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Why Do Diabetics Fail To Adhere To Dietary Regimes?

Discussion in 'Diabetes Discussions' started by datkins65, Aug 1, 2016.

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

  1. Socioeconomic; lack of funds to purchase healthy choices

  2. Lack of education or knowledge about diabetes

  3. Fresh vegetables and healthy food is not available.

  4. Depression or mental health issues

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

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

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

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

  9. The prescribed diet was not effective.

Multiple votes are allowed.
Results are only viewable after voting.
  1. datkins65

    datkins65 Type 2 · Active Member

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    I am an advanced diabetic educator dedicated in finding solutions as to why diabetic patients fail to follow their diets and exercise regimens. I do recognize socioeconomic status, level of obtained education and depression as reasons that compliance has not been achieve, but measures are being taken to address each of these obstacles.

    I am of the opinion that taking the time to assist the patient in building an individualized dietary plan creates "ownership" in the task of managing T2DM. Another component in building the dietary plan is to identify the patient's favorite foods and traditional family recipes, and discuss making minor changes to effect the glycemic load of the dish. The patient is made aware that this diet can be changed as required, and that they are not stuck with eating the same food over and over for the rest of their life. Discussions about appropriate portions of each food group, and acceptable snacks is also discussed. Before the appointment is concluded, the question as to why these dietary restrictions are so important is answered, and the patient is able to repeat this information. Written information including substitute options, easy recipes, and contact information accompany the full dietary plan created by the patient with the assistance of the diabetic educator or nutritionist. Follow-up in 6 weeks intervals.

    In tracking 100 patients over the period of a year in the clinic, these dietary changes have produced a gain of dietary compliance of 12%. Weight loss ranging from (13 to 26 pounds), and HbA1c have been decreased in these patients by 9% with HbA1c goals reached in 88%.
     
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  2. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

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    Given that 80% of overweight/obese people are not diabetic, isn't your focus a little narrow?

    Perhaps the inability to stick to a sensible eating regime has nothing to do with being diabetic; it is just that unfortunately 20% of the overweight/obese go on to develop T2 Diabetes.

    I know that it isn't that simple, and that insulin imbalances can make it very hard to lose weight whatever the diet and exercise regime, but I would be interested to know if dietary compliance is better, worse, or average between diabetics and non-diabetics.
     
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  3. azure

    azure Type 1 · Expert

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    I'm not sure that the majority do fail to follow it. In the UK dieticians will suggest foods to fit in with family meals and favourites. This is free.
     
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  4. urbanracer

    urbanracer Type 1 · Expert
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    Given that this is primarily a UK based forum (we do have some members from the US) you need to be aware of the fact that we get some forum members reporting that they've received little or no dietary advice.

    I also think that more often than not, any failure to adhere to a diet will be the result of more than just one of your possible responses.
     
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  5. datkins65

    datkins65 Type 2 · Active Member

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    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.
     
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  6. bulkbiker

    bulkbiker Type 2 · Oracle

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    I think you are missing an "in my opinion" there.

    But anyway.. I would say that as the NHS dietary regime is "in my opinion" **** then I am glad plenty of people (a lot of them here) fail to follow it. The Eatwell plate has been advocated by the NHS for ages as the Type 2 epidemic gets worse.
    I would also take you to task a bit about the glycemic index part of your statement but as I am an Extreme Low Carb High Fat advocate I have never bothered to try it as I have found a way of eating that works very well for me.

    Also a quick note on statistics if 30% of all obese people have Type 2 then that is far from a majority also if 85% of Type 2 diabetics are also overweight then you cannot draw any conclusions as 70% of the obese do not have Type 2 and 15% of Type 2's aren't overweight. So I'm afraid it is very possible to talk about Type 2 without addressing obesity.

    I realise this may not sound like a nice reply but I'm afraid you have struck a nerve with me and I fear plenty of my fellow Type 2's who use this site to give support and help rather than be judgemental.

    Regards
    Mark
     
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    #6 bulkbiker, Aug 18, 2016 at 4:51 PM
    Last edited by a moderator: Aug 18, 2016
  7. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Legend

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    I can't vote because I would have to tick most of those boxes.


