Why Do Diabetics Fail To Adhere To Dietary Regimes?

Why do the majority of diabetic patients fail to follow their dietary regimens? Primary reason.

  • Socioeconomic; lack of funds to purchase healthy choices

  • Lack of education or knowledge about diabetes

  • Fresh vegetables and healthy food is not available.

  • Depression or mental health issues

  • Does not understand about the progression of diabetes if not managed.

  • Not willing to change or not ready to make a change.

  • Advanced age; in denial that dietary changes can make a difference.

  • Youth: The idea that they are invincible to these problems & unwilling to give up fast foods.

  • The prescribed diet was not effective.


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azure

Expert
Messages
9,780
Type of diabetes
Type 1
Treatment type
Pump
Please can contributors to this thread be civil. It's perfectly possible to post constructive comments without resorting to sarcasm or rudeness.
 
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datkins65

Active Member
Messages
36
Type of diabetes
Type 2
Treatment type
Diet only
Dislikes
not having enough time, television,
OK living proof that following the eating plan that is dished out to T2 pre diabetics ...
In 2012 to 2013 was not told I was diabetic .. In 2014, was told I was T2 diabetic and to follow the recommended eating plan .. return in three months to be scolded for not following their eating plan .. By the end of 2014 I had increased my weight by 3st and was feeling very ill, again scolded by DSN for not following her eating plan (I was following it to the letter) So the wife steps in and says I am not to listen to anything my DSN says .. I went full low carb high fat .. lost my extra weight .. got my life back, with the help of these forums I made the LCHF way of eating my default eating plan.. My blood sugars returned to pre diabetic then non diabetic ... My most resent blood test was last week .. My HbA1c test came in at 5.8% (40) ...

If I continued to listen to my DSN's eating advice I truly think I would be dead now.. So forgive me if I appear slightly hostile towards any one that says I must follow the advice given on diet, life style or health... YES I am non compliant as far as my GP is concerned .. I did not follow their dietary advice .. If they gave the right advice to start with then maybe people will be able to follow the advice and see improvement in their health .. I also ignored their advice not to test my own blood sugars and purchased my own meter !

Note .. While eating to the recommend eating plan for T2, I went from 7.3% (56) to following their eating plan 9.8% (84) then I took control in 2014 and not gone higher than 6.0% (42)

You are living proof that these dietary plans need to be tailored to the individual, and the individual must construct his own plan. If a plan is not working, then additional adjustments based on extensive must be made. There is no one pill cure, and since we are all so very different, it takes an astute assessment to guide additional changes. Most physicians refuse to go that extra mile and order labs that are not covered my governmental insurance, and I am lucky to have access and funding to provide adequate medical support to determine if a diet is working or not. I firmly believe that it is not the failure of the patient, but the failure of the prescribed treatment. Thank God (pardon if I offend anyone) you were noncompliance to that diet. Something really could have gone wrong. What are you doing now? Is it effective and, most important, how are you feeling now?

I had the exact same response while following their diet. I know what the American Diabetic Association (ADA) and the International Diabetes Foundation (IDF) recommend a specific plan, but I do not even offer these since there have been so many patients that have had negative results from these. I suppose that in the perfect world, these diets work, but I am sure you will agree, there is no such thing as a perfect world especially when it comes to diabetes.
 

datkins65

Active Member
Messages
36
Type of diabetes
Type 2
Treatment type
Diet only
Dislikes
not having enough time, television,
I can't think of anything worse than this patronising tinkering. My prescribed photocopied diet sheet suggested I "fill up on starchy carbs at every meal" and "eat less pies". I wouldn't trust my dietitian to feed my cat.

Does not comply :jimlad:
I would not comply either, because I would be in the hospital with diabetic ketoacidosis (DKA) in intensive care. Are you kidding? This is malpractice. I wouldn't trust her either. Obviously, you are not following that hogwash. Is what you are doing working for you?
 

