Guest Blog: The Importance of Education

This was originally published here.

This is written by Kate Cornell, a T2 that is very active in the DOC as well as her D management.

The Importance of Education

Early on in my blog I wrote about what it was like to be diagnosed and how I was shoved out the door without any information or offer of education. I still recall all the range of emotions I went through over the years as I tried to figure out how to live with this disease. I was lucky in that I took the time to educate myself, often taking wrong paths but eventually getting back to the basics and shunning the snake oil. I was lucky, but many are not.

There are too many people who have been diagnosed with type 2 diabetes who remain clueless to the seriousness of this disease, either through ignorance or the desire to hide their heads in the sand. Diabetes is scary but it’s even scarier if we ignore it or fail to adequately understand how important it is to do all we can within our power to tame the beast. Besides the millions of people who have type 2, there are many, many millions who are walking around with elevated blood sugars, often called pre-diabetes. They don’t know they have an issue. They haven’t been tested. Some have received the news but are made to feel that it’s “no big deal. Just watch your sugar.” These people go on their merry way thinking they are “ok” because they are going to cut back on their sugar intake. They continue to eat in an unhealthy manner and probably don’t add exercise to their lives. Who wants to if they don’t “have” to?

Education in relation to type 2 diabetes has been my passion, for lack of a better word. It is something which I feel is sorely lacking and desperately needed. I am often frustrated because I’m just one person and I don’t know what it is I can do to stem the tide of misinformation and apathy. It has always felt like the “powers that be” weren’t doing enough to stress the importance of self-care and were too often hammering home the idea that we just need to lose a bit of weight and it will make ALL the difference in the world! Right. As someone who has been attempting to lose weight since my early 20s after my first son was born, I know that “just lose some weight” is never as easy as it sounds. Diabetes and controlling weight are very complex issues and I’m pleased to see more and more studies being done that say just that.

A couple of things have happened recently that have given me renewed hope; hope that people who CAN make a difference are speaking up. Unfortunately, those people happen to be celebrities, but hear me out. Two celebrities have recently spoken up about their lives with type 2 diabetes. Both have had the disease for decades and both are working with pharmaceutical companies to help educate people about living with type 2 diabetes. I’ve never been a fan of celebrity spokesmen. It gets under my skin when people feel that just because someone is “famous” they know more than Joe Shmoe about any subject, be it illness, religion or politics. However, the reality is that people DO listen to celebrities and if their message is clear and helpful then YAY!

“Dr.” Phil McGraw has teamed up with Astra Zeneca to present a plan to help people live well with type 2 diabetes. It’s called the “On it Movement”. I’m not usually a fan of “rules” and this program has “rules”. However, the rules are worthy. The list includes things like educating yourself, making a plan and finding support. I can get behind that. More recently, actor James Earl Jones has teamed up with Janssen in their type 2 campaign called “I can Imagine”.

Let’s be honest: both of these programs are designed to sell you a drug to possibly help you control your diabetes. You may decide that their medication sounds good and you might discuss it with your doctor. I’m not posting about these to encourage you to do that or to even support these medications. I’m not a doctor. There should be ongoing conversation between you and your HCP to determine what medication/lifestyle changes will work best for you and your diabetes. I think it’s important to cut the pharma companies some slack. If they don’t make money, then there won’t be any further innovations in our care. (I’m not going to discuss how often it seems as if they make TOO much money. That’s not my point here.)

Earlier I mentioned that I was more hopeful and here’s why: Lots of people watch the Dr. Phil show and if he’s talking about type 2 diabetes and how difficult it can be to live with it, discussing the emotional/mental side of our battle, then that’s an opportunity to encourage people to step up and do something about their health. James Earl Jones is a beloved actor who just happens to be the voice of Darth Vadar. That dude is serious! We’d better listen! Regardless of how you or I may feel about celebrity spokesmen, these men have a distinct opportunity to make a difference in the lives of millions of people. If their message stays clear and they don’t push the medication too forcefully, people may just learn something. That gives me hope.

