...even more intensely now, because when I got diabetes in 1974, glucose meters for home use did not exist. We pissed in a cup and dipped a stick in it to get a wild guess at what our "bg" was, or sugar. If you have had the diabetes type one 39 years, it had to be even worse when you got it then it was when I got the disease. How in hell's name would you have kept diabetes in such "good control" as to avoid complications with out making a pact with the devil him or her or itself may I ask you?
I find you hard to believe at all the more I think about it, you must really need to paint a perfect picture of yourself for your customers. I don't . I don't paint myself to be something I'm not for people to make them happy. I say "f" them if they don't like me and I don't fit the mold of perfection they want. I'm usually a nice guy, but when a person lies to me and I can see it is definitely got to be a liar, I tell them in the face what I see in them. And if you have some strong evidence to prove me wrong, I think you are telling me a lie about how perfect your darn diabetes is.
What is wrong with having problems and complications from diabetes? For you it might make you look like a bad doc and not able to deal with the disease as perfectly as your customers, patients would like to see.
I believe superbly strong that you are stretching the truth a long way.
A lady once told me she was "perfect" with her diabetes, making a bit of fun of the fact I had gone on dialysis. Several months later she was paying full price for diabetes and her kidneys failed, she ended up in a wheelchair because an infection got into her spine, and she is now is worse shape than I am.
You are not using wisdom to bragg about what perfection you think you have. There is no way in hell you can be so damn perfect having diabetes 39 years! Especially knowing the facts that when you got it like the time I got it, all that was available to normal people was urine tests. No one had good control with that kind of stuff, it was impossible.
You may be a doctor with type one, but your messing with the wrong guy when it comes to knowing truth, and I believe some where you are stretching truth about your diabetes beyond normal reality.
You may just find yourself like my friend in a wheelchair, I hope not, but don't think you are a "perfect" diabetic. I see you as a person using this to make yourself appear as a great doctor for people with diabetes who are your patients, a ploy for your job, and I say it is bull to say the least.
Be truthful, because the truth will definitely catch up with you whether you like it or not. There is no "perfect" person with diabetes type one.
You are stretching yourself very thin with "truth" about your personal diabetes. So much so I wouldn't walk on any ice you created if my life depended on it. It is about to break.
This is a wonderful situation where all writers have a bit of truth in what they write. But none have all the truth and that's why we read with such interest and try to identify which situations fit our personal experiences or knowledge. As a Type II diabetic who has decided to devote the rest of my life to helping others with the disease, I really understand the anger and frustration of the Type I writer on dialysis. Imagine that my ten years of direct experience are worthless in the pantheon of diabetes education. I don't even qualify for the training or certification, because I devoted my life to activities other than a health career. Yet, I'm more knowledgeable about many aspects of the disease than my certified diabetes health care team, whom I love and respect dearly. But they must devote themselves to a whole wide group of diseases as clinicians. That's why the community-based diabetes education program that I'm working to develop will surround the participants with "rubber on the road" experience and provide support and coaching that is not financially feasible for hospitals and clinics. They must focus on sick people, not those seeking recovery or working their program. Thus, they continuously teach Diabetes 101 and are often in "Cruise Control" which is why so many long time diabetics get so angry.
Can I get any kind of certification for my program? Probably not, but will will still use all the values of the programs, work closely with the four clinics in our neighborhood and draw on the experience of our Psychiatrist, Physicians Assistant, recovery coaches, social workers and pick-up softball team (so to speak) that comprises a long-term, replicable approach that targets on the deep concerns of people living daily with diabetes. Can our program get insurance reimbursements? Probably not in our lifetime which brings us to the contemporary meaning of Catch-22. Someday, we will recognize that certification programs that initially serve to create necessary standards become mature and in that maturity, become moat-builders, not community-builders, thus driving the cost of health care through the roof. At least the anger that prompted this whose set of postings is more focused than what I've seen on CNN lately. Let's hope we can listen carefully to one another, move beyond the shame and blame game and start visioning exactly what we want to have happen! Then we can create the plan to get beyond those polarities that merely cause fear, uncertainty and doubt. But to the doctor who started this whole discussion, remember the Jewish comedian who said, "My mother told me her doctor said his bill came back without a payment. She said, well my arthritis came back." Patients have a right to have their health care providers held responsible for outcomes as well. I once had eye surgery without cost from doctor after it did not succeed. I should be so lucky 50 years later!
