October 19, 2014

The Diabetes Support Groups and Conflicts

When a new doctor was changing the landscape and diagnosing more type 2 patients and many patients with prediabetes, he was promoting membership in the different support groups, he then realized that two of the support groups did not have doctors leading them. He started telling his patients to avoid the two support groups without a doctor as a leader.

Both support groups have since talked to Dr. Tom and the doctor has been set straight. He has learned that Dr. Tom works with both support groups in an advisory capacity, but that our support group seems to do well on its own and does more research and has better programs than any other support group.

Dr. Tom called both Tim and Greg and asked them to bring in one other member to meet with him and the other doctor. This happened on October 16 and Tim did ask me. When we were all present, Dr. Tom asked the new doctor why he would not support the two groups without doctors leading them. Dr. Jay as we nicknamed him, said because they may not follow the American Diabetes Association guidelines. I could tell the other members were rolling their eyes. I said because we would rather follow guidelines set by the American Association of Clinical Endocrinologists if we followed any guidelines, and the ADA guidelines were too high and in the area that encourages the complications to flourish.

Greg said an A1c of 7% was too high and even the A1c of 6.5% was even higher than most of the group members wanted to tolerate. Greg continued that most of the members in the support group he was part of tried to keep their A1cs under 6% or near that level. Tim added that was very much like the group he led and while we read the guidelines, it was only to know what was being said and not to follow the ADA. Tim stated that it is true we do not follow the ADA guidelines and will not until they put the patients first and not their own wallets.

Tim continued that we ask Dr. Tom questions and when we have meetings with several groups, we include other doctors. Greg said we don't have meetings with other groups, but do participate in meetings with other groups led by Tim's group. We do consult with other doctors about some topics and have had doctors speak to our group.

Dr. Tom then asked Dr. Jay if he was going to continue opposing the two support groups. Dr. Jay said that he still had questions and both Tim and Greg told him to ask them. Dr. Jay asked how many were in each group. Greg said they now had 13 members and felt that they would be adding more. Tim said we have 17 members and will know if we will be adding six more members on the last Saturday of this month.

Next, Dr. Jay asked why we did not have a doctor as a leader. Greg bit his tongue and politely said that they started out without one and liked the fact that we did not have to worry about what we say. Plus if we came up with research that said something like statins that cause diabetes, we could use the sources and not have to worry about something getting back to our doctors.

Dr. Jay asked Tim if he agreed. Tim said yes, we had started out as a group of three and then two groups combined making it six. Tim continued that Bob is a blogger, worked to help all of us become more interested in learning about diabetes, and has helped some of us more than others, but we have grown because of him. Greg added that I was the one that had brought them into Tim's group and they had left over the fact that they wanted to remain an informal group and those that left wanted a more formal group. They have included us in group meetings and we have learned a lot and enjoyed their programs.

Dr. Jay then asked what besides group formality separated the groups. I said most groups are on oral medications while most of our group is type 2 people using insulin. Yes, four of our members are now off all diabetes medications, but the rest of us are on insulin. Dr. Tom spoke then and told Dr. Jay that they were successful because they went about it correctly and have presented this to other diabetes support groups. He admitted that he now has two members of the group he leads that are off all diabetes medications. Three had tried, but because they did it correctly, when the one was having problems, he went back on medications immediately and was not ridiculed for it.

Dr. Jay turned to Tim and asked if we would accept a doctor as a leader. Tim looked at me and then said we would need to put it to a vote, but he felt that the answer would be no. We consider Dr. Tom as an advisor, but not a leader of our group. We like our more informal nature, have received support from several businesses, and have larger meeting rooms available to us for our meetings of groups. Dr. Tom interrupted and said that we were not the largest group in the area, but only two groups were larger, one in a town north of us (about 28 active members with three doctors) and another in a town about half an hour south of us (about 35 active members with one doctor and a nurse practitioner).

Greg was asked the same question and Greg said he could not speak for the group, but he would be discouraging this. Jessie said she would also discourage a doctor leader. She liked their more formal group with Dr. Tom as being available as a consultant.

Dr. Tom concluded the meeting by saying he was welcome to come with him when Tim's group presents to the group of 35 members or attend the meeting of groups next year. With that, we left.

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