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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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datkins65 said:
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?
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I have been able to stop taking statins since LCHF way of eating .. my heart failure is improving in leaps and bounds .. weight loss was easy .. (5st in 18months) cholesterol all in the normal range.. I am vegetarian ... I do eat coconut oil, olive oil .. Almonds .. sunflower oil for frying. Full fat cheese .. double cream & full fat milk in tea.
Before my T2 diabetic diagnosis, my extra weight was being treated as retained water and I had water tablets to clear this .. needless to say they just made me go to the loo more, missing the diabetes loo visits !!!! I did looses some weight with the water reduction, but not a lot. My heart failure was becoming more noticeable and I was following the eating advice from my heart failure nurse. Its sad that my heart failure nurse is truly delighted with the amazing improvement in my health .. whereas my DSN is still not happy ... ordering me not to test my own bs and to eat more carbs and only low fat foods !!!

Edit to add .. my carbs for the day was 20g .. now in remission and can eat what I want .. but I like LCHF ..so stick with around 50g a day now .. my choice
 
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If you read Shar67's original post, she said that she'd been told that her reaction to Brazil nuts was actually due to a chemical they had been treated with to keep them fresh, rather than the nut itself. I was asking what the name of that chemical was.

Aflatoxins are carcinogenic substances produced by moulds that may contaminate nuts. It is thought that their presence may affect sensitisation, but usually Brazil nut allergy is to proteins within the nut. Brazil nut allergy may be one of the commonest tree nut allergies in the UK (http://www.ncbi.nlm.nih.gov/pubmed/26233427) but peanut allergy is about twice as common as treenut allergy (http://www.gpnotebook.co.uk/simplepage.cfm?ID=x20080902175442749131)

Thanks for the link.
 
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It was a while ago in the late 1990s but I think it is an insecticide called phosmet, which was also used to kill fleas in pets, and there was some study about it causing ME. As far as I remember it is all nuts shelled or not.
If you look at mass food production, the amount of chemicals used and not just on the plants it leaches into the ground, into watercourses, then governments wonder why people have problems that were unknown 50 years ago.
 

This is an advance practice registered nurse with a master's degree certificate and certification in diabetes management & treatment. I have certification in diabetic education and will be completing the MSN soon. I am working on the second phase which will allow the certification and training of other advanced practice nurses to learn and be certified as diabetic educator. I have been working in the diabetic educator field for 25 years after becoming a diabetic myself, and over the past 5 years I have concentrated on diabetic research and education looking for approaches to education and treatment that REALLY work. I joined the military in 1972 and eventually worked as a medical laboratory specialist for some time in the US Army. During that time I was working on my BSN.

Normal range means a laboratory value that is present in a healthy individual. Example: The normal range for the HbA1c lab test is between 4% and 5.6%.

Acceptable range means the closer to the normal range, and I have been taught to keep it lower than 7. When I asked about why 7, the instructors reminded me that not all people have the ability to pull the number lower than 7. After 7 the blood glucose reaches that hyperglycemic state which we all must avoid.

HbA1c goals - these are goals that each individual sets in the mission center; for instance if we are seeing a 7.6% in the HbA1c, we might try to reach 7% or lower over a six week period.

I find it odd that not all people have food cravings in the population I serve. I have noticed for myself that the more carbs I consume, the more I crave food period. Carbs just do not satisfy my hunger. Lower glycemic vegetables (especially raw), a 3 oz chicken medallion, and lentils or beans fill my urges.

Dietary compliance can only be based on the success of that developed dietary plan which lowers the HbA1c labs, maintains that blood glucose within range, and most important, creates satiety, and an overall good feeling and energetic state for the patient. It is my own failure to not identify the correct approach to dietary intake that can place a patient in that state so that remaining on that regimen is not questioned by the patient or no laboratory value. I have seen this happen time and time again, however, I always wonder where I went wrong with those I fail.

The Harvard Gazette is published through Harvard Medical School, however, I do not use this in my research. Here are a few I reviewed this past week:

Bagnasco, A., Giacomo, P. D., Della Mora, R., Catania, G. Turci, C., Rocco, G. & Sasso, L. (2013). Research protocol: Factors influencing self-management in patients with type 2 diabetes: A quantitative systematic review protocol. Journal of Advance Nursing, 70(1), 187-200. doi: 10.1111/jan.12178

Diabetes.co.uk (2013, Dec 9). Low adherence to diet and exercise changes in type 2 diabetes. Diabetic News. Retrieved from http://www.diabetes.co.uk/news/2013/Dec/low- adherence-to-diet-and-exercise-changes-in-type-2-diabetes-02050840.html

Garcia-Pérez, L., Alvarez, M., Dilla, T., Fil-Gullén & Orozco-Beltrán, D. (2013, Dec). Adherence to therapies in patients with type 2 diabetes. Diabetes Therapy, 4(2), 175-194. doi: 10.1007/st3300-013-0034-y