Ann would you like me to upload my medical records. I did have problems at first and wen through hell. But I recovered by 95 percent. Despite nerve damage, I repaired 95 percent of that damage. I am sure every one here will say that is impossible. We should quit using the power of suggestion. Adequate insulin 24-7 and exercise does in fact restore damaged neurons. My nerve damage is mostly linked to my big toe which does not get much action. However, my approach took incredible work which most make excuses why they can't.
Excellent article. If I may offer a suggestion: perhaps you could include a source for exploring how to become certified as a CDE. This is a suggestion only a possibly a distraction from the main idea of this article.
Here is the website for those interested in learning about the CDE credential: www.ncbde.org.
I was diagnosed w/ type 2 three years ago. I did a lot of self education, which worked very well for me. I became interested in becoming a CDE. As a health care professional, it was odd that the list of those who were able to apply to get the CDE credential did not include me. It includes dieticians, pharmacists, exercise physiologists, podiatrists, psychologists, social workers, physical therapists, etc. But not chiropractors. This was disappointing to me, and odd due to the fact that I work with people on diet, exercise, stress management, and health in general. When calling the board about becoming a CDE, I was informed that chiropractors were not on the list of approved professionals. Interesting - psychologists? social workers? physical therapists? dieticians? Hmmm, all part of the medical industry. I treat them all, yet don't have parity when it comes to an important aspect of health and well being. So tell me why this is, and how it serves the public.
Oh, I also hold a MSW and am qualified to teach Mindfulness Based Stress Reduction.
Very curious.
Thank you for your comments. There have been many changes to the NCBDE in recent months: including a new CEO. I totally agree with you re the need to grow CDE's rather than making it appear as an exclusive club. I am currently off the Board, having served my 3 years as a physician liaison, so I do not know the current practice/specialty recommendations offhand. Change and growth is a good thing, however. I would suggest your review of the latest website news and contacting the present Chair of the Board directly to discuss your concerns. She will listen and hopefully take your suggestions to the Board in order to allow growth of CDE's.
When I was diagnosed, 1 yr ago come Tue. My first thoughts were I am pretty much ignorant on everything I need to know, well I cruised the net and started putting things together before my first class with an educator. These ladies were great, they explained things well, were good at checking that you did understand correctly and were very encouraging for every positive step you took. They made my first months a lot easier to adjust to. My only comment on where they could improve is to learn and teach the basics of other methodology of control, Dr Bernstein's very low carb, Glycemic index, David Mendosa. They only knew, or are only allowed to teach the ADA way which most people, at least type 2, has found is , and I ma being generous, less than optimum. There is no way I could tolerate the excessive carb intake that the ADA pushes, I have very good control at 100 to 130gm per day with just oral meds.
Thank you for commenting. My understanding is that there should no specified diet in general for people with type 1 or type 2 diabetes. Rather, there are different diet options (and recommended calorie/carbohydrate amounts etc.) that are available to meet the needs of the particular individual. I think the latest ADA recommendations are such that no one diet is appropriate for everyone. As I work with kids and teens that have both type 1 and 2 diabetes, we use carbohydrate counting as a means to adjust insulin and allow for appropriate growth (type 1). And, we use portion control for our type 2 patients and try to help with weight loss if necessary. The other diets: low carbohydrate and low glycemic index are also excellent options, particularly in adults.
I wasn't expecting a reply, but thank you very much, I was trying to get the word to the right people that there is more out there than the ADA way and if the additional ways are taught, in my opinion, more people will be in control of their BG levels. I did hear some positive information Sloan Kettering in New York is now offering a low carb diabetic menu, maybe other hospitals will advance to their standards. Not im my travel area but promising that someone is listening.
I will upload my medical test of my kidneys, my cholesterol, blood pressure, the number of insulin prescriptions each month, the number of test strips purchased and have my wife sign an affidavit to verify we still have a very intimate relationship.
In otherwords, I am not impotent. However, many diabetic wives live with celibacy. My view: marriage is about us and not me.
So yes I do live in perfect health, and nothing is progressive about diabetes as long as you get an insulin similar to the body and inject it as often as your body would. Now I would not call this rocket science. Logic would dictate this must work.