AndBreathe

Master
Retired Moderator
Messages
11,320
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
@datkins65 - Indulge me, as I ask a few questions.

Firstly, we all talk about success, but to me, success is a word like "nice". It's all very subjective and one woman's nice dress is another's horror story, if you see what I mean.

You clinic/surgery or however you phrase it; is it funded by patient fees, insurance plans?

Secondly, you are saddened by the amount of time physicians spend in consultation. What is the average length of time you would be in consultation with any given patient?

Health models in other countries are fascinating.
 
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A

Avocado Sevenfold

Guest
I would not comply either, because I would be in the hospital with diabetic ketoacidosis (DKA) in intensive care. Are you kidding? This is malpractice. I wouldn't trust her either. Obviously, you are not following that hogwash. Is what you are doing working for you?
Yes.
 

datkins65

Active Member
Messages
36
Type of diabetes
Type 2
Treatment type
Diet only
Dislikes
not having enough time, television,
Please can contributors to this thread be civil. It's perfectly possible to post constructive comments without resorting to sarcasm or rudeness.
Thank you, Azure. I understand. I have been a diabetic for many years myself, and I have seen the continued failure of treatment in the healthcare system. These costly diagnosticians continue to ignore the signs that what they are doing just not work. Good grief! They are dealing with the life and well-being of thousands, yet there treatments are out of a textbook which are only addressing the surface of this epidemic, if that. I do not take any of this offensively, but to me, this signifies how disappointed some people are in the current treatment of diabetes.
 
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hankjam

Well-Known Member
Messages
4,269
Type of diabetes
Type 2 (in remission!)
Treatment type
Diet only
Sir, I am afraid I do not follow the sarcasm regarding my education. I am far older than you, and if you require a resume, please let me know.
@datkins65 No sarcasm intended, it's probably a cultural thing. In some sub cultures in the UK, when in a forum someone writes something "off the wall" that is sure to generate posts, someone will state they will pull out the deckchair and open the popcorn to enjoy the anticipated debate. Your 150 g was going flame a bunch of folk.

In terms of your poll. These are near impossible because no one responding really understands the definitions of terms used. As we're in this for the long haul, regime change is near constant.

Delete the word diabetic from the head line, are we any different from the rest of the population? I would have thought there must be a ton of work on why people don't stick to diets.
 
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Dark Horse

Well-Known Member
Messages
1,840
i had a reaction couldn't breathe, went to hospital, whilst there a doctor asked if I had eaten anything different, no, he then asked if I ate Brazil nuts, in any form, not shelled, shelled, covered in chocolate, I said I ate shelled ones. He then told me that there had had a huge increase in people who had eaten Brazil's coming into hospitals, so many that it wasn't a nut allergy that suddenly developed but something with the nuts itself.
Later the family GP told me that the chemicals used to keep Brazil's fresh had a paper written on it and anyone who had a reaction should never eat them again.
It is also interesting as a youngster I didn't know anyone with any nut allergy, I now know at least 10 children, so it makes you wonder is it the nuts or the chemicals, either used as pesticides and to keep them fresh for longer.
Interesting. I know someone with a Brazil nut allergy so I would like to know the name of the chemical - can you tell me what it is called or give a link to the paper? Are you able to eat Brazil nuts if you shell them yourself?

Allergy UK have a page discussing possible reasons for the increasing incidence of allergies, including nut allergies, which is quite interesting:- https://www.allergyuk.org/why-is-allergy-increasing/why-is-allergy-increasing

QI have this interesting snippet about Brazil nut allergy:- "People who are allergic to Brazil nuts have a unique problem: it’s the only allergic reaction known to be sexually transmissible. In other words, the semen of a man who has eaten brazils can trigger an allergic response if a sexual partner of his has an allergy." - http://qi.com/infocloud/brazil-nuts
 

hankjam

Well-Known Member
Messages
4,269
Type of diabetes
Type 2 (in remission!)
Treatment type
Diet only
Just figured out how to do the age thing... it's not important to the discussion, so gone.
 
