight is a risk factor for developing type 2 diabetes, heart disease, and stroke.
A list of your activities. Exercise is an important part of living well with diabetes. Knowing how often you exercise and what you like to do, whether it’s walking, swimming, biking, or dancing, can help with your diabetes treatment and eating plan.
A list of your medications. Write down the names of your medications, the dosages, and the times you take each one. If it’s easier, just bring your pill bottles with you.
Your blood sugar levels record. If you have started using a blood glucose meter, bring your meter and logbook to your appointment. “If you haven’t been testing your blood sugar levels, your CDE can teach you how to check your blood sugar and how often you should test. We will go through all the ins and outs and make sure your diabetes testing is not as painful as you expect it to be,” she added.
Your questions. If you write down your questions in advance, you won’t forget to ask them. “List all questions you may have, whether it’s about something you heard on TV or from your church member or a cousin, so I can address them and make sure you know the facts about managing your diabetes,” suggests Ginn-Meadow.

At your first visit, your CDE will also ask you a series of questions to help you customize your eating plan. She’ll need your height, and weight to calculate your body mass index, or BMI. This information is important to determine whether you need to lose weight. If you do, your dietitian can help you plan menus for dining at home and at restaurants. He or she may also suggest good sources for recipes and healthy substitutions to lower fat and calories in meals.

She’ll want the details on all other health conditions you have, such as high cholesterol or high blood pressure, arthritis, or allergies, that will affect your nutrition needs, as well as any cultural influences on what you eat. “Knowing your ethnic background and the foods you eat can help us tailor a healthy eating plan for you and take your preferences into account,” says Ginn-Meadow.

Your dietitian will cover a lot of information during your first session, so it may help to take notes. You and your registered dietitian can work together to revise the food plan after you have tried the meals and snacks she or he suggested. If you find that the meal suggestions are too complicated or leave you feeling hungry, you will want to address these issues with your nutritionist at your next meeting.

In the beginning you may see your dietitian once a month. Once meal planning and healthy substitutions become a habit and your blood sugar is under control, you may not need to come as often. “I usually see most people who are newly diagnosed once a month for three months, then every three months and then every six months,” says Ginn-Meadow. “I have one person who I see just once a year because they’re doing so well.”