October 16, 2013

Communications With a Doctor

The Monday following our meeting with the doctor that Jason knew the family, I received a long email full of questions. I knew from some of the questions that he had been reading and I would need to respond. His first question was why we would not meet with certified diabetes educators (CDEs) and registered dietitians (RDs). He did comment about my interview with Adele Hite and said this means at least you follow one RD. I admit I follow several and mainly those that do not completely agree with the national organization. Then I pointed him to several blogs that point out the failings of the national and state groups and how they are working to criminalize other nutritionists that are not members of their organization. Also on the list of links are several blogs that show how the Academy of Nutrition and Dietetics (AND) is tied to Big Food and working to become the only source for nutrition information.

Then I answered his question about CDEs and stated that in general they do not feel that type 2 should take any of their time and especially those on oral medications. I gave him several links about this and how they seem to run away from patients needing help with depression.

His next question was why we don't follow the pronouncements of the American Diabetes Association (ADA). For me this was an easy question. I did send several links, but said that the ADA way as well as the AACE did nothing to encourage patients to take charge of their diabetes and prevent it from getting worse and the complications becoming part of the treatment. The fact that both organizations had leaders that did not think testing for those on oral medications was important except of the A1c test quickly soured us on their teachings.

I then stated that when the two organizations stopped putting out information that promoted progression of diabetes and started working with patients to show them that diabetes did not have to be progressive we would consider respecting them. Then I said that with the conflicts of interest existing in both the organizations and the officers behind the guidelines, we had no reason to respect anything coming out of the ADA or AACE. Then when the Society of General Internal Medicine (SGIM) chooses to follow the advice of the officers of both and recommend stopping testing for those on oral medications, even they lose our respect.

There were several more questions, which I will only answer to him, but I know that he will have more questions. Jason said he received many of the same questions and said he agrees with my answers and hopes that the doctor understands what we have said.

No comments: