I don’t know why but for some reason they think that throwing sugar-free syrup or sugar-free jello on a tray makes it magically diabetic-friendly. It’s ridiculous.
Is really ridiculous!
I spent 6 days in the hospital on diagnosis. Typical meals. Breakfast: eggs, hash browns, OJ. Lunch: Hamburger, fries, salad. Dinner chicken fried steak, mashed potatoes, salad, veggie. I remember commenting to friends who visited “The diabetic diet isn’t so bad, I can live with this”. But when I got home and researched what my blood sugar goals needed to be(I was never given this piece of info) I realized this diet would kill me in short order.
I don’t know what I’ll do if I ever wind up in the hospital again and they start feeding me this diabetic diet. Meals like that would put me way over 200, hard to say if I’d ever come down at any point over 24 hours.
It was really frustrating while working in the hospital to see many people suffering from the complications of diabetes while subsequently being fed a diet that probably contributed to them (at least it sure didn’t help). The problem with hospital meals is that there is no individualization. People with diabetes are put on standard high carb diets and there is no second thought about it. Sure some people can tolerate carbs better that others. Some people do not have the same reactions to different foods. But hospitals do not take this into account. They don’t do a follow-up to see how patients are handling the diet they prescribe. Unfortunately, sometimes the sheer number of patients often prevents this from being a realistic expectation.
The last time I went to the ER w/ a hypo (last summer…) I pretty much refused to eat most of the food they lugged down…about a quart of OJ, chips, a chicken salad sandwich on a croissant and some cookies and a Sprite. I had like 1/3 of the OJ and the chips (being unable to pass up a potato chip within striking distance…) and was like “no, that’s all I’m gonna eat” the doc bailed out at that point, I guess “ok Mr. Smarty Pants. I’m done with you”
Angie, how terribly frustrating that was. Sick people need the most nutritious food possible. Absurd that this isn’t seen as a priority. I found out later that the hospital didn’t prepare the meals on site. It was trucked in from a central commissary several times a week. No wonder the salad was brown around the edges & no eggs were on the menu. Everything was precooked, sitting around & microwaved.
The woman who shared the room was a T2, but wasn’t there for anything diabetes related. She heard the nurse scolding me for not eating & chimed in that I needed to eat my starches to get stronger.
My husband was hospitalized for a week years ago from a car accident. I brought him lunch & dinner every day. The floor staff hated it, but I did it anyway.
So let me see if I understand this. I’m lucky enough never to have been hospitalized::::knocking on the coffee table:::::So they do have a “diabetic diet” but the only difference between that and regular hospital food (which doesn’t sound too good for any sick person) is that the things that usually include sugar are “sugar free”?
When I stopped eating sugar due to my eating disorder I sometimes found it easier to just tell people I was diabetic, especially in Latin America. I will admit I actually thought that’s all that diabetics had to change, but you would think hospital staff would know better. How commonly do they allow us to continue to manage our own diabetes when hospitalized? (I had heard that you could do it if you had your doctor place an order). At least if I could bolus for it I would have half a chance of surviving hospital food! That or leaning on friends to bring me real food!
I’m also a vegetarian so I can imagine trying to survive on iceberg lettuce and frozen vegies. In California, ironically I think there is more understanding of vegetarians than diabetics. My own family, actually says things like “they have great pizza at this restaurant for you Zoe”.
Laura, your posts are coming off as knee-jerk defensive and, frankly, narcissistic. I’m sure you don’t mean to sound that way, but that’s how they sound to me.
I wasn’t talking about you as an individual in the nutrition field.
I was talking about the American Dietetic Association, the mother-ship for the nation’s dieticians and nutritionists as a whole.
I have been close friends for twenty years with a vegan nutritionist and best-selling cookbook author from Canada who got licensed here after she married an American. She has THE EXACT SAME CRITICISMS of the ADA that I have. I do not lump her in with them because I know that she’s fighting them, too, and has been for decades. People like her have changed the ADA over the years, although sometimes it seems to us that the ADA follows people like my friend – usually by about ten to twenty years – rather than leading the way to better nutritional advice based on current science and research.
If you want to lump yourself in with them, by going on the defensive every time someone criticizes them, that’s your choice. If I were you, I’d set yourself apart from them and work to change them, not become martyred every time someone posts or verbalizes a legitimate criticism of their historically unprofessional, ignorant and unscientific practices and policies.
Every post about the experiences people have had with other dietitians and nutritionists isn’t really about you, after all. I’ve never met you. I don’t know if you give good advice or not. I don’t know if you’d prescribe a breakfast of white bread, refined sugar cereal, juice and milk as part of a standard diet for a diabetic and then tell them that they can’t have eggs because “they’re too high in fat”. Maybe you would. Maybe you wouldn’t. If you would, then (Dr. Bernstein and) I would have a bone to pick with you. Otherwise, I’m not talking about you.
