April 4, 2008

The Email I Have Not Received

I get a lot of emails in response to the postings on my Blood Sugar 101 Web site. People write me with comments, questions, and requests of all kinds.

I file each email away into the appropriate folder. I was as I was doing this today, it occurred to me that there is only one kind of email I do not see, and that is one that says, "I followed the advice I saw on your web site, lowered my blood sugar, cut back on my carbohydrate intake, and it made my health worse."

Given the contentiousness of the web, I would expect to see such emails. After all, the ease with which anyone can set up a completely anonymous email account makes it very easy to send such an email. We all known that anonymity encourages people to indulge in behaviors they would never consider if they knew that their identity could be tracked down. So you'd think that in the normal course of events I would get a couple of emails of that type.

But I don't. Instead, I get emails from all over the world from people who tell me how surprised they were at the ease with which they could recover their blood sugar control once they understood that carbs are what raise blood sugar and that cutting back on carbs is the best way to lower blood sugar. I also hear from people who tell me that my web site gave them the courage to go in to their doctor and demand insulin after cutting carbs could not get their A1c below 7%, who tell me how hard it was to convince their doctors that the ADA's recommended blood sugar target was too high to provide them with health and safety.

I also get emails from people who tell me how lowering their blood sugar improved the pain in their feet and how they wish their doctors had told them that, rather than putting them on expensive medications which had unpleasant side effects.

I mention this not in defense of my advice--it needs no defending, but because it highlights how heinous it is that now, a decade since advice like mine first made it into the mainstream, The American Diabetes Association continues to whine that the strategies I promote "Need further study" and still refuses to put the word "carbohydrate" on its "tight control" web page.

The ADA does this despite a decade worth of research that has proven that for people with diabetes the low carbohydrate diet lowers blood sugar and lipids and improves health far more effectively than the expensive oral drugs that may be their alternatives. And the ADA still tells doctors that the 7% A1c is all that is required for people with Type 2, which in effect means most family doctors do not start drug treatments of any type until their patients have had an A1c over 8% for at least a year.

The ADA continues to behave as if cutting back on carbohydrates and shooting for a normal blood sugar might have some hitherto unrevealed negative consequences so dire that they cannot recommend either strategy to the doctors that treat millions of people with diabetes.

It does this at the very same time that it advises patients to keep taking drugs like Avandia whose negative impact on health has been so well documented that only people with a hefty investment in the drug companies that manufacture them or who are on those companies payroll could justify advising people to keep taking them.

But of course, the ADA for all practical purposes is on the payroll of these drug companies. The drug companies are major contributors to the ADA and major funders of the enormous salaries earned by the ADA's executives, none of whom, I believe, actually has diabetes, though they do have professional resumes filled with jobs as health industry and drug company lobbyists.

A friend of mine just got back from her doctor with a prescription of Humalog, which she needed badly and an armful of brochures, many with the ADA stamp of approval, urging her to eat a diet rich in bananas, raisins, whole wheat bread and oatmeal--a diet guaranteed to raise blood sugar.

I'd urge you to write to the ADA to share how badly you fared while eating that particular diet, except that long experience has taught me that the ADA does not respond to emails from us folks with diabetes. We aren't their priority.

The only time they think about us is when they hire telemarketers to call us up and ask us for money. Otherwise, our emails go into the dead letter bin. Where all that money they raise goes is unknown. About a million dollars worth of it goes to their top executives. The rest of it seems to go into those brochures urging people to eat the high carbohydrate foods that will worsen the health of people with diabetes.

If there is one thing that really "needs further study" it is this: How did an organization funded almost entirely by companies who profit only when people with diabetes have poor control and staffed by people who do not have diabetes become the major authority informing doctors how to diagnose diabetes and treat diabetes?

How is it that people who have never tested their own blood sugar after a meal once in their entire lives and who have close ties to those who earn the most money when your blood sugar goes south get to recommend diets to those of us who do?

And most importantly, what will it take for people with diabetes to make their voices heard by the ADA's top leadership, who currently give far more access to drug company executives and junk food industry lobbyists than they do to any of us who actually have diabetes.

If you can figure that out, send me an email. I'd really like to know!

P.S. Full disclosure: I was thrown out of the ADA's bulletin board by the ADA's appointed moderator who accused me of trying to promote my "agenda." As long as my email box fills with letters from people who tell me that my "agenda" changed their lives and health for the better and that they wish their doctor listened to people like me instead of the ADA, I will continue to do just that!


Laura Williams said...

Okay, I followed your advice, reduced my carbs (~150gm/day), and my A1C went UP. 5 one year, 6 the next.

Increased my carbs (wasn't tracking, don't know how much) and stopped testing, my A1C is down to 5.5. Why am I not going on an anti-jen rant?

Cause carbs make my readings go up. Carbs make me feel ill when I overdo. Carbs are definitely a big source of the problem.

I figure there's something else going on here, and I haven't figured it out yet. Your advice is not invalid, it's incredibly valuable: I just have to figure out what the other pieces of the puzzle are.

The Old Man and His Dog said...

Small note: My new "Diabetes Educator" could not understand why I told her I can't eat bananas. I told her my BS goes up and she said she never heard of that before and that if that was the case I should still try to eat them, but only half of one. We sure are in good hands with help like that huh? Needless to say I UN-enrolled from the $700 2 day diabetes education class they signed me up for.

Russ said...