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datkins65

Active Member
Messages
36
Type of diabetes
Type 2
Treatment type
Diet only
Dislikes
not having enough time, television,
@datkins65 - Indulge me, as I ask a few questions.

Firstly, we all talk about success, but to me, success is a word like "nice". It's all very subjective and one woman's nice dress is another's horror story, if you see what I mean.

You clinic/surgery or however you phrase it; is it funded by patient fees, insurance plans?

Secondly, you are saddened by the amount of time physicians spend in consultation. What is the average length of time you would be in consultation with any given patient?

Health models in other countries are fascinating.

A short definition of success and a goal in treatment in the diabetic mission is to meet the goals of the patient to achieve and maintain an HbA1c within a therapeutic range. (Some can reach normal levels and other may only reach, let's say, 7.) In addition, if weight or abdominal girth is an issue, than hopefully the regimen of diet and exercise chosen by the patient will be effective in reducing both. Many in this clinic cannot afford "the nice" food, as they call it, and we grow foods and provide to this patients. There is no charge.

The mission is funded by my husband's family. We have lost many to diabetes in this country, and when the urgency was identified here, they contributed land and minimal funding (rent & utilities) to open the mission. Secondly, grant funding has supported medication, foot clinic, exercise room, and diabetic supplies for blood sugar monitoring. Labs are funded by both grants and donations. This is why there is a difference.

I perform all the physical assessment and lab interpretation on each patient. On intake socioeconomic information is obtained (# in family, employment status, etc), and current foods eaten, favorite foods, and we try to identify problems this individual might have obtaining healthy foods. I intake 10 clients a day, working a total of 12 hours. I spend one hour with each, and intake is completed after 1.5 hours and they are discharged to come into the mission kitchen to observe a variation of a traditional dish being prepare. These 10 (and family) get a chance to taste the new recipe, get a copy of the recipe and take a parcel home to prepare. They are invited back the next week for a diabetic education class to learn about foot care, and the importance of control of blood sugar in maintaining eyesight and skin integrity. Each week, and as needed, this patients come to the mission for one or more reasons. Over half come to the dance we hold on Saturdays, some to exercise in our donated gym, some need medication adjustments or dietary adjustment. We see 60 a week in the foot clinic.

I believe it is an insult to spend 6 minutes with a patient. If I want someone to take care of my health, and they only take 6 minutes to assess me, than I do not feel anyone could determine what my medical needs are with such a short time spent.

We need more time to make a notable change in the treatment and prevention of diabetes (T2DM). With budget cuts across the board everything is being trimmed down, however, the cost on the economy at this point ranged in the 250 billion dollar are, it would seem a little more time could be spend at addressing the problems so that money can be saved in that manner. Sometimes, people cannot see past the end of there nose.
 

datkins65

Active Member
Messages
36
Type of diabetes
Type 2
Treatment type
Diet only
Dislikes
not having enough time, television,
Interesting. I know someone with a Brazil nut allergy so I would like to know the name of the chemical - can you tell me what it is called or give a link to the paper? Are you able to eat Brazil nuts if you shell them yourself?

Allergy UK have a page discussing possible reasons for the increasing incidence of allergies, including nut allergies, which is quite interesting:- https://www.allergyuk.org/why-is-allergy-increasing/why-is-allergy-increasing

QI have this interesting snippet about Brazil nut allergy:- "People who are allergic to Brazil nuts have a unique problem: it’s the only allergic reaction known to be sexually transmissible. In other words, the semen of a man who has eaten brazils can trigger an allergic response if a sexual partner of his has an allergy." - http://qi.com/infocloud/brazil-nuts


