Type 2 Diabetes – an alternative view

I’m banging my head against a brick wall here but trying to get help for a diabetic is really hard. I’m working with the local rep frm Diabetes NZ to try and find out what my family can do.

The standard info, though, seems to be look only at exercise, nutrition and medication.

That’s all well and good but lets look at the dieting industry as a whole. The reason it exists is because we find it really hard to put that balance in place when we are young, fit and relatively more able to make the choices. As you age (although unfortunately in NZ we now have adolescants with Type 2 diabetes) and your metabolism slows it gets harder and harder. What was hard before must seem impossible now.

But it’s not so hard, surely. We know what to do. It’s all spelt out to us, we see people doing it all the time. But still, the vast majority of us fail to actually make the necessary changes and to stick to them.

Consequently we have a new generation of books like Dr Phil’s The 7 Keys to Weight Loss Freedom and Paul McKenna’s I can make you thin which focus on the habits and lifestyle choices of being overweight rather than the mechanics of how to change it.

Yet the official line from the Government seems to focus on education. This may be important and it seems to be invaluable in some of the news items I’ve seen. But for many others education isn’t the problem. They know how to eat well but their western, affluent lifestyle requires them to eat large, rich meals – otherwise aren’t you mocking the western, affluent lifestyle? I doubt any of them would consider they think that way but going without the vast array of goodies paraded in front of you whenever you step outside, go shopping, watch TV or read a magazine is impossible.

Buried deep within the National Guideline Clearinghouse is an article on Management of type 2 diabetes. Here is one of the “Good Practice Points”:

GPP Consider referral to weight management health care practitioners for motivational counselling or specific energy balance assessment and advice when general lifestyle advice does not achieve a sustained weight loss.

Should this be a GPP? Or should it be a compulsary first step? Counselling is an anathema to many, too touchy feely. But if it helps a patient to accept that turning down the goodies is essential then maybe it’s a really good thing! If it helps them to accept the changes they need to make then it must be good. And if it helps them to understand just why they used to overeat then surely that’s good too!

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12 Comments

  1. November 20, 2006

    Very interesting website!
    Barrie Segal Founder of diebetesmellitus.blogspot.com

  2. January 13, 2007

    I don’t think people think it will happen to THEM. It sneaks up on you so you can’t feel or see it happening. All the education in the world won’t work because there isn’t any immediate feedback.

  3. January 13, 2007

    It doesn’t sneak up. You have years of warning – years of over eating and inactivity! While slim people do get it, the vast majority are walking timebombs and have no excuses.

    Sorry, but I’ve just accompanied my mother to the Dr and you really don’t want the health issues that come hand in hand with the diabetes.

  4. March 16, 2007

    Diabetes runs in my family and I am keeping an eye out on my health to catch type 2 early. I try to exersize and stay thin. My weekness is pepsi. Can’t help it. keep up the good work!

  5. April 27, 2007

    I think you’ve missed the point somewhere. The fact is that olympians such as Sir Steven Redgrave suffer from diabetes. Exercise does help it seems to me but will possible delay the onset.

    I personally find the biggest part of weight loss is really an educational one. Not concentrated on the facts about foods etc, rather on the alteration of a mindset. We are what we eat and if we can alter our mindset, we may prolong the onset of this health issue.

  6. April 27, 2007

    Not having a clue who Sir Steven Redgrave is I had to do some searching. Turns out he’s a famous British rower. But for all the reading I’ve done I haven’t been able to determine whether he is Type 1 or Type 2. From the language used I suspect he’s Type 1 and I haven’t heard that Type 1 is at all preventable.
    The point of my post though, was that education and exercise will be futile in an obese person until you tackle the issues about WHY they allowed themselves to be obese.

    Now you may think that no one wants to be obese, I beg to differ. Who gets to size 18 and doesn’t act?

  7. Babs
    May 22, 2007

    to Sarah King: I really hate it when people assume that all Type 2 diabetics have a choice. I was slightly overweight when diagnosed, by 12 pounds and worked out 3 nights a week. I ate a fairly balanced diet and basically tried to take care of myself. My risk factors included a family history and my age (over 45). My older sister had more risk factors than I did, including being more than 20 pounds overweight and babies that weight more than 9 pounds at birth, and she doesn’t have it. My weight got down to 120 pounds (I’m 5’4″ and wear a size 4) and my medication went up. I’m stuck with this disease, like it or not. I watch what I eat, exercise and take my medication and hope that one they’ll find a real cure. And I get irritated when people just assume that it all has to do with life style.