Halali, F., Mahdavi, R., Mobasseri, M., Jafarabadi, M. A. & Avval, S. K. (2016). Perceived barriers to recommended dietary adherence in patient with type 2 diabetes in Iran. Journal of Eating Behaviors, 21, 205-210. doi: 10.1016/j.eatbeh.2015.03.001

Koenigsberg, M. R., Bartlett, D. & Cramer, J. S. (2004 Jan 15). Facilitating treatment adherence with lifestyle changes in diabetes. American Family Physicians, 69(2), 309-316. Retrieved from http://www.aafp.org/af

LaCroix, S. (2015, Aug 11). Are you in diabetes denial? Why it is dangerous to ignore your diagnosis. Safebee. Retrieved from www.safebee.com/health/are-you-diabetes-denial

Linde, R. (2016). Diabetes risk management. The Doctors Company. Retrieved from http://www.thedoctors.com/KnowledgeCenter/PatientSafety/articles/Diabetes-Risk- Management

Masters, K. (2015). The health promotion model: Overview of Pender’s health promotion model, Nursing Theories: A Framework for Professional Practice (pp. 215). Burlington: Jones & Bartlett Learning.

Mohammed, O. M. I., & Hassanein, M., (2016). Can structured education improve metabolic outcome and quality of life in diabetes? A systematic review of randomized controlled trials. Middle East Journal of Family Medicine, 14(2), 31-43. Retrieved from http://eds.a.ebscohost.com.ezproxy.uttyler.edu:2048/eds/pdfviewer/pdfviewer?sid=4a76b eb5-6a12-463b-8afd-42043d756d6e@sessionmgr4005&vid=2&hid=4108

Nam, S., Chesla, C., Stotts, N., Kroon, L. & Janson, S. (2011). Barriers to diabetes management: Patient and provider factors. Diabetic Research and Clinical Practice, 93(1), 1-9. doi: 10.1016/j.diabres.2011.02.002.Epub 2011 Mar 5

Pender, N.J., Murdaugh, C. & Parsons, M.A. (2016). Interventions for health promotion and prevention. Health Promotion in Nursing Practice (pp. 157 – 163). Boston: Pearson.

Shrivasta, S. R., Shrivasta, P. S. & Ramasamy, J. (2013, Dec) Role of self-care in management of diabetes mellitus. Journal of Diabetes & Metabolic Disorders, 12(14). doi: 10.1186/2251-6581-12-14

I hope that I have answered your questions.
 

So true. They use to use arsenic to dust plants, and I have seen the devastation of agent orange in soldiers I have treated who served in View Nam. Honestly, either folks are unconscious or they only think as far as they see, which is not so far in most cases. Look at the poison our kids see on television each day while that sit on their backside and play video games. Please do not get me started on the past failures of mankind. That is what I classify in lab language ass TNTC (too numerous to count).
 
mahola said:
If you are an "advanced diabetic educator", should you not already know why?
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That would be nice, but NO ONE KNOWS. All the research blames a multitude of reasons all except one, and that is the failure of the treatment plan itself. The majority of research is bickering about the failure of the low-carb diet, the failure of certain drugs, the limited success of this and that, but nothing proves a working plan in identifying what went wrong in the metabolism of that individual patient. In the perfect world, all diabetic educators should know, and there should be a pill to cure diabetes.
 

No one has all the answers. I believe in the low-carb diets and help people who tolerate the diet and do well on it to set it up. Some, however, do not do well and may do better with another approach. As I continue to say, this is not a one size fits all world. You, by the way, are doing wonderful on your management. Congrats!!!!!
 

Perhaps one aspect that could answer your question there is Dr Robert Lustig from Universtity of Calfornia and his study on the hormone leptin. The more people eat and the more weight they gain the more insulin is released as well as leptin. The leptin levels are too high and not doing their job to stop people from eating. So basically there is not only insulin resistance but also leptin resistance. If you haven't heard of him, he has vids on youtube... a good one is "The Complete Skinny on Obesity".
 
You have quoted that some do well on low carb and some don't!
Is it because a low carb is still too high a quantity in your experience, because if you have an abnormal hormone imbalance it is not blood glucose that is the problem. It is the other hormones being excessive that gives the symptoms and finally T2?
Do you know why diabetes and hyperthyroidism have similar symptoms?
Why is anxiety and depression among other mental states are rife in a lot of metabolic conditions?
Why is endocrinology the study of all metabolic conditions and not just diabetes?

I think you have more studying to do!
 

I also had a problem with consumption of dairy products and completely cut them from my diet 15 years ago (as advised by NHS dietitian without any testing). Since then, through my own experiments, I have discovered that it is only cow's milk products that affect me and can consume goat's, ewes and buffalo cheese, butter, double cream etc without issues. Not tested, but I suspect that is the A1 beta-casein in cows milk products that causes my issues.
 
datkins65 said:
It is very unhealthy to cut carbs lower than 130 grams a day. Without knowing that carbs are essential in brain metabolism, energy and immunity, many have cut carbs down so much that they becomes depressed or physically ill.
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This statement is absolutely without scientific validation. The body has it's own inbuilt way of providing the glucose it requires by a process called gluconeogenesis. There is no requirement for exogenous carbohydrate or people fasting wouldn't survive past a day without the 130g you claim they need.