I have thought that I could survive by simply requesting being able to choose from the regular menu. Skip the potatoes double up on the veggies etc. If you have the right doc he could simply order this simple change. Wrong doc, to bad so sad.
Dietitians need to start policing themselves as a profession and raise the bar. If they did, then people like me wouldn’t have so many recent horror stories.
I have tried seeing the dietitians hired by my HMO as recently as this past December and YOW.
The one I saw was just as bad as they were twenty years ago: pushing white bread, white rice, white-flour baked goods and apple juice (apple flavored sugar water) with nary a naturally occurring vitamin, a mineral or a wisp of fiber in sight.
She wanted me to eat about triple my current carb consumption even though my last HbA1C was 9.1, I have severe insulin resistance and I need to lose a tremendous amount of weight. It was like she was in a time warp back to 1955; she had zero ideas on how to transition to a healthful but lower-carb diet. Women like her are not critical thinkers, they’re not scientifically sound in their advice, they’re not readers of up-to-date medical research. They just whip out their little silicon food examples (“here is a serving of rice”) and follow the formulas they learned in school two or three decades ago, without recognizing that for people like me, a high-carb diet is metabolic poison.
Hi all,
Back to the “Paleo Diet” part of this Paleo Diet discussion. For those interested, you can look at a few of the intro pages on Amazon’s website:
http://www.amazon.com/Paleo-Diet-Weight-Healthy-Designed/dp/0471267554
It gives a primer on the basis of the diet: removing all the dairy, refined grains and sugars (hi GI foods) out of one’s diet, and returning to lean meats, fresh fruits, and fresh vegetables, which are very nutritious and low Glycemic Index foods. It talks about what foods can we eliminate from consideration, even if we can’t “see” the paleo people themselves. They also cite early explorers’ accounts of their visits to the New World, when they met “paleo” peoples. And contrary to popular thought, there are still “paleo” people in the world today…you’ve just got to look hard to find them, where Western civilization hasn’t yet crept in.
What can be excluded from a paleo diet? A great example is milk. Where did it come from? It comes from some sort of docile mammal, such as a domesticated cow, or goat, or whatever. Back before domestication, it would not have been possible to “milk” a wild beast. Would YOU milk a buffalo, an elk, an antelope (good luck catching one…), a mammoth… No thank you, not me. The point is, milk and all its derivative products (cheese, ice cream, yogurt, etc.) would not have been on the menu of the paleolithic person’s diet.
The book is an interesting read, to be sure. I just finished The Paleo Diet for Athletes, by Cordain and Friel. I can’t argue with any of their dietary arguments. I haven’t successfully switches over to the Paleo Diet yet, but scientifically, it makes perfect sense. At least to me…
For what it’s worth,
Cheers all, Mike
p.s. - My intent here is not to flame anyone. If Bernstein works for one person, the Paleo Diet works for another, South Beach for a 3rd, the “Carb Bomb” diet for a 4th, hey it’s all good with me. Do what works for you, what’s comfortable for you. I’m not telling ANYONE they have to do this…or that…or the other. Do what works for you!
I agree, Mike, it’s all about what works for you. I have experience with someone who was in very poor health while their diet included dairy. It took a while and a more than a few experiments but in the end, eliminating it made a 100% difference. (Turned out to be a casein intolerance.) Energy returned, better skin/hair, mood improved. Amazing turnaround. Just amazing!
I agree. I avoid RD’s as well. I haven’t personally met an RD yet who can think outside the ADA box. I don’t want to hear their ADA rhetoric.
Another shining example is the diabetes education of the newly diagnosed T1 child where Johnny or Suzy is told repeatedly that she can eat whatever she wants if she doses for it.
Then Johnny or Suzy is handed multiple pictures of crap food…cake, potato chips, brownies, pizza, cereal, crackers, white pasta etc and taught how to add up those carbs because after all, they can eat whatever they want.
This is a recipe for an eating disorder. Gee, sorry you’re a T1, but the good news is YOU get to eat whatever you want! Bonus!
It’s also a recipe for a horrendous A1C. Sorry, but a kid who’s been given permission from a medical professional to eat whatever they want actually wants to eat all that crap food you trained them on - all the time! What kind of a cruel joke is this?
And surprise surprise, I never heard any mention of fat spikes and how one should dose for those either. All I heard about was a very simplistic insulin/carb ratio, as if it is just so easy to control blood sugars while eating in cheesecake and pizza.
I’d love to bring an RD home for the weekend so we can live in the real world and see just how difficult it is to have decent blood sugars while we eat whatever we want.
Laura this is not referring to you.
LOL thanks!
