As I participate on various blog sites I find writers who are disappointed with the American Diabetes Association. (I am not a member). This disappointment ranges from a desire for slight changes in ADA recommendations to outright distrust of and loathing for the organization.
To anyone falling in this range of opinions, I offer a challenge.
I come at this from the national healthcare viewpoint where for two decades I have directly cared for patients, managed medication formulary issues affecting thousands of people, and educated patients, families and medical staff on diabetes and other health issues. In this time, I have learned that decisions that affect vast groups of people are not often simple ones. Nor can such a decision perfectly suit every person in every possible situation.
Diabetes and pre-diabetes affect one-quarter, yes one-quarter, of our US population. 75 million out of 300M Americans. Easily one-half of these people do not even know that they have these conditions. Of those that are aware, their understanding ranges from zero to the solid comprehension of many motivated readers of blogs such as this; all the way to diabetes medical specialists who understand both diabetes as well has how to balance its treatment with every other varied medical need of their patients.
Some know the differences in carbs and can create a menu for a whole month at a time, while others wouldn't know a carbohydrate if IT ate them.
As a CDE as well, I can assure you that not everyone learns the same way or with the same ease.
When diagnosed with diabetes, people often undergo the stages of mourning or loss; denial, anger, depression, bargaining, acceptance, etc. What is a challenge for one feels like a reason to give up living for another.
People understand their own situation by past experiences and understanding. For example, the children of a man placed on insulin shortly before dying may hold a misplaced (and incorrect) fear of insulin.
Understand that people don't "die" from diabetes so to speak, just as they don't "die" from HIV infection. They die from any of a host of related issues that diabetes (or HIV) makes them more susceptible to (kidney failure, heart attacks, strokes, infections, etc.). Treating diabetes is NOT ONLY about blood glucose.
So here is my challenge. Submit a plan that addresses everything and improves on the ADA recommendations. But here are the ground rules and restrictions. Your plan must be:
Broad enough to encompass 75 million INDIVIDUALS but
Specific enough to do the most good for all.
Easy enough for everyone to understand and implement, but
Complex enough to tackle a complex disease.
Sufficient in scope to teach people how to eat to control blood sugar, but
Understanding enough not put kidneys and blood vessels at higher risk.
Stern enough to WARN people of the dangers but
not so much as to lead someone into depression.