About 40 years, but I did not alway have good health but with a huge amount of effort I recovered from nothing but a walking skeleton, my skin litterally falling off and my foot was starting to become deformed. I had blood sugars so high most would have just fallen over dead. I will tell you some gory details. When I ate noodles they came out as noodles and I could tell you even more you don't want to hear. I began researching diabetes and learned on my own how to fix it all. I married and have three children despite I was once a barely breathing disaster. I am living proof that even in dire straights diabetics can recover almost everything. I have spent my life researching diabetes and I am personally opposed to diabetic drugs because the disease is simply about too little insulin or none at all im my case.
For the past several years, I have used Humalog insulin injected every two hours, which is what the human body would do naturally. Because our liver stores energy, we need insulin more than when we eat. The liver releases that energy through out the day, and insulin keeps that release stable as well as metabolizing glucose. I don't use any specific diet and just eat what every one else does, with the exception of very little meat and no junk food like pizza and chips. My son at age 8 showed up with diabetes.
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...and then maybe you will know something about the reality of the disease! LOL! Your certifications, license and all that junk don't mean much to a person with these diseases if you don't solve the problems of these illnesses. What matters is if you can solve problems in realistic manners.
I've lived with type one diabetes for 35 years, got it when I was six years old, and the doctors and all the other professionals are missing some important points. They only advise, they don't live with the disease 24/7 and in real life, 24/7 with diabetes is a totally different universe than the "ideal life" doctors imagine in all the "fascinationg" bs they come up with when I was a kid and now days with diabetes type one for "solving" the issues that come up living with the disease.
Take a day of your life and all the things that come up, and try to imagine it with diabetes type one for instance, what you would have to do to control blood sugars using a shot needle for instance and a meter. Would what a doc suggests actually help much in a normal day for you doing this method of treatment? Is it really a good way to solve the problem of you as an individual, or are the "paths" of treatment adequate?
Actually, you guys don't solve the problems of diabetes at all. The individuals who live with the disease have to make the best with what they have at hand and do it themselves. You guys only make suggestions, but you don't don't do anything as far as any real actions, the patients themselves have to figure it out based on what you guys teach, and they handle the problems of the diseases on their own!
I've found most of my life doctors are a waste of my time for the majority of time I've spent with them. As well, educators like yourself in my life with type one diabetes has been a waste of my time too. I pay out cash for bull advice that gets repeated over and over, but nothing that works in the world of reality for the majority of advice given.
Diabetes is a real disease that does quite a nice chunk of damage, I know because I've gone thru every complication it can dish out, and am on dialysis now. I'm told by people in medicine it is "my fault" when I didn't ask in the first place to get the damn disease. If I could kill diabetes I would, but it is a disease that you can't kill unless a real cure is found. The current treatment methods are bull when a real possibility for ways to cure it are already here!
For instance the continuos monitoring bg insulin pumps that are out. Now those would be a real solution that would bring down the rate of complications in diabetes. Why are they not approved yet by insurance and the industry for wide use? Because if they were put out to solve the problem of diabetes, complications would go down, and jobs like yours might get eliminated, and well the industry of diabetes couldn't handle the economic downfall of loosing out on the complication side of the business diabetes brings coult it?
A cure is possible now. But will it happen? I doubt it when greed brings out inverstors to profit on the dark side of illnesses.
Your job exists because the cure is always around "the corner" as the bull ADA always says.
The cure is possible now, in a huge variety of ways, but it isn't found because disease profiteers would lose money, so people pay out cash for bull and die because the business needs illness to keep products on the market like insulin and more.
It is a business of bull, and people like you, are you really solving problems?
Only the people with diabetes can solve the problem on their own. You guys are just side line "watchers" who don't actually do a damn thing but observe and give advice based on a reality we live you actually have no idea about when you don't live it.
I wouldn't hire you myself as an individual with diabetes because I consider what you do bull. It is a waste of money. I'd rather the money people spend to talk to you for bull advice go for a real cure, but most people with diabetes are so mystified about reality, they don't realize the soluiton is what they have to do themselves.
A real cure is possible, but will never happen in our lives because there is a profit to made thru the industry of diabetes.
It is curable already. Industry sees a cure as disastor for profits, so a cure is avoided at any way it can be and the "people" are fed bull to keepp them fooled about reality.
It is amazing to me all the solutions I've seen "snuffed" for bull that people like you enjoy putting into the minds of the gullable.
