Forget the uptight approach to diabetes management. When patients come to Rhonda Howard, RD, CDE, at the Humphreys Diabetes Center in Boise, Idaho, they are taught to trust their bodies instead of fight them.

"I try to take a really individualized approach to my patients," says Howard. "I start by asking them exactly what brought them into the office, what they hope to achieve."

One area that particularly interests her is nutrition. Howard teaches clients to place faith in their hunger rather than in arbitrary guidelines like diets or pre-determined meal times. Instead of treating nutrition like an unbending regimen, she encourages people with diabetes to eat what they want but to understand how particular foods affect their bodies and blood sugar levels.

"I don't believe in restrictive diets or calorie levels. I have people focus on their hunger and do frequent blood sugar testing. They need to really tune into what's going on in their bodies."

"There are no 'good' or 'bad' foods. I teach people about carbohydrates, proteins, fats, and then encourage them to experiment, to find out how different foods affect their blood sugar."

Howard got involved with diabetes education in 1991, and worked with Dana Armstrong of King Medical Group in Salinas, Calif. Armstrong is the educator who recently hosted a conference called 'Ending Dieting and Diabetes Dilemmas: A Non-Diet Paradigm' (see DI, December 1995).

"I worked with Dana for four years," says Howard. "She introduced me to this non-restrictive approach. It works, but at first the idea of letting patients take control of their eating makes people nervous, especially healthcare professionals."

At the Humphreys Diabetes Center, Howard also teaches about the importance of having fun with exercise instead of thinking of it as a chore.

"People need to move their bodies in ways that they enjoy," she says. "Just like dieting, exercise can be taken to extremes, and then people give up. I tell my patients, do what you enjoy and don't set limits on yourself."

In early 1995 Howard, a California native, was lured out of Salinas by the beauty of Idaho and is happy in her new state. Today, in addition to meeting with clients one on one, she also teaches classes about nutrition and diabetes management. Those interested in classes at Humphreys Diabetes Center can call (208) 378-4190.

Rhonda Howard definitely loves her work. "I've always been interested in diabetes. This is what I want to do."