October 11, 2013

Nutritionally Unsound Fad Diet Endorsed By AND

I admit the last three weeks have not been good for my blood pressure. Again, my anger is fired by another group telling people with diabetes what they should be doing. This time it is the Academy of Nutrition and Dietetics (AND) that is endorsing a fad diet based on white rice and fruit. White rice is not a food that is good for diabetes and causes our blood glucose to spike to high levels because the glycemic index is very high. The right fruit can be beneficial for diabetes, but certainly not all fruit as this fad diet proclaims.

Amy Jamieson-Petonic, a registered dietitian and a spokeswoman for AND is promoting the Rice Diet as nutritionally sound. The AND supports the Rice Diet, with few concerns such that it is difficult to follow and that it is low in vitamin D and calcium.

“There are so many weaknesses with this diet that it’s difficult to know where to start.
  • First, the reason people lose so much weight is that dieters consume only 1200 calories per day—many of which are empty calories.
  • The diet is low-fat and low-protein, even though healthy fats and proteins are essential for maintaining health.
  • Despite the fruit, it’s low in micronutrients (vitamins and minerals), and this may accelerate the degenerative diseases of aging.
  • White rice is extremely high on the glycemic index, which means that rice is rapidly digested and absorbed, resulting in dramatic fluctuations in blood sugar levels—the very things that can develop into type 2 diabetes or for those with type 2 diabetes, make it more difficult to manage.
  • Too much fructose in fruit can be dangerous as well. While it’s better to have fructose in the form of whole fruits, people with diabetes, high blood pressure, and high cholesterol should be careful to limit fructose to 15 grams per day or less and even healthy people should probably not exceed 25 grams a day. One way to assess your fructose sensitivity is to have your uric acid levels tested.”

Given these reasons, I have to seriously wonder why people are determined to follow the AND way of nutrition when they have many companies in the processed food industry and companies such as Coca-Cola sponsoring their activities. The AND is continuing to press state legislatures and the federal agencies to allow them to be the only group educating people about nutrition. Then after getting many states to pass the legislation, they seek to criminalize degreed nutritionists who actually promote good nutrition.

October 10, 2013

Casual Meeting with a Doctor

At 7:00 PM, seven of us gathered at the library with the doctor Jason and I had met that afternoon. Jason said that there were others that wanted to be there, but already had plans for the evening. After introductions, the doctor asked us if we could discuss what made us successful as a group.

Tim started the discussion by stating that we always support each other no matter what the problem. Jason said we try not the let our personal problems dominate the meetings and since so many of us do research, we normally have this to guide the conversations. A.J. stated this was what appealed to him and the fact that two or more people always sent out emails summarizing the meetings, and therefore if it was necessary to miss, you were included after the fact. I stated that we all have email addresses for each other and telephone numbers if necessary. We use video conferencing if needed and use emails quite a bit to let people know about different articles.

The doctor asked how he could apply this to a group that seems to desire secrecy in everything. Rob stated that this could make it difficult to overcome, but if presented correctly, could be overcome. Allen said that secrecy was bad as far as he was concerned, but it is true that many do not want to talk about their diabetes and don't want to hear about other people's problems. Max added that with only two of us being overweight, he was always concerned about people making comments about our weight, but this has not happened.

Sue's husband, Bob asked if a lot of our success has come from our willingness to accept people as they are. Jason commented this is probably contributes to much of our success and not being judgmental. The doctor asked Bob why he would say this. Bob said that he was the one that had outed his wife's diabetes and he had actually hoped that we would give her payback for being the diabetes police. He said no one would and instead asked where they could be of help. They gave her the encouragement to adapt her food plan, continue her exercise, and maybe eliminate medications. Bob continued that when I announced that I had type 2, the support was there and I have been able to get off medications. A.J. said he has been able to do the same.

The doctor asked what age range the group included. Tim stated from 60 to 76 years of age. The doctor then asked the range of time people had diabetes. I said I think I am the oldest there with ten years and A.J. said he was just past his 6-month point. I asked Allen how long he had diabetes, and he stated just over 9 years. I added that four people of the group presently were not on medications with the remaining 10 on insulin.

The doctor was shaking his head and Tim asked why. The doctor asked why so many on insulin? Jason said because we were not liking the side effects of oral medications. Allen said at just almost 8 years, Tim and I had questioned him about how long he had been on metformin. Then they asked if I had been tested for Vitamin B12 deficiency and Allen said the doctor would not test me. They would not let me go any longer without being tested and set up an appointment with their doctor to be tested.

