Is it the diabetes educator? Yes once more, for many and varied reasons. If you have received a referral, this person can get in the way. Sometimes it is not intentional, but they sometimes lack the ability to think for themselves and settle into poor habits of thinking they and only they are right and forgetting about the needs and maybe the goals of the patient. They should not openly disagree with the doctor, but many do.
If done properly, they can be of great help to the patient. The largest problem is the lack of diabetes educators so many areas of the country just do not have them available. Many others have not left the profession, but are not working with patients because they have related jobs and some are authors and will never be available to advise patients. Some have good books and some have books.
So if you get one that understands diabetes, personal goals, what the patient desires, and what the patient is capable of, treasure this person. Make use of what they have to offer and get questions answered. They will communicate with your doctor and see that you receive the best outcome. In some states, these educators are not licensed, but still have much knowledge and are able to communicate at all levels.
It is the dietitian? I must continue to answer yes. These people sometimes are so wrapped up in following the guidelines of their national association and other medical groups that they forget about the help patients need to battle diabetes. They are locked into dogma and mantra's that are losing favor among the rest of the population.
It is unfortunate that they are so locked to low fat and whole grains that they push these ideas to the exclusion of patients needs. One person who will never talk to a dietitian has celiac disease and cannot tolerate any wheat products. She was still advised to eat whole grains even after explaining that she could not eat whole grains and that she had celiac disease.
There are many good dietitians that are not fearful of their job and work for and with patients, doing what ever is necessary to serve the nutritional needs of people with diabetes. They work with people to make nutrition first and at the level that the patient desires to be able to achieve their goals.
The problem many people have is locating a good dietitian that knows diabetes and can work with you. People living in rural areas may not be able to locate a dietitian or have to travel hundreds of miles to see one.
Both the educators and dietitians can be assets to doctors and they can help patients when they can put their own importance and titles behind them on a shelf or wall and don't wear them on their lapels constantly remind people of their importance. These are the ones that are also assets to patients.
I will be covering more in part 3. (2 of 3)
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