Paul Community Dietitian “I work in two ways. One is as part of a team working towards improving the care of people with diabetes. The other is working with groups of local people to improve their skills in eating and cooking more healthily, with the aim of reducing future ill health such as diabetes and heart disease for them and their families.”

Paul works in a large city. He divides his time between working generally as a dietitian and as a specialist in diabetes. Paul's based in a medical centre with a large number of other health professionals; it's above a GP practice.

Sum up the best thing about your job:

Easy – no two days are ever the same.

What might you do in a week, then?

About twice a week I meet with patients. This is usually connected with my specialism, diabetes. I meet with patients on their own, but also in partnership with a senior diabetes nurse (she's called a diabetes nurse consultant.) We might see the patient together or in next-door rooms; it depends on how the patient feels most comfortable. Patients might be newly diagnosed or their condition may not be controlled for one reason or another. My aims are always to inform people about their condition and to enable them to take control of it by managing the types of things they eat and drink along with their activity level.

Why do you specialise in diabetes?

There's been a huge increase in diabetes. There are two types, both occur when there is a lack or relative lack of insulin. Type 1 can happen at any time, sometimes suddenly, and no one quite knows why. Type 2 used to be especially among older people, but this is the type greatly on the increase – being over-weight or obese is often the cause.

When I see a newly diagnosed Type 2 diabetes patient I'll give them advice as part of a wider education they'll receive. This is aimed at self-management of the disease (and often aimed at weight reduction – 80% of Type 2 diabetes patients are overweight). I'll talk to them about the importance of regular meals and eating something 'starchy' – like potatoes, rice, pasta, chapatti and so on. They should include at least 5 portions of fruit and vegetables each day, and 'oily' fish such as salmon, mackerel, sardines or trout twice a week to protect from heart disease and stroke. We don't recommend 'diabetic' foods, we focus on healthy eating – a diet low in fat, sugar and salt, but not necessarily fat-free nor sugar-free.

Do you like working with a partner, like the diabetes nurse consultant?

Yes, I do. But the diabetes community team is much bigger than us two. In the full team there are the diabetes nurse consultant, a diabetes specialist nurse, a diabetologist (someone of consultant doctor level, 80% with us 20% in hospital), a link worker and a podiatrist. And me, of course. We also have access to eye screening services.

How do you spend the other 40% of your time?

On a project we call ‘Food Net’. We work with a whole range of people in our local communities to encourage more healthy eating. Some we train to be Community Food Workers. It's part of our drive to reduce heart disease.