Allen continued that the doctor would not let him leave with his driver's license and that he had two shots that day, one for Vitamin B12 and one for Vitamin D. At the next appointment, he was given two more shots and put on a daily supplement that included several more vitamins and minerals and scheduled for two more shots the following week. When his two vitamins were back in the normal range, he was given his license back. Allen concluded that if we had not insisted that he see their doctor, he might not be alive today as deficient as he was.

Bob said this creates a loyalty that makes people want to be part of a group. A.J. added that this is why people like the diabetes clinic they use. The clinic will suggest insulin for the right reasons, to bring diabetes under quick management, and then if you adapt the lifestyles, they allow you to get off medications as they allowed me.

The doctor said this will be difficult to use to bring a group together and then asked if we had a doctor in the lead. He was a little surprised when we gave him a unanimous NO. Tim said this was our choice and another reason we feel like we have been successful. Allen said that about the only person we listen to as a group is the nutritionist relative of our blogger. The doctor said you don't have meetings with a certified diabetes educator and he received a no, a registered dietitian, and again the answer was an emphatic no.

Then the doctor just had to ask what our A1c's were. Tim answered that Sue, Bob's wife was the lowest at 5.2% and Max and I were the only two above 6.0%, but under 6.5%. Now the doctor was in shock and asked how many episodes of severe hypoglycemia each of us experienced on a quarterly basis. Silence and Tim asked him to define severe. Tim said we receive so much grief about this that we want to be sure were are talking about the same numbers. The doctor said to start at 45 mg/dl, and he could see that he was not getting any answers. Tim then said that most of us very seldom get below 55 mg/dl and this is infrequent. I stated that in the last year, I have only been below 55 mg/dl one time and that was 54 mg/dl. Two others admitted that they had been as low as 64 mg/dl, but the rest had not been lower than 70 mg/dl.

Tim had been looking for the blog of mine on hypoglycemia and when he had it asked the doctor what he considered the start of hypoglycemia. The doctor knew he was being tested, but said 80 mg/dl. Then Tim asked him to read my blog. After he completed this, he asked Tim to open the link and Tim directed him to the next tab where he already had the link open. After he read this, he said you fellows are more up-to-date than I am. Allen said this is because we do our research and try to educate ourselves.

With that, the doctor looked at the time and said he needed to get back to his parents, but asked Tim to enter his email address and send him a list of those present. Tim said okay and entered the email address. The doctor said he appreciated our time and that we were different than most groups and apparently took our education very seriously. Then he said to Jason and me that he would be in touch. I will write more on communications with the doctor in another blog.

October 9, 2013

Persons Not Understanding Diabetes - The Cure Police

Those of us with diabetes receive many false accusations by people that are uninformed and do not know what causes diabetes. Oh, yes, they claim they know, but most are half-truths and some of their own suppositions. Even many people without diabetes are accused of having diabetes.

That is because these people stereotype and allow for no exceptions. They read about something or hear it in the news from our ignorant people in the media looking for sensationalism. Then they make their own assumptions and apply this to their stereotypes.

I would rather have a conflict with the diabetes police or the diabetes food police than the cure police. This is because these people are so sure of their being right and knowledgeable that there is no room for disagreement or even a rational discussion. They have the false facts and because they read it somewhere or heard it on the news, rational discussion is impossible. Earlier this summer I even heard one of these self-proclaimed experts argue with a doctor even after having people tell her that she was talking with a doctor. Her parting comment was then why won't he tell people about the cure for diabetes.

Talk about not respecting a doctor. Those of us in the group just commented about how ignorant this person was and disrespectful. Then when two others left the group and said we had less knowledge collectively than she had in her little finger, we knew that there could be other of her friends still in the group. Therefore, the topic was changed to another topic and sure enough, two others left.

With their departure, discussion returned to diabetes. The doctor asked us if this was a common occurrence or just a thing that happens now and then. All of us agreed that this did not happen with regularity, but did happen. I commented that the diabetes police were hard to ignore, but these people were more of a pain as they are more difficult to reason with. The doctor commented that this was his first encounter outside of the office setting. He continued that there are a lot that argued with him in the office setting because they won't accept there is not a cure. He said he has stopped discussions with them and will not refer them, as he does not wish them on other doctors.

Another member of the group asked him about people that accepted the prescription and headed for the nearest health store for a natural remedy. The doctor admitted that there was probably more than he realized and he said a few have come back in a few months asking him to give them a prescription for a cure. He said he does not even try to convince them differently and says until they realize that there is no cure, he would just prefer they did not come back.

