How Virtual Dietitians Are Expanding Access to Diabetes Care
For years, nutrition support has been an essential but underutilized part of diabetes care. Despite strong evidence that medical nutrition therapy improves outcomes, many people with diabetes have faced challenges accessing consistent, high-quality guidance from registered dietitians.
That’s beginning to change.
Virtual care is breaking down long-standing barriers, making it easier to connect with dietitians in timely, flexible, and personalized ways. As a result, virtual dietitians are helping close critical gaps in care, and nutrition counseling is becoming more central and more accessible than ever before.
The Evolving Role of Nutrition in Diabetes Care
While nutrition has long been a part of diabetes management, even before the discovery of insulin, it was historically delivered in a rigid, prescriptive manner, often centered on strict carbohydrate limits. Today, that approach is evolving.
There is growing emphasis on patient-centered care that honors individual preferences, cultural eating patterns, and mental well-being. Instead of one-size-fits-all rules, the focus is shifting toward optimizing cardiometabolic health while supporting a healthy relationship with food.
A wider range of evidence-based eating patterns, including Mediterranean, plant-based, DASH, and even ketogenic diets, are now being used to complement care and, in some cases, reduce the need for medication.
Why So Few People Receive Nutrition Counseling
Despite its well-documented benefits, fewer than 10 percent of people with diabetes receive nutrition counseling. Several factors contribute to this low utilization, with insurance limitations and referral requirements being among the most significant. Medicare and Medicaid typically require a provider referral and often cap the number of covered visits, creating unnecessary barriers to access.
Awareness and accessibility are also key challenges. Many individuals simply do not know where to find a registered dietitian trained in diabetes care. At the same time, the abundance of online content from websites, social media, and influencers can feel more convenient, even if it is not personalized or evidence-based. This represents a missed opportunity for qualified professionals to connect with and support people with diabetes in meaningful and engaging ways.
The Rise of Virtual Nutrition Care
Virtual nutrition care is helping make registered dietitians more accessible than ever before. Platforms like Nourish, Fay Nutrition, and Berry Street offer care from licensed providers across all 50 states, often with risk-free trials and comprehensive insurance coverage. Many offer evening and weekend appointments, along with clinicians who represent diverse cultural backgrounds and eating patterns.
Maximizing the Nutrition Visit
As a clinician currently providing virtual nutrition care, I encourage my clients to make the most of our time together by coming in with a clear sense of their goals.
I ask them to reflect on both short- and long-term goals. What do they want to learn? What aspects of their nutrition or lifestyle do they hope to improve?
Rather than focusing only on information, I encourage clients to think about the skills they want to build—like reading a nutrition label, navigating a restaurant menu, or preparing glucose-friendly meals at home. This helps me tailor each session to their needs and make it more actionable from the start.
I also remind clients that nutrition therapy for diabetes is not about restriction. I’m not going to ask them to cut out sugar entirely, eliminate entire food groups, or follow a rigid list of “approved” foods.
Instead, modern nutrition counseling is collaborative and patient-centered. We focus on what’s already working, explore small, sustainable changes, and find ways to include meaningful foods that support their glucose goals without unnecessary restrictions.
- Evert AB, Dennison M, Gardner CD, et al. Nutrition therapy for adults with diabetes or prediabetes: a consensus report. Diabetes Care. 2019;42(5):731-754. doi:10.2337/dci19-0014
- Calcaterra V, Verduci E, Vandoni M, et al. Telehealth: a useful tool for the management of nutrition and exercise programs in pediatric obesity in the covid-19 era. Nutrients. 2021;13(11):3689. doi:10.3390/nu13113689
- Arena L, Austin R, Esquivel N, Vigil T, Kaelin-Kee J, Millstein S. Understanding barriers and facilitators to participating in diabetes self-management education and support services from multiple perspectives: results of a mixed-methods study of medicaid members, medicaid managed care organizations, and providers in new york state. Clinical Diabetes. 2024;42(4):505-514. doi:10.2337/cd23-0082
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