Brazil nuts have similar aflatoxins found in peanuts which also produces a similar allergic response. In an article I recently read, the Brazil nut is the most common nut allergy in Great Britain. I commend you on wanting to know more about this allergic response, and will provide a link below for more information. I do know that delayed digestion and breakdown of this nut provides adequate time for an allergic response to muster. Please be careful in eating any peanut, walnut etc. as well. This is a dangerous reaction and you are blessed you got help in time.

http://www.jiaci.org/issues/vol17issue03/10.pdf
 

AndBreathe

Master
Retired Moderator
Messages
11,320
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
A short definition of success and a goal in treatment in the diabetic mission is to meet the goals of the patient to achieve and maintain an HbA1c within a therapeutic range. (Some can reach normal levels and other may only reach, let's say, 7.) In addition, if weight or abdominal girth is an issue, than hopefully the regimen of diet and exercise chosen by the patient will be effective in reducing both. Many in this clinic cannot afford "the nice" food, as they call it, and we grow foods and provide to this patients. There is no charge.

The mission is funded by my husband's family. We have lost many to diabetes in this country, and when the urgency was identified here, they contributed land and minimal funding (rent & utilities) to open the mission. Secondly, grant funding has supported medication, foot clinic, exercise room, and diabetic supplies for blood sugar monitoring. Labs are funded by both grants and donations. This is why there is a difference.

I perform all the physical assessment and lab interpretation on each patient. On intake socioeconomic information is obtained (# in family, employment status, etc), and current foods eaten, favorite foods, and we try to identify problems this individual might have obtaining healthy foods. I intake 10 clients a day, working a total of 12 hours. I spend one hour with each, and intake is completed after 1.5 hours and they are discharged to come into the mission kitchen to observe a variation of a traditional dish being prepare. These 10 (and family) get a chance to taste the new recipe, get a copy of the recipe and take a parcel home to prepare. They are invited back the next week for a diabetic education class to learn about foot care, and the importance of control of blood sugar in maintaining eyesight and skin integrity. Each week, and as needed, this patients come to the mission for one or more reasons. Over half come to the dance we hold on Saturdays, some to exercise in our donated gym, some need medication adjustments or dietary adjustment. We see 60 a week in the foot clinic.

I believe it is an insult to spend 6 minutes with a patient. If I want someone to take care of my health, and they only take 6 minutes to assess me, than I do not feel anyone could determine what my medical needs are with such a short time spent.

We need more time to make a notable change in the treatment and prevention of diabetes (T2DM). With budget cuts across the board everything is being trimmed down, however, the cost on the economy at this point ranged in the 250 billion dollar are, it would seem a little more time could be spend at addressing the problems so that money can be saved in that manner. Sometimes, people cannot see past the end of there nose.

So, are you the sole Health Care Professional (Registered Nurse?) in your clinic, or are there Doctors and so on?

I'm a little unclear; do you see 10 patients per day, plus the intake, or is the intake handled differently?

Once you have seen them once, and they then go to other areas - kitchen, gym or whatever, on average, how many times do they see you, for monthly consultations and is it for an hour each time?
 

Lamont D

Oracle
Messages
15,793
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Are you treating diabetes as a sugar/glucose problem?
 

datkins65

Active Member
Messages
36
Type of diabetes
Type 2
Treatment type
Diet only
Dislikes
not having enough time, television,
I am non-compliance regards to following the eat well gov guidelines dished out to T2 diabetics. did try to follow it, but quickly found it was affecting my health in a very bad way. I now LCHF
I could not vote, as you have no box for the .. diet told to eat is wrong

Thank you for your response. You are among many who report the LCHF approach has been effective for them. Does it help weight loss in a positive way? What about fat labs: cholesterol, triglycerides, LDL & HDL? What kinds of fat?
 

datkins65

Active Member
Messages
36
Type of diabetes
Type 2
Treatment type
Diet only
Dislikes
not having enough time, television,
I am non-compliance regards to following the eat well gov guidelines dished out to T2 diabetics. did try to follow it, but quickly found it was affecting my health in a very bad way. I now LCHF
I could not vote, as you have no box for the .. diet told to eat is wrong

Thank you for your response! What type of fats? What are the effects on fat labs? Does it help with weight loss?
 