Solve diabetes?
Diabetes is solved by individuals who live it, you in the medical field in the United States are all full of bull solutions, you don't kknow reality of the disease at all.
I don't find any of you useful.
Think a while on that and figure out whaat the point is I'm pointing at.
A cure is possible, that is the point I'm pointing at, but it isn't made because diabetes is an industry.
Pardon me, but I must respond.
I'm sorry that you are on dialysis, and that the diabetes you have is not the diabetes I have. I have been living with type 1 for 39 years and I have no complications.. at all! The question is what's the difference between you and I? I got it when I was 5 and have managed to enjoy life without too many diabetes bugs. But then I hear about people like you and Allie Beatty, who have had a totally different story and I don't think it has to do with what I did vs what you didn't do. I think this is why research is key to changing this issue. In fact I even more strongly agree that more needs to be focused first on complications and last on a cure! My support toward the The Artificial Pancreas and the future of SmartInsulin has been a large chunk of my time for the last two years!
I lived with diabetes before the BG meter, the invention of synthetic insulin, pumps and continuous glucose monitors, so what's the difference between you and I? For one, all of pumps and CGMs have been covered by my insurance! but my CDE Gary Scheiner put the billing through for me! Ahh, there those people you say are utterly worthless, they have certainly saved about $10,000. I would have had to pay out of pocket for diabetes management!
After 39 years of living with this disease, I agree there are plenty of docs and CDEs out there who don't do their job. But to make a blanket statement about endos and CDEs that did not work for you is like saying everyone who has has complications is to blame for the condition!
So you do have the disease, and you sure you have no complications? LOL! For 39 years, and nothing has happened, no eye problems, no feet problems, no neuropathy, no bad circulation, nothing? I find that very hard to believe to say the least! You have to have some kind of problem going on, or you wouldn't have diabetes type one.
Now insurance I did not get until after I got complications of the disease, I paid out of pocket all my life because I couldn't get insurance until I got so ill it went "catastrophic" on me as I'm termed now, to the point of bankruptcy.
Insurance that I get is the kind old people get, you know, medicaid and medicare. The type that keeps you living, not the glamor kind of insurance a paid doctor can afford.
And I find it hard to believe if you are a doctor that you don't get some awesome insurance, why would a doctor have to pay out of pocket?
At the moment, I find it hard to believe you are a real human! LOL! With diabetes I see no way you can be "perfectly" healthy? There is something you are basically not being truthful about, it is impossible to have had type one diabetes for 39 years and not suffered some form of complication from it, especially type one, unless you are like Howard Hughes about the disease as he was about germs. NUTS!
You must not be human at all, you must be a machine yourself and don't realize it. A cyborg or something, or as a doc you've found something to solve your problem with diabetes you don't want any one to know! LOL!
I find it tremendously difficult to believe any one with type one for 39 years could be "perfect".
Bull to say the least! LOL!
Explain in detail do tell, how you do it please if you are not a liar!
Verify the truth!
I am perfectly healthy living with diabetes! I have a torn rotator cuff and stiff neck from hiking, but that doesn't count towards diabetes complication! I see my endo every 4 months, my eye doc at the beginning of the year, and since I still have all the reflexes in my feet, I am not in need of a neurologist! Kidney function is normal, etc, etc. Apparently, I'm in a 2% bracket.
This is what gets me, what is the difference between you and I? Really! This is why I would love to see more research done on us type1 adults. Am I MODY? What is the difference!!! I am classified type 1 for sure, but there HAS to be a hitch! What is it that my body is doing that your is not. Because you and I are not newly diagnosed, its nearly impossible to find studies looking at my function vs yours and that is a worry to me!
Also, I'm not a perfect patient! To reach a target A1C is not that hard for me, another symptom, if you will, that something is different! I also live in an area with another woman who has had type 1 for 51 years and she has no complications either! Several of my local D-friends don't have complications and have been 20-25 years also. All we can do is push for the science/research to let us in! Last year, I gave a speech at the JDRF gala and the ED rec'd calls saying best speech because I said that if we could get rid of complications, then we could all qualify for a cure when it comes!
On the insurance front, my husband is a broker and we both complain all the time! I live in a state where there are no pools, so if you don't have it, you simply can't get any! I'm very fortunate to have a group policy I bought thru my business! But I pay for it, I just got a rate hike of 10%.