Adventures with Manny - Diabetes Innovation 2012 (part 2)

This post continues my "Adventures with Manny (part 1)" reporting on our attendance at the Joslin Diabetes Innovation Conference.

The final highlight on the first day for me was hearing the voice of industry. Not the drug or medical industry, but companies like Target, McDonalds, and CVS. Yes, McDs will “toe the line” and is offering low fat items and post calorie counts on their menu, but not the carb counts. Again, it was like the elephant in the room, this is about diabetes, it is about the carbs. I’m happy for McDs, but they don’t really get it (nor do many of the other delegates) and I’m not clear they have any ethical or moral basis for their corporate strategy. And I came away shaking my head at Nestlé who talked about their efforts to “improve” infant formula. I cannot for the life of me figure out why they would choose that topic given their colored history with formula. But I sense in other areas companies are taking a real interest corporate strategies that are in line with public interests in people’s health. Target surprisingly has entered the market for really affordable clinic care and is increasingly moving to offer products that are healthier, including fresh whole foods through their grocery and health branding products. And hearing their talk and speaking with a number of their representatives I actually believe they are doing this to “try to do the right thing.” I hope we can see the same principles in other companies.


The second day started out a little rough. We heard from the CDC, NIH and HHS about their activities. And then we heard from some of the payers. The next talk though made me a little angry. Manny took a picture of me during this talk. The speaker lectured us like a bunch of little kids about how obesity was just eating too many calories and that he was going to fix it by helping us with the math. If you look at the picture you can see the speaker. If you could see my face, I was scowling. Fortunately, you do get a good shot of my shiny head and the Diabetes Hands Foundation logo. I wore my “Big Blue Test” shirt on the first day. It was during this talk that the gentlemen in the back stood up and invoked the name of Taubes. I was unable to speak, I didn’t think I could say anything nice.


Of course the highlight of the second day was Manny’s lunchtime keynote. I know he worked hard on this, and I think for many in the room it was a highlight of the conference. Manny presented a stark picture of what the world looks like as a patient. Many in the room were themselves diabetic (those of us who are diabetic feel a calling to help and many become part of healthcare) and understood these challenges. Manny showed a touching montage video from the “You can do this project.” If you have not seen this project, I urge you to go check it out. But the real focus of Manny’s talk was that social media and connectedness has a real and measurable effect on the health of us as diabetics. Diabetes is as much a “mental disease” as it is a glucose metabolism problem. Feeling alone, helpless or just being uninformed about the basics of dealing with life with diabetes will kill us just as surely as the complications. Healthcare professionals may touch our lives for brief minutes throughout the year, but for the rest of time, we have to depend on each other. I hope everyone took away his messages and shares them.

Besides Manny’s keynote, my favorite talk of the two days I attended the conference was by Nicholas Christakis, MD, a well-known scientist at Harvard. He is an actual scientist, in my opinion something, most medical researchers are not. Dr. Christakis is known for his paper “The Spread of Obesity in Social Networks.” He also wrote a book “Connected: The Surprising Power of Our Social Networks and How They Shape Our Lives,” a signed copy was given out to all the delegates (surprisingly his signature shows handwriting worse than mine, something I though truly impossible). Dr. Christakis was an engaging speaker and what interested me most is that his approach suggests a way to formally assess the benefits of social media. Perhaps in harnessing his work, social media can be assessed in a way that can enable it to finally fit into the “evidence” box that is so dear to our health care system.