DaftThoughts

Well-Known Member
Messages
397
Type of diabetes
LADA
Treatment type
Insulin
Good Day LittleGreyCat,

My dissertation is focused on T2DM and nutrition. However, I must say that there is nothing narrow about the epidemic of obesity and T2DM. This is all interlinked.

Actually the majority of overweight/obese people can be classified as prediabetic as some do fully convert to diabetes, and others go back and forth from prediabetes state to a normal state and then back again to the prediabetes state. The important point is that being overweight is damaging to the metabolism and sets insulin intolerance free to attack every cell type in the body. Some of the latest research identifies fat as causing metabolic conversions in the liver creating insulin resistance which has the tendency to be permanent if not dealt with quickly and aggressively. I have seen many who have been able to reestablish normal labs including HbA1c's that actually convert back to a normal range. There are others that regardless of the weight loss and increase in activity never achieve a normal range again, however do reach an acceptable range where damage and risk factors are minimal.

According to the Harvard Gazette (7 mar 2012), 30% of all obese people already have T2DM. In addition, they state that 85% of all diabetics are overweight. Impossible to talk about diabetes without addressing obesity as well. ( See: http://news.harvard.edu/gazette/story/2012/03/the-big-setup/ ) I have reviewed many articles just based on being overweight, and the compliance failure for both remain well under 50%. One cannot discuss obesity without referring to diabetes these days.

Thank you for your comments.

I want to start off by saying, I'm a 6'1" female weighing in at about 270lbs. I have been tall and heavyset my whole life. I'm also a type LADA, and my weight did not cause my diabetes, nor is it really relevant in my treatment at this time. It's all in the genes. I do have T1D and T2D in both sides of the family, which confirms to me that genetics play a bigger role in diabetes than diet and environment. There are many other types out there indicate obesity does not have to be involved in every diabetes discussion - MODY is a good example. As many pointed out before me, there is ample evidence that the reverse is true - diabetes causing obesity.

That's why so many people are upset that you're creating this link. I also feel like your focus is so heavy on T2D that you didn't consider the vast variety of conditions before creating this poll.

The reason I didn't follow my dietitian's plan and stopped seeing her is because she put me on a 1400 cal plan. (My BMR alone is over 2000 calories, never mind the exercise I do almost daily.) The options she gave me weren't bad, tailored to what I liked and disliked, but ultimately she was more focused on crash dieting me into quick weight loss than she was about sustainable eating habits that worked with my glucose levels. At the time I was assumed T2D, and she was of the opinion that if I lost weight, my diabetes would disappear, I never saw her again after I was diagnosed as LADA because it was clear she was focused on pushing an agenda, personal or professional, and had no interest in figuring out what would work for me and my condition. To my knowledge she doesn't even know LADA exists.

I am still working on my diet. I can't low carb because my own insulin production is too high (although I need basal insulin to maintain good fasting values) and I crash into hypos quickly if I don't eat around 40g carbs a meal minimum. I exercise about 4-5 hours a week through commuting on a bicycle, which requires a higher carb intake lest I pass out on my bike (I am hypo unaware during exercise, but not when idle). I am insulin sensitive to my knowledge partially thanks to metformin. My diet is also partially determined by my income. I'm on disability, a fixed income, with a massive load of debts. I have a budget of €40 a week for every expense I could have groceries wise, including cat supplies, toiletries and anything else that pops up, leaving the rest for food. Sometimes I haven't much of a choice in what I eat, though I can choose to eat smaller portions and fill up on water if my values run high.

To answer the question: I know my body better than most doctors. I know my weight is not related to the fact I am a diabetic (although it can affect treatment). I know more about my diabetes than most healthcare professionals. The last time I saw someone to figure out my diet, I was put on a dangerous crash course because the dietitian only saw a fat woman in the chair in front of her and assumed all her problems would go away by restricting her calories to 60% of what she needed in a day. I don't always have the luxury to buy the food I need, but I have become excellent at compromising. My values have never been better, and I got here without anyone's help.