One more thing: The Diabetes Prevention Program. A study was done that eventually teamed up with the YMCA that went about teaching people how to make lifestyle changes to keep type 2 diabetes at bay. These people had been identified as having pre-diabetes. The program includes dietary changes and added exercise and it worked. People were able to have some control over their rising blood sugar levels and stave off full-blown type 2 diabetes. The federal government took notice and now Medicare has said that they will pay for people to participate in the Diabetes Prevention Program. I think that’s pretty huge.

Let me say right here that I do not agree with a lot of the dietary changes that the DPP pushes. There are way too much carbohydrates suggested, IMHO. I have learned, and many people with diabetes would agree, that lowering our carbohydrate level is imperative to attempt to control blood sugar. However, as I’ve said ad-naseum, I’m not a doctor nor a nutritionist nor a CDE. I’m just a patient who has learned what works for me. It’s going to take a long, long time for the “establishment” to get on board with what science has shown to be the best way to eat. In the meantime, think about this: dietary changes aren’t made overnight. People often do better when they ooze into them. Here is a quote from a previous post I did on this very subject:

The reality is that some people who are newly diagnosed have been used to eating upwards of 200 grams of carbohydrates per meal and the idea that they can miraculously reduce that carb intake to 35 grams is ludicrous at best.

Let’s look at a typical trip to McDonald’s. Big Mac – 46 gr carbs, large fries – 63 gr of carbs and a large Coke – 86 = 195 grams of carbs. (information from their website) Wow. (We aren’t even going to discuss fat and sodium.) This meal is consumed by an awful lot of people in this country on a regular basis. Now, compare that to a recommended meal for someone with diabetes. 3 oz. 90%-lean hamburger patty, 1 cup 1% milk – 12.2 gr carbs, 1 whole-wheat roll – 21 gr carbs , 1 cup prepared coleslaw – 15 gr carbs = 48.2 grams of carbs. (approximations by Kate) 195 vs 48. Enlightening no? I wouldn’t eat that recommended diabetes meal now. I’d lose the roll and (add a lot more fat). But that’s me and I didn’t get here overnight!

The DPP may not be perfect, but it’s a start. I applaud the “powers that be” for trying to get the message out there that poor diet and being sedentary are causing us to become unhealthy. A scenario of fast food and couch surfing can increase your chances of developing type 2 diabetes. They don’t cause it, but they increase your risk. That’s an important message that this program can deliver to millions of older Americans; those people who are at greater risk of developing type 2 due to their age.

Do I wish that people would listen to Joe Shmoe instead of celebrities? Yes. Do I wish that the idea of low(er) carb would find its way into the minds of those who are teaching people with diabetes? Yup. But in the meantime, I have hope that these types of programs will cause the masses to pay better attention and bring the severity of type 2 diabetes to the forefront and, hopefully, remove some of the stigma. Heck, if James Earl Jones and Tom Hanks have type 2 and they’re cool dudes, then maybe people will think twice before condemning the rest of us for just being normal folks who happen to have type 2 diabetes.

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Are links to blogs from other sites permitted here?
How does this subject fit with others on this site that have objected to diabetes educators following the ADA guidelines.
Personally I favor education that is inclusive to all options, even maybe Bernstein.

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Thank you very much this post was very helpful.

@Fraser70 Yes this link is permitted because I received permission from the OP.

We welcome all opinions here at TuDiabetes.

We appreciate your feedback.

Sarah :four_leaf_clover:

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Can I get permission to post anything I want? Like
Well controlled T2 on diet and exercise only? Which I have been told is for some reason means I m convicting t2s to not do meds?

I would be happy for you to post your ideas on how to manage T2 with diet and exercise only. I think if you can control your T2 without meds that is ideal.