So before I end, I want to talk about my favorite subject, food. I attend lots of conferences and as a diabetic; it can be a real challenge. I am often faced with a provided breakfast that has donuts, bagels, croissants and fresh fruit. None of which I can eat in the morning. I have learned to deal with it and adapt. Joslin truly provided some good choices, eggs for breakfast, cheeses available for snacks and good low carb options. But the boxed lunch was clearly limited by what the hotel could supply. As I sat there in the front row watching Manny’s keynote I dug through that lunch. I had chosen the “lowest carb option” a roast beef in whole wheat wrap. But it came with an apple, bag of potato chips and a cup of orzo. There may have been a cookie; I was too scared to look. I normally would have unwrapped the sandwich and eaten just the insides, but I chose to bolus and to eat the whole wheat wrap and I just skipped the rest of the lunch. A lunch with what I estimate as 90g of carbs I just cannot do. Despite that I tested 2 hours after lunch and I was still over 200 mg/dl. I felt disappointed in myself and some sadness. Every once in a while you try to do everything right and you get kicked in the face. I just have to face things, I am diabetic and I really can’t handle wheat. I’m sure that many of the delegates didn’t come to the conference appreciating how hard it is to be diabetic and to still deal with self-care in a rational manner. But I do, and I hope after Manny’s talk, they appreciate a little more of the challenge. I know I can thank the social connections I have made through places like tudiabetes for helping me with this. So I did what I had to do, I corrected and enjoyed the rest of the day. As our member Danny always likes to say “Tomorrow is another day.”


And to complete my story of my “Adventures with Manny,” I’d like to talk about a fellow member Lynn. He was diagnosed 68 years ago and I was just blessed to have a change to meet and talk with him. I mentioned that I had just learned that Elliot Joslin had his first clinic in Boston at a place that I had walked by many times totally unaware. Lynn told us that he had actually been treated at Dr. Joslin at that very site. Joslin moved to its current location in 1956. Eliott Joslin is one of my heroes, meeting someone who met and was treated by Dr. Joslin moves me up to a Diabetes Erdős Number of 2.

I really had a great time finally meeting Manny. We spent literally hours talking about things. We will no doubt remain friends for life. I hope everyone out there has an opportunity like I did.

I have a problem with Mickey Dee's not posting the sodium value. With fragile kidneys that I'm willing to do anything to preserve, I have to know how much sodium I'm getting. Yes, it can be looked up online, and there is literally nothing there that I could eat an entire portion of without using up my daily allowance. Blah blah bah.
And mercy, Manny looks so stately and dignified - like a professor!

You are right, McDonalds does make nutrition information (including sodium or carbs) available either on-line or I believe if you ask at the restaurant. I just found it strange that they would present to an audience focused on diabetes that they were posting on their menu board calories and not carbs, let alone sodium.

ps. And you are right, they have a really salty menu, almost everything is at least 1000 mg except the ice water.

TO ME COUNTING CARBS IS MORE IMPORTANT THAN CALORIES.I JUST EAT LESS FATTY FOODS & SMALLER PORTIONS BUT CARBS I HAVE TO BOLUS FOR WITH INSULIN.EASY.

Does McD really not have carb counts on their food in the US? They do in the UK - or at least, everything that comes in a wrapper or cardboard box has the nutritional information printed on it. Both calories and carbs.

http://nutrition.mcdonalds.com/getnutrition/nutritionfacts.pdf
for McDonald's nutrition info. I always thought Big Macs were 77g of carbs, I knock off a few as I get no special sauce. I hadn't eaten there for a pretty long time but split an order of fries w/ MrsAcidRock recently. We were like wolverines!

Thanks for the reports on the conference Brian, it's good to read about engagement and progress. It seems like dialogues about food are a significant opportunity area. Low cost. All it takes is a leap of faith to try something different. After I eat the rest of these fries...oh, ok, tonight I had sushi, brown rice, from Whole Foods. I'm getting old...

Thanks for the post. I've eaten fast food a couple of times since going LC. I get a double cheeseburger, toss the bun, and wipe off the ketchup. Doesn't require much insulin, and doesn't taste very good.

I DON'T EAT AT MCDONALD BECAUSE I'M KOSHER BUT WHATEVER OR WHENEVER I EAT I DON'T EAT MORE THAN 40/50 CARBS AT A MEAL.NO MATTER WHAT IS SERVED.I ALSO TRY TO BALANCE IT.STARCH..PROTEIN..VEGETABLE..& FRUIT...& OF COURSE LOW FAT.:) I'VE EATEN THAT WAY ALL MY LIFE/THE MEDITERANIAN DIET