I would be happy to write on any “diabetes” topic , where I have personal experience or have done my own sort of research of the topic.
Much of what I know is personal experience plus communications with a lot of other diabetics that are also striving to control their bg to a level to minimize complication risk.

I feel that many, if not most diabetics are not given sufficient knowledge about this disease, what can be done & what results can be achieved thru “their efforts”. As I probably said before, diabetes is unlike most other diseases in that it’s the patient that must make most of the daily decisions that will determine the ultimate outcome.
It isn’t necessarily easy, at least at first, but it can be done. It’s not rocket science & being done on a regular basis by even “little old ladies”. Don’t mean that to be an offensive comment, but just to say “it can be done by anyone who’se motivated to try”.

Anyway, contact me if you’re still interested in my contributions.
Roger

What bothers me though about a study that says that self-testing is not really useful is that it will encourage even more diabetics to not test because that’s what some “study” said was OK!

I’d bet that this study was done on a sample of diabetics that are typical in that they were told nothing about what to do with the test results. So, of course the testing is of no benefit.
The best I can tell, that’s the vast majority of diabetics.
Drs, Nurses & “diabetic classes” do not tell their patients what to do with the information & I don’t understand “why”. I’m willing to bet that even those same Drs & Nurses don’t know what to do with the testing information, so how can they possibly pass knowledge on to their patients?
Shouldn’t this be something learned in medical school? If it is taught, it’s soon forgotten.

I can understand why a Dr might not have the time to instruct their diabetic patient on testing & what actions to take based on the results. They are very busy. But I’d think that it should definitely be part of a DE class, but is not in the several I’ve attended.

From what you say, it sounds like you may be teaching this information in your classes & that’s a good thing. The CDE’s I’ve listened to in person don’t even come close to mentioning the subject.

Now, on the ADA—
Many, if not most, in the medical community give their patients a diet plan based on the ADA’s recommendations. This will usually include upwards of 150 grams of carbohydrates per day.

For Type 2 diabetics, there is one food type that makes their bg go up & that is carbs.
Each gram of carbs can raise our bg’s by 3 to 5mg/dl, so pencil that out against that 150+ grams of carbs per day.
Does it make any logical sense to prescribe high amounts of the very food that will aggrevate our bg situation?

As I see it, the ADA’s treatment regimen for diabetics is “here, eat lots of carbs to drive your bg’s up & now take these medications to bring them back down”. They don’t say it in those words, but that is what is the result.

To get back on original topic—If people would really test before & after eating, “eating to their meter”, they would see that what they were most likely told to eat just isn’t working for them.
Without testing, they are lost.

And what should our BG goals be? No higher than 140 at 1 hour after eating, 120 2 hours after eating. And yes, these goals are reachable with some effort. It will likely mean giving up some of your favorite foods. But weighing that against the loss of properly functioning body parts makes it worth while, at least to me.

And what foods are the major culprits? High glycemic index foods, such as ANYTHING made with grains – and this includes cereals, pastas, breads; starchy veggies such as potatoes, and rice, as well as most fruits. A small amount of berries can be eaten, as they are the lowest GI fruits.

The best advice diabetics should be given is, as others have said – EAT TO YOUR METER. Test before your meal as well as 1 and 2 hours afterwards. If your BGs go above 140 at 1 hour and 120 at 2 hours, try deleting those high GI foods from your diet and test after that meal at the times mentioned. You may be be surprised at the results.

I understand that some diabetics may not want to make the effort. But doctors and CDEs owe it to their diabetic patients to at least let them know that eliminating those foods from their diet will vastly improve their chances of avoiding diabetes-related complications.

Kendra,
Do CDE’s teach such a concept?
Without taking action based on test results, I’d agree with the “why bother testing” arguement!

I strongly feel that diabetics need to be taught that to really control this disease, it’s largely up to them to be “pro-active”, do the testing & take appropriate actions based on that testing.

Not doing so & following the current practices is what’s led our hospitals to be literally filled with folks with one or more diabetic complications.

No, most patients don’t want to do anything about their disease, expecting the Dr to prescribe them some easy cure that requires no action on their part.
They need to understand that if they don’t work to control their diabetes to at or near “normal non-diabetic” bg’s, that in most cases, there will, in time, be complications & quality of life will suffer greatly.

Drs can only prescribe treatments like medications or insulin, but it’s up to the patients to make the daily choices that can really control diabetes, primarily regarding diet.

As a society, we’ve come to expect our doctors to “cure us”, with no more actions on our parts than taking a pill (or insulin). With diabetes, for best long-term prognosis, it just doesn’t work that way.

It’s really sad when I talk to diabetics with complications & they say “I did what my Dr/Nurse/CDE told me to do so why did this happen”?
Well, IMHO it’s because they weren’t told enough & made to understand that with diabetes they must be the one that controls their disease.
This is not emphasized enough.
Roger

Thanks, I think it is great to have all these differing techniques and points of view. Your thoughts are appreciated! Have a good day!

Diabetics, especially new diabetics, need to be taught how to “eat to the meter” to control their BS. This means, that within reason, there are no “diet” restrictions. The only limit from a diabetic point of view is what are your after meal, post prandial, BS readings. If they are high you have to react to it. Kid of “if it hurts, don’t do it. Modify the meal that caused the offending BS to bring it down, downsize the portion or cut carbs. Carbs are OK, even white ones, if they don’t impact your BS, but I suspect that your meter will say they do.
My Dr. actually told me on diagnoses that I didn’t need to test at all. How was I to see what I needed to change? Prior to diagnosis I suspect that the vast majority of us did not eat right. We respond very poorly to the word “diet”. Saying you can eat anything (yes I did say anything) BUT, (the big BUT) you have to check your BS prior to a meal to see the starting point and after a meal to see what impact that meal had, and you MUST change something to reduce the impack of a meal that results in high BS. Obviously the result is not instant, but the resulting improvement in lifestyle when you retain your sight and limbs is immeasurable.