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Unfortunately brian some of the recent post are in direct conflict of what you have proposed.
You have been against the big drugcompanies and cost, the post is against government trying to control cost, and people aren’t happy with the choices,
And your negative opinion of certified diabetes educators, which unfortunately I do agree.
I see this site degrading into how can they do that, it is so wrong, I thought
This site was about persons with diabetes to not feel alone.
I am more than frustrated with site.

i have been fortunate to be able to control my T2 from BG of 325 to an A1c of 5.6 no meds, it worked for me, others may not be as fortunate, we have to individually find our path.

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One final thought for Brian’s how much would you be willing to pay or to have your insurance company pay for a cure for your condition?

@curlysarah Not sure how to address this to Kate Cornell… … Education that doesn’t include even a small mention of Bernstein as one thing to try is a bit narrow for my way of thinking. Offering options, especially when offering them from a position of authority is fairly important. It may not be everybody’s cup of tea, of course, but finding out about lo-carb as one option should be as easy as finding out about every other option. I wasted 6 months post dx before finding Bernstein’s approach (right here at TuD), during which my emotional arc ranged from rage to despair and back again. That was a decade ago. And as yet, I don’t need meds, though that could change at any moment, given the diabolical whimsy of this scourge. Once my numbers rapidly approached normal, I was hooked…

At some point one has to say to the newly diagnosed, “moderate your carbs or die before you need to.” And I would never do that in the context of talking about “lifestyle”, which has come to imply all kinds of “stupid” choices that are one’s own fault and so seems like it is shaming in nature…

The truth is—we are all our own guinea pigs and, “If you want to treat diabetes by the book, you need to write a new book for every diabetic.”

I get that so many folks are in denial about their diagnosis. That is not good. I have just lost all faith in “easing” them into it. Not with The D at epidemic proportions…

Blessings. Thank you, Kate Cornell, very much, for taking the time to write your blog and thank you very much for sharing it with us…Onward!..

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Interesting. I am T2, no meds for a decade and this site literally saved my life back in 2007. I often post about the varied ways in which I accomplish my current position.

I have never been made to feel that I was trying to proselytize about no meds.

I am sorry you feel that way. I certainly don’t…Blessings…

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I definitely agree that most people with type 2 diabetes aren’t given ANY education, and often enough just a prescription and a follow-on appointment in 1-3 months. Education was how I’ve managed to manage MY diabetes.
That said, I believe that SELF-education (perhaps directed by a professional, if the newly-diagnosed PWD is lacking in critical evaluation skills) is the most effective method of putting together a plan, and the lifestyle changes, that work.
I won’t say that moderating one’s carbs is the answer. A lot depends on the individual and the way he or she responds to different dietary challenges. For many of us, moderating calories is the key — which means moderating not just carbs, but proteins and fats as well. Sometimes going from meals to grazing can help. Sometimes it’s a matter of changing the type of carbs one eats can help. Eating healthier overall can help. There are so many different types of “type 2” diabetes, and each responds to a different type of diet, exercise, and medication plan.
I don’t discard Bernstein — but I consider him to be an extremist on the low-carb side. The USDA’s Pyramid (the old one, suggesting 9 daily servings of grains) is extreme to the other side. Dean Ornish is extreme to the low-fat side (trying to limit the risk of heart disease); Atkins goes over to the high-fat side. Medications to manage not just diabetes, but other conditions as well, can enforce or limit the need for specific foods or food types; so can extreme environments or extreme lifestyles (such as those of elite athletes and stage performers). Somewhere in between all of is is the meal plan that fits a given individual, with an individual type of diabetes.
But I think the bottom line really is that as a society, we look at diabetes as a lifestyle issue, not a medical issue — and because of this, we ignore and blindside and minimize the need for education and self-management, especially where (as is common with “type 2” diabetes) there isn’t the need for constant monitoring to adjust insulin administration. Until we see “type 2” as a significant suite of legitimate, not self-imposed medical conditions, nothing is going to change.
And until see “type 2” as something other than “an old-and-fat people’s disease”, nothing is going to change.