  8. May 23, 2007

    Babs, you don’t mention if in the past you had been more than “slightly overweight” and I don’t know you so I can’t judge you.

    I can however have a view on the thousands of children and adults in NZ who are grossly overweight, far more overweight than my mother.

    Let me tell you about my week. I’ve been spending 12 hour days at the hospital supporting my mother through end stage renal failure. It’s quite a peaceful disease – you just get sleepy and stop being around so much. The Doctors have given her a neck-line for dialysis and the dialysis has brought her back. Nothing short of miraculous. However because of her weight she damaged her back years ago – the sort of injury a slimmer, fitter person would bounce back from. Now lying still for 3 hours is unbearable and it’s horrid watching a grown woman howl in pain. Soon she’ll get a perma-cath which will give her the ability to move during dialysis and eventually a fistula. In the meantime she worries that her memory is shot. We know the dialysis will help clear the fug in her head – but the nerve damage she’s experiencing in her feet is replicated in her brain (as seen in a recent CT scan) and the diabetes is slowly robbing her of her.

    While there will be exceptions and unfair examples – such as you, Babs – there are also a huge number of people where it is avoidable. Pies for breakfast, inactivity and cultural acceptance of obesity take many people down a road they don’t need to travel.

    It’s nearly 2 years since I made my post and I stand by it. I believe people need counseling to work through the issues about how they got obese and why they have chosen to stay obese for so long that they get sick.

    Oh, and one of my babies was over 9 pounds, according to http://www.halls.md/ideal-weight/body.htm I’m 10kg overweight so don’t think I’m not aware that I have my own health issues I have to confront and deal with.

  9. Babs
    May 24, 2007

    What your mother is going through is my biggest fear. To be so ill that the quality of life has diminish. I fight my diabetes every day in hopes that I can avoid that part of the disease. My heart goes out to you.

    And I agree, so many people can make better choices to benefit their health. At the ‘support’ classes I took when I was first diagnosed I was always the smallest (and no I was never extremely overweight). I felt angry that they really had a choice to have this disease or not. If they stuck to a diet and lost the weight, for them, the diabetes would miraculously disappear. I was very envious of them.

    Sometimes I think it all started with a virus that my husband caught and passed on to me. We were both very sick for weeks. His went into double pneumonia and I ended up a severe sinus infection. It took several weeks to recuperate for both of us. Shortly after is when I started noticing that my muscles seemed always fatigued. And 10 months later I was diagnosed with diabetes. I don’t know that there is any correlation but it’s always in the back of my mind that that was when everything went bad.

    After being diagnosed I went on a strict diet. And medication. When my glucose seemed to be in check I requested that I stop taking the meds and my doctor agreed. To keep my glucose levels in check I would eat very little. I had no energy and would suffer from hypoglycemia frequently. Finally, someone mentioned that I should be seeing a endrocrynologist. I made the appointment and got on the right medication and diet. It took another year for my energy levels to come back but it did. And I’m really feeling great!!

    Do whatever you have to do to keep yourself in check. Seeing your mother suffer daily should be a reminder to you. Maybe you’ll never get diabetes, and I hope you never will. Take care of yourself, make good choices. Hugs to your mother.

    And thanks for chatting….

  10. May 25, 2007

    Hi Babs – thanks for sharing your story and Good Luck! It sounds like you are tackling this challenge intelligently and with courage.

  11. September 8, 2007

    It is nice to read stories shared by strong people. I have dealt with diabetes and have learned that I can live a wonderful and full life. I will have to read up on your more recent entries.

  12. February 17, 2008

    I understand exactly what you’re saying. I work with type2 diabetics. The most difficult part in getting them started is all the “authoritive” mis information out there. How can diabetics take heed to not eat so many carbs when the ADA says it’s perfectly ok?

    Why should teens quit drinking soda when they see ad after ad telling them they’ll lose weight?

    How can people make good food choices when their choices are corrupted by the food industry? Take yogurt. Some diabetics are forcing themselves to eat yogurt. The problem is they’re buying their yogurt at the grocery store and it’s nothing but sugar and transfats. No live bacteria cultures which is the whole point to eating yogurt.

    Then you have the government telling people to eat more whole grains when most of diabetics are glutten intolerant.(which suppresses the thyroid)

    When it comes down to it, it’s not that diabetics don’t want to take responsibility. They’re overwhemled with misinformation.

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