    I would like to know what you mean by compliance. Which type of diet is not complied with? Which foods do the non-compliers eat?

    Sadly, in the UK at least, the dietary advice given to type 2 diabetics is nothing short of criminal. I would happily have complied with the advice given to me - basically cut out sugar, have carbs at every meal, a jacket potato with a tin of baked beans is an excellent lunch because of the glycaemic load and so on and so forth. Compliance with this advice is of no help to any T2 and those "in the know" will not comply with it.
     
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  8. Squire Fulwood

    Squire Fulwood Type 2 · Expert

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    Why Do Diabetics Fail To Adhere To Dietary Regimes?

    Have you any particular dietary regime in mind. I don't follow most of them especially the diet sheets I got from the surgery.

    Going to see the dietitian didn't help since she wanted to push her own opinion with which I didn't agree.
     
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  9. MissMac

    MissMac · Well-Known Member

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    Whilst we know that weight can be a factor...yet again another person who believes that the weight came first and not as a symptom of the increasing insulin resistance. I am particularly tetchy today but the original poster has also hit one of my large nerves and that is a grave shame as this forum has been a life saver for me and has always felt like a "safe" and supportive place. The poll is total tosh...how can you vote when we have NO idea on what the "diet" is consisting of? As others have said, the NHS in England continues with their "eat well" plate which we know to be damaging. Maybe you need to elaborate as others have suggested and maybe not consistently attribute Type 2 to those who are overweight...you do very much run the risk of upsetting a lot of people further than they need to be upset.
     
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  10. dbr10

    dbr10 Type 2 · Well-Known Member

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    This minor tinkering will be completely inadequate.
     
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  11. donnellysdogs

    donnellysdogs Type 1 · Master

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    @datkins65

    From the foods that you list for eating was there a reason for no dairy? Or only olive oil?

    As you stated at one point "all diabetics" I have jumped in here because I am included in the "all diabetics" range not T2.

    I also think nutritionalists / dietitians have to look at the wider picture too of so many people nowadays having stomach issues. Some people (myself) have very limited foods that can be processed by their stomachs/colons and a lot of foods can impact upon things like IBS/constipation etc...

    One size does not fit all in this world.

    Even my gastro enterologist and dietitian says that I am the only one to try a food and see if it ok as one size does not fit me....
     
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  12. Brunneria

    Brunneria Other · Guru
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    Could you give us an idea of the kind of dietary tinkering that you usually suggest?
     
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  13. dbr10

    dbr10 Type 2 · Well-Known Member

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    We are carbohydrate intolerant (specifically type 2)
     
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  14. 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:
     
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  15. Enclave

    Enclave Type 2 (in remission!) · Well-Known Member
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    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
     
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  16. JohnEGreen

    JohnEGreen Other · Master

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    [​IMG]
     
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  17. equipoise

    equipoise · Well-Known Member

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    Sorry to sound sceptical, but could you explain what you mean when you say you are an 'an advanced diabetic educator'? What actual qualifications and experience do you have? What 'dissertation' are you doing and where are you doing it? What are the 'many articles' that you have read? How many of these are in proper medical journals (as opposed to 'the Harvard Gazette')?
    So much of what you write begs so many questions -- 'normal range', 'acceptable range', 'hba1c goals' -- and you don't make any allusion to the role that certain foodstuffs have in generating food cravings ('diet compliance' is not just down to 'attitudes').
     
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  18. 4ratbags

    4ratbags Type 2 · Well-Known Member

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    To be a truly 'advanced diabetic educator' you should spend.some.time here on the low carb forum. If you are educated by the so called experts then you have unfortunately been led down the garden path. The so called healthy plate is not very healthy for your average diabetic.
     
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  19. donnellysdogs

    donnellysdogs Type 1 · Master

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    Or the average human!!
     
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  20. lizdeluz

    lizdeluz Type 1 · Well-Known Member

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    All of the 'reasons' in the poll seem quite offensive. This is a poll for people with prejudices, not for people with diabetes.
     
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