Until we speak up, speak out, advocate like hell on the person-to-person level, and change it.

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Hear, hear. Without exaggeration, I estimate that about 5% of what I know about managing diabetes—not the biochemical pathways but real-world day to day control methods and practices—came from medical professionals. The other 95% came from self-study and interacting with peers (including this community).

Well, yeah, sort of. It depends on how loosely you define the word “common”, I guess. Something like 30% of diagnosed T2s do use insulin, and we face pretty much the same practical issues as any other insulin user. That’s close to a third.

But your fundamental theme is right on the money. Until we start really viewing it as a medical condition, the attendant issues aren’t likely to get much better. I would just add, in regard to the T1/T2 divisions in the diabetic community, that until we learn to speak with a single voice we will never attain the degree of public and governmental understanding and support enjoyed by cancer, heart disease, and others.

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@Judith_in_Portland, I appreciate your point of view on this. Let me clarify a few things here. This guest blog is one person’s perspective on the topic. I asked if she wouldn’t mind if I promoted it here because we have a lot of members that are passionate about this topic.

@Fraser70, It’s our goal at Diabetes Hands Foundation to encourage our members to express their opinions and engage in conversation. As with @Brian_BSC I would encourage you to tell us about how your D management has benefited you.

We will continue to promote guest bloggers in the future. In fact, keep an eye out for Dblog week coming soon!

Sarah :four_leaf_clover:

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Of course And my post is one other person’s view. Nothing more or less…

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Well said, @tmana…And how delightful to encounter you again. It’s been awhile. Hope you are well!..Judith

GMy diagnosing doctor was very clear I was in trouble (BG 325)’ but as a doctor’s she would dole out medication. And gave me a prescription to meet with those who could help me. An education course I have mentioned before
Day one to count carbs day two a buffet for lunch count more carbs, day three so how many carbs is it today.
That and the great fortune that am in the the 10% that does not require meds.
The reality I dose carbs as strictly as those on insulin calculate how many units they need,
My initial diabeteseducator (a T2, was fantastic) she taught me to eat to your meter which I still do.
Now that I am well control with an A1c of 5.6
I am damned by the cetified diabetes educators and questioned by my Doctors if I am still a person with Diabetes.
Goal meter readings: min 80 max 120 90% in range some high some lower.
2 hour after start of dinner tonight, including avacado for desert BG 106
FYI this does not include increasing bit it a bit for 5 or 10 K run

And to be honest this site has not been supportive either. I am not a fatbetic as described by members nor am I a goody two shoes that thinks I am better than any one else another thread

Done with my rant. Thanks for listening,

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I am sorry you feel that way about TuD. Many of us have experiences in one form or another that overlap with yours, including me.

Just how do you define support? What more can we do to support you? What is lacking? With our current membership numbers, the variables on who sees and can then respond to any single post are nearly infinite…

Perhaps if you experimented with initiating your posts in different categories, until you gradually engage with folks who are familiar with you. I have been with TuD since long before the switch to this platform and I am often at a loss where to post anything, except in general forum or the community places…I just recently figured out how to “Link” a topic so I can do that soon when I post an update about my sister’s battle with cancer…

As far as I can tell, you have certainly never been admonished by Admin, so you are doing nothing wrong…

Don’t give up. Every writer needs to find the right audience. Poke around. Experiment. You are doing great with your self-management and that is a Grand Accomplishment. So Bravo!..and Onward!

Thanks Judith you are a gem, I do have one blemish in my record here for an in appropriate rant. I do have a temper.
I am in San Francisco so have some personal connection to the office.
As much as I like and admire all who I have meant at TuDiabetes,
I have finally come to the realization that the experience has overall been very negative. So I need to accept that and go on.

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What type of support would you like to find here? I would be interested in hearing more about how you manage to increase carbs successfully while prepping for 5 and 10k runs? that’s a topic we share an interest on…

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