October 4, 2015
Know When You Are Receiving Bad Advice
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.