I feel this is the case for a majority of diabetics. We are numbers, we are money making conditions, rarely are we people who deserve to be treated as individuals. It's no surprise we don't listen to people who don't bother to learn about us beyond the basic "What do you like to eat?" and "How much do you weigh?".
 

Lamont D

Oracle
Messages
15,793
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
I want to start off by saying, I'm a 6'1" female weighing in at about 270lbs. I have been tall and heavyset my whole life. I'm also a type LADA, and my weight did not cause my diabetes, nor is it really relevant in my treatment at this time. It's all in the genes. I do have T1D and T2D in both sides of the family, which confirms to me that genetics play a bigger role in diabetes than diet and environment. There are many other types out there indicate obesity does not have to be involved in every diabetes discussion - MODY is a good example. As many pointed out before me, there is ample evidence that the reverse is true - diabetes causing obesity.

That's why so many people are upset that you're creating this link. I also feel like your focus is so heavy on T2D that you didn't consider the vast variety of conditions before creating this poll.

The reason I didn't follow my dietitian's plan and stopped seeing her is because she put me on a 1400 cal plan. (My BMR alone is over 2000 calories, never mind the exercise I do almost daily.) The options she gave me weren't bad, tailored to what I liked and disliked, but ultimately she was more focused on crash dieting me into quick weight loss than she was about sustainable eating habits that worked with my glucose levels. At the time I was assumed T2D, and she was of the opinion that if I lost weight, my diabetes would disappear, I never saw her again after I was diagnosed as LADA because it was clear she was focused on pushing an agenda, personal or professional, and had no interest in figuring out what would work for me and my condition. To my knowledge she doesn't even know LADA exists.

I am still working on my diet. I can't low carb because my own insulin production is too high (although I need basal insulin to maintain good fasting values) and I crash into hypos quickly if I don't eat around 40g carbs a meal minimum. I exercise about 4-5 hours a week through commuting on a bicycle, which requires a higher carb intake lest I pass out on my bike (I am hypo unaware during exercise, but not when idle). I am insulin sensitive to my knowledge partially thanks to metformin. My diet is also partially determined by my income. I'm on disability, a fixed income, with a massive load of debts. I have a budget of €40 a week for every expense I could have groceries wise, including cat supplies, toiletries and anything else that pops up, leaving the rest for food. Sometimes I haven't much of a choice in what I eat, though I can choose to eat smaller portions and fill up on water if my values run high.

To answer the question: I know my body better than most doctors. I know my weight is not related to the fact I am a diabetic (although it can affect treatment). I know more about my diabetes than most healthcare professionals. The last time I saw someone to figure out my diet, I was put on a dangerous crash course because the dietitian only saw a fat woman in the chair in front of her and assumed all her problems would go away by restricting her calories to 60% of what she needed in a day. I don't always have the luxury to buy the food I need, but I have become excellent at compromising. My values have never been better, and I got here without anyone's help.

I feel this is the case for a majority of diabetics. We are numbers, we are money making conditions, rarely are we people who deserve to be treated as individuals. It's no surprise we don't listen to people who don't bother to learn about us beyond the basic "What do you like to eat?" and "How much do you weigh?".

I can empathise and sympathise about your misdiagnosis and treatment.
My misdiagnosed T2 years, when on every diet and NHS recommendations, I only put on weight and my health got progressively worse.
Every time a newbie joins the RH forum, we ask two things, have you a monitor and an endocrinologist.
The first is to discover what we can tolerate and the second for specialist care, as we cannot trust the untrained doctors/dsns and most of the medical industry. As they know nothing of controlling the condition.

I believe the op is of the same mentality regarding metabolic conditions.
As she has not answered my questions.