Medical Nutrition Therapy for Type 1 Diabetics


As future Registered Dietitians, we have been taught over and over again about the importance of open-ended questions. Anybody who has taken FN 355 Nutrition Counseling with Dr. Kessler can confirm this. As stated in the text Basic Nutrition Counseling written by Kathleen Bauer, “In motivational interviewing, certain types of open-ended questions are used to evoke a self-motivational statement.” Bauer also states, “Open-ended questions give a person a great deal of freedom to answer and encourage elaboration.” It is not realistic to assume that your future patients will openly discuss their dietary lifestyles with a stranger, that stranger being you. Implementing open-ended questions is quite crucial to the success of reaching future goals with patients because you can distinguish their level of readiness for change by evaluating their responses. By asking an open question, you open the door for new information that will help you as an RD best council your patient and steer them down the right path. Interestingly enough, the hard part usually isn’t having to remind yourself to ask open-ended questions. The hard part is having to tailor the questions per patient, which may be something you’ll have to tackle in the near future.

In a research editorial recently published in the Journal of the Academy of Nutrition and Dietetics, researchers comprised a list of open-ended questions that can be used in medical nutrition therapy when counseling individuals with type 1 diabetes mellitus. Listed below are just a few of the examples:

  • How does your diabetes affect your day’s schedule or routine?
  • What food and beverages do you have when you are at school?
  • What are some foods or beverages you choose or stay away from because you have diabetes?
  • How do social situations affect what you eat or drink?
  • How does physical activity affect what you eat or drink?
  • What are you goals with regard to diabetes?
  • What would you like to know to make managing your diabetes easier?
  • What role(s) do you [friends, family, couch, school nurse] play in managing your diabetes, eg, helping you manage hypoglycemia?

I find these all to be very great questions and I hope you do too!

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