A.J called several others and me last
Sunday to meet with him and Jerry. When we were all gathered, Tim,
Allen, Ben, Barry, Jason, and Max were in attendance. Tim asked what
was happening. A.J said that Jerry and he were talking to several
people new to type 2 diabetes and they were upset with the doctors
they had. He continued that the doctors were setting the goals for
them and demanding that they achieve them.
Jerry said the two people he was
talking with were both over 70 years of age and one doctor had told
the person to achieve an A1c of 7.5 percent (at diagnosis the A1c was
11.8 percent) and at the same time consume 50 grams of carbohydrates
per meal and eating three meals per day. Jerry said the fellow was
overweight by 50 pounds and wanted to lose the weight, but the food
plan he was on was keeping him from losing any weight.
Jerry said the second person was about
Allen's age and his doctor told him to achieve an A1c of 8.0 percent.
His A1c at diagnosis was 12.7 percent. He was told to consume 55
grams of carbohydrates per each of three meals. Jerry said this
person was almost 80 pounds overweight and had also been counseled to
consider bariatric surgery.
I suggested that we invite the persons
to a meeting with us and really get down to business when we could
ask them questions directly. Tim said he agreed and unless A.J and
Jerry had objections to this, we should do this. A.J said he agreed
and he had three people he was talking to and they were all over 67
years of age. Jerry agreed and said he could call his two people and
A.J said he would call his people.
Max said he was happy that the two of
us were there since we were overweight and this should help them feel
more at ease. I agreed and stated that we should find out what
medication or medications they were taking before going too far into
the discussion.
While we were waiting for them to
arrive, we discussed what some of our objectives should be and how
far were should promote them. All of us agreed that we should ask
them what they felt like and depending what they thought should
encourage all of them to consider insulin. We all agreed that a
reasonable A1c for them would be between 6 percent and possibly 7
percent but preferably below 6.5 percent.
They were all present after 30 minutes
and the discussion started. They surprised us by asking questions
about what medications we were using. When they found out all of us
except Jerry and A.J were on insulin, they were asking why and what
was our latest A1c was. When Allen said his was 4.6 percent, they
wanted to know how this was possible. Allen said he follows Dr.
Richard Bernstein and his “law of small numbers”. Small numbers
of carbs consumed require small amounts of insulin which helps
prevent hyperglycemia (highs) and hypoglycemia (lows) which are both
dangerous. These can still happen, but are fewer than if we eat
larger numbers of carbohydrates.
They then asked why the doctors were
pushing the large number of carbohydrates and Tim said because they
are not comfortable with our way of eating and still believe in low
fat. Tim said we all consume lower carbohydrates and most of us eat
less than 50 grams of carbohydrates per day and higher amounts of
fat. Most of us consume a mid-range amount of protein, but the exact
percentage each person eats will vary as we test to find out what
works best for each of us.
This brought a look of surprise and two
asked how we test, as their doctors had not said anything about
testing anything. At that point, Barry asked if they had any lab
results from their diagnosis. All shook their head and one said how
do we obtain these. Tim said that they needed to request in writing
for the information. You should put the information on paper, then
go to the doctor's office, and ask for the information. You will be
given a form to complete and sign. This will mean transferring your
information to their form. Then write the date your requested the
information on your paper, as you may need this later. Expect most
doctors to take the full 30 days to respond and you may need to
remind them that the 30 days have passed and they you are filing
papers with the Department of Health and Human Services, Office of
Civil Rights (OCR).
We talked for another two hours and I
will have another blog on this.
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