I am a diabetic educator AND have diabetes. teach my patients to stay under 45 for females and 60 for males–I usually NEVER go over 30 and I tell my patients that…
If you are compliant and stay on lower carbs–great!—but I teach people who just started or NEVER had a bit of education and need a carrot on a stick approach or they feel like they “will starve”—Remember if you are a person who reads,or comes to this site, you have a far different approach to control issues…I have all my patients on the first class, test at 2 hours pp. Honest–I get 75% to higher getting numbers over 180----Even “know it all” long time people–
The RD had her class and two women told her–they wouldn’t come back because she was so rigid—I make sure when I teach I offer lea-way so they can see some results-- Starting off most people cannot staying under that amount of carbs.Yes very kow is better, but we have to start come where.
Hi Lora, First of all I would like to thank you for your chosen field. I suggest to many who are a bit confused or overwhelmed to try to get referred to a diabetic educator, as these people are fantastic about teaching you the basics, making sure you understand what you must and are rapid at positive feedback for your progress, but I also warn the person that they only know or are only allowed to teach the ADA way and that you can use what you learn there as a safety zone in traffic while you learn what you must do for your individual disease. What would make the program much better in my opinion is to teach about other ways, Dr Bernstein’s very low carb, using the glycemic index, how to use fats and protein to slow the absorption of carbs. I was having fairly good control, staying under 140 90% of the time,before I went and was told to up my carbs to the excessive ADA levels. Once I found how to test my reaction to every food, which came from a diabetic site and unfortunately not from my diabetic educators, I was able to maintain excellent control. In the last 4 months my lowest has been 80, and my highest, twice, was 127. HbA1c is 5.6% Currently my carb intake is 20 to 30 gm 3 times a day and 10 to 15 gm per snack twice a day. I’m not grousing at you as an individual Lora, just the system and the way the ADA is allowed to run free with bad, bordering on criminal, info
Well…I don’t get why diabetic educators push carbs. I wasn’t eating any carbs but vegetables, and now they put me on carbs. I have had 3 tell me the same thing. They want me eating 45 grams of carbs 3 times per day plus 15 carbs before bed. Now, I feel like eating the whole house. I have food cravings I never had before. I not only polished off a whole bag of chips, I couldn’t stop at the one cup of rice at dinner and ate 3.
I never ate like this. I used to eat something like 2 slices of turkey, a cut up tomato, some veggies. I was told that wasn’t healthy because I am not eating enough carbs. I don’t get it. I can’t live with these cravings.
I want less carbs, not more. It seems this whole field really stinks, and no one really knows the answers.
Last night, after the recommended dinner, my blood sugar was 204. This is progress?
That’s what they are doing to me. I have been to 3 diabetic educators. They all want me to eat carbs. I have been told over and over, it doesn’t matter if it is rice, candy, apples…it’s all carbs. Now, my blood sugar is up, and all I want to do is eat.
It sounds like you know where you need to go for your own good “When I ate low carb, I had no food cravings, and I didn’t need appetite suppressants” I don’t get cravings, I don’t get hungry, I eat by the clock and my blood chemistry is great, a little high on potassium last time. but that is all. I only did the high carb for the first month while I was putting the pieces together to figure out what I needed to do to live with this rather than die from it.
Doctors, CDE’s, dieticians shouldn’t assume that people can’t or won’t do something. Present what is in the clients’ best health interests & treat them as adults to make their own decisions. Gatekeeping information isn’t helpful. People come to you to be educated. It’s a disservice to do otherwise & is disrespectful to those seeking your assistance. They’re not children.
None of us knew anything about diabetes. We all came to this uneducated. That’s the role of your profession. Saying that people who read & come to this site have a “far different approach to control issues” is begging the question. Many people come here because they want real information, information they’re not getting from their healthcare team.
“Starting off most people cannot staying under that amount of carbs.” Part of the problem is that this is where people start off & remain because they’re never told differently. This is all the info they’re ever given by authority figures. Why would they question or seek to investigate another approach?
Hi Gerri, Well stated, maybe better than I did at trying to make the point that presenting the whole picture, all of the methods not just one viewpoint on BG control would be better education.
Please not “dump on” Lora, Ladies and gentlemen. Those of us on this website DO have a different mindset on control. Go to a free clinic in an urban area to a diabetes class. You will lfind many people there who have limited access to the internet, and have not had the advantages of education, insurance and opportunity to find information about diabetes and health care… They WILL run from what they see as a “starvation” approach to diabetes management. Her slow step approach is probably the BEST approach.
Gerri, she is not “gatekeeping” information. Many newly diagnosed diabetics are completely overwhelmed by the amount of information they have to understand and manipulate., No, they are not children, but I have personally seen many people, some of my church members and type 2 friends, run in absolute terror and confusion when told what they cannot eat( strict low carb ); instead of being slowly guided to what they CAN eat . Then they reject diabetes management in every aspect ,and we know what that leads to .Remember , every one does not have the educational opportunities or experiences we have. It is not treating people like children to give them information in small doses.
That’s my point. People who don’t have access to other ways to inform themselves should get the best education they can from healthcare professionals since it may their only source information. People diagnosed as adults all come to this scared, confused, overwhelmed. I sure was.
