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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. azure

    azure Type 1 · Expert

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    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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  2. datkins65

    datkins65 Type 2 · Active Member

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    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.
     
  3. datkins65

    datkins65 Type 2 · Active Member

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    If you are a Ms, sorry.
     
  4. datkins65

    datkins65 Type 2 · Active Member

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    Happy to have your opinions about what is working for you in your therapy?
     
  5. datkins65

    datkins65 Type 2 · Active Member

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    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?
     
  6. AndBreathe

    AndBreathe I reversed my Type 2 · Expert
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    @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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  7. Yes.
     
  8. datkins65

    datkins65 Type 2 · Active Member

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    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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  9. hankjam

    hankjam Type 2 (in remission!) · Well-Known Member

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    @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.
     
    • Agree Agree x 4
    #109 hankjam, Aug 19, 2016 at 7:34 PM
    Last edited by a moderator: Aug 19, 2016
  10. Dark Horse

    Dark Horse · Well-Known Member

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    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
     
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  11. hankjam

    hankjam Type 2 (in remission!) · Well-Known Member

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    Just figured out how to do the age thing... it's not important to the discussion, so gone.
     
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  12. datkins65

    datkins65 Type 2 · Active Member

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    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.
     
  13. datkins65

    datkins65 Type 2 · Active Member

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    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
     
  14. AndBreathe

    AndBreathe I reversed my Type 2 · Expert
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    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?
     
  15. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    Are you treating diabetes as a sugar/glucose problem?
     
  16. datkins65

    datkins65 Type 2 · Active Member

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    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?
     
  17. datkins65

    datkins65 Type 2 · Active Member

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

    DaftThoughts LADA · Well-Known Member

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    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?".
     
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  19. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    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.
     
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