If you want to learn more about low carb and ketogenic diets, the following research paper is a great starting place:
Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base: http://www.nutritionjrnl.com/article/S0899-9007(14)00332-3/fulltext

If you want to learn about the very latest research on ketogenic diets, I'd highly recommend the videos from the Metabolic Therapeutics conference earlier this year where researchers talk about the results of their latest studies on the ketogenic diet in epilepsy, cancer (especially brain cancers), diabetes, neurological conditions and athletic performance (both endurance and weight training):
https://www.youtube.com/channel/UCkUl8S70DCT66YJ30w75d6A
 
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I like bread. And I get cravings. I have to have toast. It's like a drug, I know its bad, but it tastes so good, with lashings of melted butter running down my chin . . . I am off to make toast, darn it.
 
DumfriesDik said:
I like bread. And I get cravings. I have to have toast. It's like a drug, I know its bad, but it tastes so good, with lashings of melted butter running down my chin . . . I am off to make toast, darn it.
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I have cheese on toast for breakfast every day now ...... yummmmmmmmmmmmmmmie
 

I am absolutely the same.
 
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In the UK I'd say a reason people don't stick to the diets they may be prescribed as 'diabetics' or pre diabetics, is because most doctors and practice nurses peddle the NHS eat well plate as a 'one size fits all' healthy eating regime. It's ridiculously high in carbs for a diabetic - it would have required me to eat more carbs than I ate before. I was told I must have starchy carbs at every meal. Of course they also wanted to give me drugs (which they get more practice money for prescribing).

I was not overweight on diagnosis so definitely agree that obesity is often a result of the diabetic or pre-diabetic condition, not a precursor to it. My mother is diabetic Type 2 at a little over 7.5 stone so not at all overweight. Having lost some weight (over a stone as a by product of the low carb high fat lifestyle), my 'carb intolerance' is unchanged, although I'm no longer technically pre-diabetic now.

I eat low carb - much less than 130g a day (I try to eat less than 50g) and have done for over a year now. I also eat high fat so I am fuelled by fat and am fitter and with better health markers (cholesterol/trigs/BP/HbA1c etc) than ever before. I have no trouble sticking to a low carb high fat diet as it has nice food and has let me reduce weight effortlessly without having to count calories or worry about portion size. I just eat til I'm full. Some days I stuff myself and other days hardly eat anything if I don't feel like it.

Another reason I imagine people don't stick to diets is because dieticians are still hung up on calorie control and portion size so people are expected to count calories or think about how much they eat - that gets real old real quick. By eating low carb high fat the body appears to self-regulate to a much greater extent. Carb cravings are gone so there is not the urgent hunger that insulin can set off and no carb roller coaster. Previously I would get very irritable if I didn't eat often whereas now i can go a whole day even with exercise too and not really bother to eat. The less you have to think about what you eat the less you think about eating and usually therefore you actually eat less as a result of not thinking about it.

If diets were less prescriptive they'd be easier to stick to and so the low carb high fat lifestyle wins on that aspect as you can eat what you want as long as it's low carb and you are eating plenty of fat and once you have done a bit of experimenting with a BG meter you know what range of foods you can eat and what to stay away from.

Carbs are most definitely not essential - I'd go so far as to say they can be positively harmful. Since giving up carbs and becoming fuelled by fat i haven't had even a cough of cold when all around me were going down like flies and several other minor health niggles have simply vanished. I think cutting carbs from the diet can cure more than just diabetes. The fewer carbs the happier and healthier I am.
 
You also might find that you don't put peoples backs up as much if you don't use words like compliance and regime.
 
I am not sure how I can define 'my dietary regime' in terms of your question. When I was diagnosed with prediabetes, I managed to reduce my HbA1c down to the lower end of prediabetes. When I asked my GP about paleo (I did not know what I was doing, but I was eating low-carb-ish), he reacted somewhat outraged and told me to eat the Mediterranean diet. Within less than a year my sugars went up into the proper diabetic range. If this Mediterranean diet was 'my dietary regime', I stopped it because it did not work. I am creating my own, reading scientific papers and this forum. My new GP now comments on it simply with "Just continue with ... eh... what you are doing." If this is 'my dietary regime', I don't fail. I have exceptions in social situations, for example, but generally my bloods are in the healthy range, so I won't classify a bite of cake as failure.

Regarding the papers you listed, I doubt that the dietary regimes are the LCHF regimes of the forum members. Such papers need to take into account the discrepancy between the prescribed eat well plate, which does not work, increase cravings, leave people frustrated and decreases trust in the NHS on the one hand, and the LCHF diet on the other hand. Do you have papers at hand that research compliance with LCHF?
 
watch and listen and learn from this
http://www.thefatemperor.com/blog/2016/8/18/dr-jason-fung-and-fat-emperor-the-fad-of-fasting-part-1
there is no need for a pill..in my humble opinion.
 
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