Giving info in small doses isn’t the same thing as not presenting different views so that people can choose for themselves. Withholding info under the assumption that clients can’t handle it, is gatekeeping. People hear one way from an authority figure & think it’s The Way. What hope is there for improved health if the attitude is that partial info is good enough?
I do not think Lora is not presenting an alternate view, just probably just not all at once. I know that the amounts of carbs one CDE told me, 75 grams per meal, was far more than I would want to consume. She assumed becuase I was type 1,relatively thin, and active, that I would want to eat that much…I did not. I do not think that was her “party line” for a person who is 60 pounds overweight and insulin resistant. I worked with her to find a meal plan that would work for me, at 30 to 45 carbs per meal…But by the way , this CDE was in the suburbs…The one I had in the clinic in the inner city pushed the higher carb ADA version and did not stress any variation, nor did she seek any input from me.
I see where you are "coming from’…but do you see the difference in what the “Authority figures” are saying, depending on the ears of the listeners?
How can Lora, as a CDE, who wants her clients to do well, be able to educate well at one shot? Many do not come back for follow-up, so the small steps may not lead to bigger ones? It is hard to determine the most effective path to diabetes self-management. Hats off to those who try to do it…
Most of the Diabetic Educators I have talked to immediately assumed I was someone who ate 2 meals a day at McDonald’s, whole cakes for snacks, and didn’t know what a salad was.
I am sure they do get people like that,
I think, from what I have run into, and what others have run into, there is a “One Size Fits All” mentality here.
We are not disagreeing on whether the client should come back or not, but that really sound advice is being given.
I see people on here, and many other diabetic forums, who have had to find their own way, because all they get from the DE’s is what the ADA pushes, which is a lot of carbs.
How IS that eating BETTER or more healthy?
I had one put me on 45 g of carb per meal, plus 15 for snack, and told me, “We get you to eat the carbs, then get the medications to be adjusted to how you are eating.”
I said, “Why would I want to eat a lot of carbs, then have to take MORE medication?”
In the world of medicine, there is no equipment to use, no administering medicines, no drawing blood, no long hours, no night, weekend, holiday, or on call shifts. No nonambulatory patients, no combative patients, no fluids, etc.
Two I met with used the public library, but they say they work out of their homes, so they get write-offs that way.
They aren’t held to anything. No accountability. If they give us a diet and our blood sugar goes up or we get worse, then they claim it’s not the right diet for us or that they need to “adjust things.”
I can see why they would want to go into that profession.
But I don’t hear of them really telling people how to really control their diabetes. They say you need to, but they don’t know how.
Are you talking per meal or all day? My RD tells me I can eat 45 per meal!!! I think that is way high. She says I am not eating enough carbs. She wants me to eat a *minimum of 100 carbs a day! I am eating more like 50 carbs aday and my blood sugar is still around 150 average. When I eat like she wants it goes to 205 fasting! I have one more class.
Can you tell I am a brand new diagnosis? I loved low carb eating and was at a very good weight until quitting smoking…the only way I am actually good at controlling my weight is low carb.
I’ve learned over the years to always consider that diabetes is a little bit different in everyone. There are varying degrees of insulin resistance, to carb/insulin ratios, to amount of exercise a person gets, amounts of calories people need, etc. and etc. Thus the saying, Your Mileage May Vary. I appreciate your point of view, however I do not believe that low carb or lower carbs is a blanket answer to all people’s food plans. I suspect diabetics have a better chance of success with their control if a diet and medication therapy is developed that will meet them where they are at in their diabetic journey and give them good bgl’s. As a person learns about their diabetes, incorporates healthier lifestyles (if that is at all lacking), etc. their diet/therapy can be adjusted.
I eat a lot of carbs - usually around 200 per day, but some days way more. I have excellent control with my diabetes.
Honeslty though, as T1, I have tried low carb it and it DOES NOT work for me. Sure, my #'s may be fabulous at an hour or two after I eat, but when the fat and protein hit me, it’s killer for my BG and results in highs that are often quite stubborn to get down. It’s difficult to match insulin to that kind of rise… I hate this mindset that “low carb” is the ONLY responsible way to manage D… it’s not, and it isn’t ideal for everyone.
It’s easier for me to just eat carbs and cover appropriately with insulin… it works, and it’s reliable - rarely unpredictable. I am almost never as high as 180 after meals.
I don’t follow the ADA diet… I sort of do my own thing, but it’s definitely not what most would call low-carb… my CDE is fine with that, as is my nutritionist… both agreeing “if it works for you, let’s just leave it alone.”
RDs, CDEs & most doctors push ADA recommendations which are higher carb with correspondingly higher A1cs. They don’t believe that people can eat low carb, or could it be that the ADA is heavily funded by big pharm?
Glad you found out early what works better for you. I had out of control BG when I followed what dieticians & the CDE said to eat.
I can’t say low carb is working for me yet, however . My blood sugar is still too high. It’s freaking me out. My fasting number this morning was 163! I had scrambled eggs with a little onion in it last night about 9:30. What’d I do wrong?
Today for breakfast I ate more scrambled eggs (left from last night) then at 2 hours my blood sugar was 132. Still higher than I want it to be.
I can’t say my life is stress free. So…when eating low carb and your levels are still to high, what do you do??? I can’t just leave work and start walking like Forrest Gump. I’m afraid that’s what I’m gonna have to do!!
