When dealing with registered dietitians
(RDs) and certified diabetes educators (CDEs) you will often be given
bad advice. You need to learn what some of the bad advice is and how
to turn this back on them.
Yes, I can say mandates, mantras, and
other platitudes because they are often what you will receive. They
often don't properly assess you and try to bully you into accepting
what they are telling you.
Recently, two of our members met with a
RD/CDE (dual titles) for classes. Sue had not intended to go, but
her doctor did ask her to go and report back to him. The other
member was Jennifer and she was hoping to hear something more than
she had been hearing from us.
When the class started, the emphasis
was on whole grains and eating enough carbohydrates to prevent brain
damage. Jennifer asked how many that meant and the answer was 45
grams to 70 grams per day. This told Sue that she had to think fast,
but the instructor was on to planning meals that would see to it that
they consumed enough carbohydrates.
When she finished with this and asked
if they understood what they had been told, Jennifer asked if testing
showed that they were too high for the blood glucose reading, should
they reduce the grams for the next meal? The instructor did not miss
a beat, but went right to telling them that if the reading was too
high, they should talk to the doctor about increasing their
medications or adding another medication.
Sue held her peace for that round as
she was planning on dropping the bomb later. Jennifer asked what
would be too high a reading and the instructor stated 180 mg/dl.
Jennifer said that is in the range that could cause complications and
the instructor said not if she was able to add another medication.
Jennifer said then she would need to
reduce her carbohydrates as anytime she consumed whole grains; she
would spike over 220 mg/dl. The instructor then advised her to have
a talk with her doctor as she needed the nutrients found in whole
grains.
At that point, Sue felt things had gone
far enough, so she explained to the instructor that she was off all
medications and eating low carb/high fat as was her husband. That
really upset the instructor to the point she said that then she was
not diabetic and why was she taking the class. Sue said that she
had support from her husband and their support group and her doctor
to work at getting off all medications and with the exercise and food
plan has been able to stay off all medications.
Sue continued that whole grains are not
the end-all and the nutrients could be found in other foods that were
nutrient dense and did not have the carbohydrate content. Sue said
even the ADA has partially accepted the low carb/high fat food plan
which meant that the instructor was following the USDA guidelines
instead. Sue concluded that by not encouraging testing and advising
more medications that she was a fraud and did not have the best
interests of patients in mind, only the interests of the corporate
sponsors of the AADE and AND.
With that Sue and Jennifer left.
Jennifer was very surprised at what the instructor had said and the
way she was pushing whole grains, carbohydrates, and medications.
Sue said she was glad Jennifer had asked about testing as most of the
time they will not talk about testing and the readings to avoid. Sue
said that her pushing medications is not good as this is what causes
people to gain weight and often need more medication. The meal plan
needs to be such that less medication is needed and if necessary help
lose weight.
Jennifer asked how often to test. Sue
told her to always test in pairs to be able to see how the meal
affected her blood glucose levels. They had arrived at their cars
and Sue said she was welcome to contact most of the older members and
to ask her questions. They went their separate ways and Sue told her
doctor what had happened. He thanked her and said this confirmed an
earlier report by one of his patients.
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