Wednesday, May 20, 2020

Retrospective #460: The Blind Leading the Blind

No offence intended if this “microaggression” offends any blind person to whom this column is read, but that was my reaction to a “workshop” I attended a while back, conducted at a local hospital by two state-trained Registered Dietitians (RDs). There were 13 attendees all looking for help to deal with their type 2 diabetes.
The workshop began with a brainstorming session in which each person was asked how they felt about being a type 2 diabetic. The moderators – I’ll call them Tweedledum and Tweedledee – dutifully wrote the feelings down on a mammoth 20 x 30-inch Post It. Virtually everyone expressed negative emotions, among them anger, confusion and frustration. I was last to be asked, and I said I had no such negative emotions because my type 2 diabetes was now under control. My last A1c was 5.0%, and the only diabetes medication I take is Metformin.
I was then asked by Dee, reasonably, why I was attending the workshop. I explained that I had seen an invitation in the newspaper inviting type 2 diabetics to attend. I had been a type 2 for thirty-four years, and my diabetes progressively worsened until I was taking 3 different orals meds – maxed out on 2 – and my fasting blood sugars were still out of control. Then, 16 years ago, to lose weight, my doctor suggested I try a Very Low Carb diet he had read about and tried himself. The first day, to prevent hypos, he had to take me off 1 med and within the week he cut each of the other 2 meds in half TWICE. Over several years I lost over 180 pounds and I wanted to share the good news.
Although I mentioned  NYT Magazine cover story my doctor had read, nobody – neither Dum nor Dee nor anyone taking the workshop – expressed any interest in how I accomplished what I did. Of course, they weren’t there to listen to me. They were in this group because their health-care providers apparently had sent them there to help them deal with their anger, confusion and frustration. The free book that everyone got said it all: “Living a Healthy Life with Chronic Conditions.” In other words, give up hope of reversing your T2D; just get used to it.
I really did feel sorry for the hapless participants, each with different issues but one thing in common: Type 2 Diabetes. They were all victims of the current healthcare system. The course syllabus, from which the workshop facilitators READ VERBATIM, was based on the Chronic Disease Self-Management Program (CDSMP) developed by Stanford University. The homework assignment for workshop #2 was to read the “food guide” in the text and learn about “healthy eating.”  It is based on is the “Dietary Guidelines for Americans,” as illustrated in the book by ChooseMyPlate.gov, and the American Diabetes Association’s, “Create Your Plate.”
The Dietary Guidelines “Choose My Plate’ plan is ¼ fruits, ¼ vegetables, ¼ grains and ¼ protein, with dairy in a bubble. No fat. The ADA’s “Create My Plate” plan is ½ non-starchy veggies, ¼ starchy foods, and ¼ meat or meat substitute, with 8 oz non-or-low fat milk. Clearly the US Department of Agriculture and the American Dairy Products Association had a hand in developing these essentially identical plans, helped by Big Pharma and Big Food Producers. How all this corruption co-exists is explained in “Root Causes” by Jason Fung, MD.
The penultimate task of the workshop was to come up with an individual Action Plan for the coming week. Mine (I was last again) was two 36-hour total fasts, on alternate days, until I lost the weight I had gained since my last annual doctor’s visit. On the other 5 days I would eat Very Low Carb/One Meal a Day (VLC/OMAD). 
At the conclusion of class, we were all asked for our impression on how things had gone. I think Dum and Dee were hoping to get feedback that we all felt better after having attended our first group therapy session. Once again last to speak, I commented that I thought it odd that most people’s “Action Plans” were to exercise more. Doesn’t everyone realize: “DIABETES IS A DIETARY DISEASE.” Tweedle Dum replied with a non sequitur: “Well, everyone’s different.”
If you click on both “Plate” links above, you will get a visual image you won’t forget. Americans have been following these guidelines, and the incidence of diabesity has skyrocketed. Sadly, no one in this workshop will have any hope of self-managing their disease. Our government has failed them with bad dietary recommendations. I think the only thing that this “self-management” program is designed to achieve is acceptance of their feelings of failure. That is truly sad.

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