I asked him why he does not use the lifestyle changes and encourage them to apply them to their lives with the idea of managing their diabetes and getting off medications. He asked what we considered lifestyle changes. One of the group that I did not know started listing what he thought. He listed weight loss, exercise, and healthy food. At that point, Jason came in and had his laptop with him. I asked him to open it and go to my blog on lifestyle changes. Jason did that and quickly brought this one up.

The doctor read the blog, said this is very good, and read off the lifestyles that many people need to consider. This created some discussion and a couple of those present did not consider some of them lifestyles to change. The doctor asked for the URL and wrote it down. Jason asked if he wanted my email and the doctor said if he has it listed, it would be on my profile page. I affirmed that it was.

At that point, the doctor said he needed to leave and asked Jason and me to accompany him. Once outside the restaurant, he asked us whom we saw for our diabetes, and said am I correct in that? Yes, both of us have type 2. He then asked if we both lived here. Again, both of us answered yes. He then introduced himself as a doctor and said he was in town because of his parents were both ill and not expected to live much longer. Jason knew immediately who his family was and asked where he practiced and asked if it was, and gave the city and the hospital.

The doctor answered yes to both and said you do know my family Jason. To this, Jason said he graduated with the doctor's eldest brother and gave his name. Again, the doctor answered yes. Then he turned to me and asked Jason how he knew me. With that, Jason said we belong to the same diabetes support group and we have known each other for about three years. Jason then answered that he went to one doctor and I went to a diabetes clinic. I said three of us had been getting together for about six months and another group of three had been meeting on another day.  We finally became aware of each other and became a group of six when we realized we all had type 2.

The doctor said that is unusual. Most of the time people with type 2 diabetes don't want to be around other people with type 2. Both Jason and I laughed and said he missed being around about 50 of us at a meeting. With that, the doctor asked if he could get together with a few more of us later that evening, as he must see to his parents. We agreed and said we would see him at the library at 8:00 PM if that was acceptable and he asked for 7:00 PM if possible. We agreed and we parted with Jason saying he would email the group.

October 8, 2013

George Will Be Back On Friday

Barry let us know that George has his appointment on Wednesday and will get ready on Thursday and travel Friday. He stated they will try to have the support group together for at least one afternoon/evening while George is here.

Tim and I had a meeting to discuss the fifth support group attending some meetings and we will present this to our group when we get together with George. We have both heard from a couple of their members and the doctor. Tim stated that we are missing the email addresses for some of the group and he has requested the person that had many of them, to obtain those that wanted to be included in emails about the meeting and other upcoming events.

Tim stated that we still owed the one doctor a return meeting, but that he had heard from the doctor stating that the two meetings were important and that his group was happy they were included in our meetings. Therefore, unless something else came up this year, having one with them was not necessary. Plus, they did not have a place that could hold the number we had at the last meeting and even the first meeting. The doctor and several of that group had sent thank you's for hosting the two meetings since we had the room.

Tim commented that it had worked well for us and allowed for interaction among the groups, which both doctors felt was important. Even the group with Jessie and Elaine were happy to have been included and had emailed Tim their thank you's.

I said that the fifth group learned about the meeting from my blog and Tim admitted this was good. I said that the group I had spoken to, had asked for him and me to speak to their group in October or November about our two meetings. Tim said this would be good and maybe we should consider taking Allen, as well as he knows the VA. I asked Tim to check with Allen and once I had his answer, I would contact them.

Then we talked briefly about how many more we could accommodate if asked and we agreed that even if everyone made it from the five groups, we could add maybe another 12 or 15. We agreed that we should not include any new groups at present to allow the current groups to be able to add members.

Tim said he had heard from Hospice thanking us for not asking them as they would not have had time and they will let us know when they think it may work. I said that needs to be announced at the get-together for George as Allen has been working on another group. Tim stated he had forgotten this and would discuss this with Allen tomorrow.

October 7, 2013

Support Groups Have Second Joint Meeting

On September 28, we had our second group meeting with all four groups in attendance. Tim announced we had a request for attendance from a fifth group and he asked if there was any objection to them joining. There was none, and Tim brought them in and introduced everyone. The group had 14 members present of 17 members total. In addition, they had their sponsor with them. He apologized for not having made contact earlier as several in the group had wanted to come shortly after our last meeting.

Both doctors summarized what they had been informed by the Society of General Internal Medicine (SGIM) and then stated that they felt that with the members present from the four groups that they were right to oppose what the SGIM stated and they will continue to fight for test strips for their members. This drew a round of applause from everyone.