Unfortunately, I have never come across one of these dieticians/nutritionists you speak of in a diabetes related setting such as the endo’s office, or the hospital. I wonder if perhaps they choose to work in other areas of medicine that have a more progressive view of the links between nutrition and disease management. I have never once been counseled on how to maximize fiber let alone how to obtain phyochemicals in organic vegetables in a diabetes related setting.
The bulk of dietician’s working with diabetics seem to subscribe to the ADA gameplan. Diabetes education always seems to be based around these same ADA guidelines.
Every meeting I’ve had with a dietician has been quite honestly a joke. If these folks want respect than they are going to have to stop spewing these ridiculous ADA guidelines. Just my humble opinion. If you are that minority that works in an endo’s office and doesn’t utilize the ADA guidelines in counseling diabetic patients, I commend you for that!!
Unfortunately, I have never come across one of these dieticians/nutritionists you speak of in a diabetes related setting such as the endo’s office, or the hospital. I wonder if perhaps they choose to work in other areas of medicine that have a more progressive view of the links between nutrition and disease management. I have never once been counseled on how to maximize fiber let alone how to obtain phyochemicals in organic vegetables in a diabetes related setting.
The bulk of dietician’s working with diabetics seem to subscribe to the ADA gameplan. Diabetes education always seems to be based around these same ADA guidelines.
Every meeting I’ve had with a dietician has been quite honestly a joke. If these folks want respect than they are going to have to stop spewing these ridiculous ADA guidelines. Just my humble opinion. If you are that minority that works with diabetes patients and doesn’t utilize the ADA guidelines in counseling patients, I commend you for that!!
Unfortunately Laura, I have never come across one of these dieticians/nutritionists you speak of in a diabetes related setting such as the endo’s office, or the hospital. I wonder if perhaps they choose to work in other areas of medicine that have a more progressive view of the links between nutrition and disease management. I have never once been counseled on how to maximize fiber let alone how to obtain phyochemicals in organic vegetables in a diabetes related setting.
The bulk of dietician’s working with diabetics seem to subscribe to the ADA gameplan. Diabetes education always seems to be based around these same ADA guidelines.
Every meeting I’ve had with a dietician has been quite honestly a joke. If these folks want respect than they are going to have to stop spewing these ridiculous ADA guidelines. Just my humble opinion. If you are that minority that works with diabetes patients and doesn’t utilize the ADA guidelines in counseling patients, I commend you for that!!
I agree. But the problem does not stop with RD’s. I think the rub is that it is often targeted specifically to RD’s. I am absolutely appalled at the WHOLE medical community. Family Doc’s, Internal Medicine, Endo’s you name it and I have seen some pretty crazy stuff (sliding scale 70/30 that is dosed off 1 hour post meal glucose- needless to say this person was dealing with some serious hypo’s yet her A1c was high). This critisism is not only for diabetes. In general there are a whole lot of questionable things happening in the medical field. Regardless, we have what we have and we need to find a way to work within it. I would challenge anyone who has these issues with RD’s to ask some pointed questions to these RD’s. Not attack mode mind you but show them that you are getting good control. Challenge them that you ARE getting all your vitamins and minerals. CHallenge them that you are getting all of your fiber. Challenge them that your lipids HAVE improved. I agree that RD’s need to police themselves but the real change will happen when the patient demands change. I am glad you are challenging the beliefs and science. I think this is imperative to find what really is optimal. My only issue comes when it is assumed that you HAVE to do it one way or another to get desirable results. Everyone’s different and hopefully you can find an RD who is willing to listen to reason and help you have a healthy dietary plan regardless of which type of approach you use. But if it is assumed that ALL RD’s are like many people have described you will never find that person who may be able to provide you help and support that everyone needs (that’s why we are here right?)
Unfortunately most RD’s and the general Medical community for that matter do not have DM so they really can’t live in our “real world”. If they do not understand it as we do then they will be rigid in what was learned in school. It is a natural reaction to be that way.
For me it is not one thing or another that bothers me. It is the WHOLE experience that really rubs me the wrong way. Dr’s that aren’t willing to actively listen, RD’s who are rigid in their beliefs, Nurses that are giving advice that has no bearing on reality. We all have horror stories related to one profession or another.
I personally do not believe there is a whole lot we can do about this BECAUSE they are not dealing with what we are and until they are there will continue to be misunderstandings and problems. Progress can be made but this is an isuue I think all PWD are going to have to deal with until (some will never find it), they have a stroke of luck and find that team that will provide them with individualized care that we all need and frankly deserve.
I think a large part of the reason people like Laura get offended and respond defensively to these types of conversations is because she IS one of those RD’s that work very hard at providing that individualized care and that probably has a whole lot to do with she CAN, and does on a daily basis, reside in the “real world” of PWD.
I never did get any response to my comments about the issues regarding “eat whatever and bolus for it”: Not just poor A1C but weight gain, insulin resistance and the difficulty of accurate bolusing at that level leading to serious highs and lows.