The sponsor from the fifth group asked who the blogger was and I raised my hand. He asked if I had any more emails and I said only one from the doctor and now two from other patients. I continued that the two from other patients was encouraging because their doctors have indicated they will work for their patients that want to test and one of their insurance companies will be continuing their current policy of reimbursing for one test strip per day. The sponsor for the fifth group said this was the response he had received from two companies in our state. Things seemed more on an even keel than we had anticipated. The doctors did ask which companies and after finding out, this made everyone a little more at ease, as this was the two companies representing the majority of those present.

After this discussion, the two doctors asked for a show on hands for those on insulin and with everyone present, the numbers were larger than expected. Tim then asked for a show of hands for those not on any medications. The number was nine and this surprised everyone. The sponsor of the first group stated that five of his group were not on any medications and Tim stated that four of our group were medication free. This meant that those on insulin were only a couple less that those on oral medications.

Allen said the numbers are three short of those present. One of the fifth group said she was on Byetta and another said she had just come off Victoza and gone on insulin. Allen said that makes the numbers come out as he was including the person that did not have diabetes. Elaine's husband raised his hand stating guilty as charged.

Tim then stated that we always welcome spouses of those with diabetes that are supportive of their spouse with diabetes. Otherwise, yes, we would prefer that they not come. Tim then asked Allen to discuss the VA and asked if any of the new group were being served by the VA. Three said they were veterans and Allen asked them to move to a corner while he, Ben, and Barry talked to them.

The sponsor asked why they were singled out. I spoke up and said we are finding people that are veterans and are not aware of the VA benefits available to them. All diabetes testing supplies are provided at no charge and medications have as copay, but only to the level that is means tested or based on income less qualifying expenses. With that two others joined the group Allen was talking with. Our local doctor said that this is important for any person that has been a veteran, and not just those with diabetes. This caused two other hands to be raised. One asked if this meant that a spouse who was a veteran could receive medications at a reduced cost.

At this, Tim asked Allen to address the entire group even if many had heard this before. Allen said yes, and came to the front and carefully stated that anyone who had been honorably discharged could qualify. They would need copies of all DD forms 214 (discharge papers) and then they would apply for VA benefits. Income would include husband's and wife's income less qualifying expenses. He asked which counties were represented and three counties were. He told them that they should go to the county seat courthouse and seek out the VA office. There they would be asked questions and if they qualified, given a form to complete and submit to the VA. Once submitted, then the wait would start for a determination letter stating the VA status level and amount of copay for most medications and certain other equipment.

Allen concluded that the VA officers at the county courthouses were certified for both the state and federal level and could be of assistance to answer questions and give assistance where needed in completing the application and support at other times. The one question was about a husband that would not consider joining the VFW or other veterans organizations so how could they get the benefits. Allen quietly stated that these organizations are completely separate and unrelated when talking benefits. There is no organization to join for VA benefits. Allen asked if there were any other questions. None was asked and Allen gave the wife his phone number so that the husband could call if he had questions.

Tim said that we did not cover everything we had planned, but felt that some confusion had been eliminated and important information clarified which had been in doubt. Both doctors thanked everyone for attending and they wanted to talk to the sponsor of the fifth group.

Several more wanted to talk with Allen, Ben, and Barry about the VA. Several of the new group wanted to ask me questions. I called Tim over to see what the plans were for the future of including this group. Tim was not sure, but asked me to gather email addresses and he would make sure to get the email for their sponsor. One of the group spoke up and said he had many of them and if Tim gave him his email address, he would email the list he had including their sponsor. I asked everyone else to write theirs on the pad I laid on the table. Only one put the email address there.

Two of the new group asked me where I had obtained the information for one blog. Since one already had the blog up, I had her scroll down to a link and click on the link. When this came up, she said now I understand why the different colors. She read the link while I talked to a couple of others and when she completed reading the other link, she asked to interrupt and thanked me for my patience and now she understood what she had been missing. I asked her to go to the profile page, which she did and those watching said that was good to know and when they saw the email, one asked her to click on it. They asked then if they could contact me with questions, I said that is why it is there.

Then their sponsor asked to speak to Tim and myself and introduced himself as the doctor for several, but not all of the group. He continued that he had much to learn about diabetes, but the other two doctors had given him much to think about, and he asked if he could also contact the two of us. Tim asked him to enter his email and Tim sent the email addresses for the two of us and the two doctors after they approved giving out the office emails to this doctor.

We talked a little longer and he asked about my blog, I said that when Tim emails me his address, I will send him a message that has my blogs listed in the signature block. He said you have more than one blog. Tim said yes, and one is not always positive about doctors, but he is using doctor blogs as the basis for them. He said he did not think his people had but one of my blog sites. I said this is possible as most were not aware of the profile page until I showed them. We talked a little longer and the meeting ended.