Jenny, for heaven's sake, do keep promoting your agenda! I just picked up three copies of your book -- one for me, one for each of my local diabetic friends, one of whom has been in a treatment tailspin -- his a1c after years of "treatment" is as bad as mine was when I was diagnosed!


I want to note as an aside to laura williams above that 150g/day doesn't seem very "reduced carbs" to me. (I mean, I concede it's lower than, say, 200g/day, but it's not low, in my view.) Of course, I stick to a Bernsteinesque 30g/day give or take, so there it is.

I've been in the 5% club ever since I discovered your site (and through you, Bernstein), and this week my FBG was in the mid-80s every single morning, no medication involved. So yeah. Promote that agenda. :)


Anne said...

I saw a new cardiologist today. When I told him I was on a low carb diet, he was not happy. I told him that I use my glucometer to tell me what I can and cannot eat. I have found keeping my carbs to 20g per meal keeps my BG below 120 most of the time.

I am happy to say that my PCP understands that I want to get my A1C down to 5 and he is willing to work with me. Right now I am seeing how much I can do with diet alone.

I will be attending a Diabetes Update program tomorrow. Will be interesting to hear what they have to say.

Laura Williams said...

Well, I was probably on 300-400 a day before. 40 of that is my breakfast (oatmeal/oatbran), most of the rest is dairy (milk, cheese, yogurt) and the a single slice of bread, or a little bit of potato.

I'm pre-diabetic, so for right now that level is keeping my a1c normal. I don't know how I'd go lower without giving up dairy. :(

Anonymous said...

I am so glad I found this website. After surviving quite well without doctors, a recent trip showed glucose levels in the 200 range. Sometimes lower with the home kit, but obviously a problem. I do no like the doctor I went to. He mentioned going on some drugs, and that's it. I plan on reading through everything on this excellent website, and finding another doctor--perhaps a female endocrinologist, that is more in tune with what's really going on--at least interview her and see what her leanings are.

At least I will go in with knowledge--the low carb approach makes a lot of sense. I love the journal studies referenced on this site, and most people can understand them.

Anonymous said...

As a footnote to my last comment, the doctor quoted ADA guidelines on the definition of diabetes. He said two abnormal readings, and you're a diabetic. End of story. I asked for more informed information such as diet alternatives...and more information on the medication and side effects, which evidently p*ssed him off---with a sneer he said, you have diabetes and it's very serious!

I learned years ago the organizations in health care that people put their trust in, don't always deserve it--nor are they without bias.

I attended an FDA sponsored workshop over l0 years ago headed by David Kessler. He had started an iniative as far as handouts people should be given to inform them of side effects they should be aware of. By a certain year--somewhere in the 2000's pharmacies would be required to give handouts with the prescriptions. Now, this wasn't to take the place of counseling (although nowadays it does in some pharmacies)---Kessler had a sincere desire for people to become self-empowered, and to limit severe adverse effects by people becoming aware of what to look for.

The head of the AMA spoke. My mouth dropped when he spoke against giving too much information out. He had two reasons. One, that was giving medical advice and only doctors were qualified, and people would get scared and not take the drugs. Secondly, people would throw the handouts on the floor, and not read them, and that would create a slipping safety hazard. I couldn't believe what was coming out of his mouth.

SO...when it comes to large medical organizations and what they spout, caveat emptor (buyer beware).

Anonymous said...

To Laura Williams,

I can't imagine why you would consider dropping dairy before dropping the oats, the toast, and the potatoes. Those are all high starch/low nutrient foods whose limited nutritional benefits can be obtained elsewhere from non-starchy foods).

I can understand dropping milk and substituting cream or half & half to reduce the lactose (milk sugar), but only if dropping the grains and spuds isn't effective enough.

There's a good chance the missing "puzzle piece" is still too much starch, especially for breakfast, rather than too much dairy. Have you given that any thought or experimentation?

Laura Williams said...

Yep, I have tried things. No carbs at breakfast means I don't function well in the morning. My brain just works better on a solid breakfast. I do the oatmeal/oatbran because it doesn't spike my sugars too badly, low gi enough.

The toast/potatoes is the only other starch I have all day. I don't have the willpower to go starch-free, but I can stick with smaller doses, whole grain/low gi and less often.

Anonymous said...


I am so disgusted with the ADA . . . and their claim to represent/serve the interest of ALL diabetics, as well as their solicitations to 'find a cure.'

Below is my most recent response to their extortionate entreaty for financial support:

American Diabetes Association
1701 N. Beauregard St.
Alexandria, VA 22311

To Whom It May Concern:

I am returning your nickel and want you to remove my name from your mailing list. Please consider that if you had saved the bulk-mailing cost for this letter, you would have had a few more nickels to “find a cure for diabetes.”

In fact, any group that has done such a poor job of finding a cure for diabetes over the many past decades should probably cease operation. At the present time, you are nothing more than a “shill” for the pharmaceutical industry and ancillary businesses that prey on the diabetic population. Your emphasis on “education” is also nothing more than a ruse. All you really do is “educate” diabetics to patronize your corporate sponsors.

The enclosed letter is only your latest attempt to fraudulently elicit contributions from me. I will consider any further contact by you as harassment and proof that your charitable efforts are akin to fraud/false claims and specifically target vulnerable individuals like myself who has been diabetic for over 50 years.

What gives you the right to harass me, use my disease as a tool for extortion, and accept money in my behalf from gullible people and corporate sponsors when you have no intention of ever finding a cure.

Very truly yours,


Unknown said...

I only had to go down to 150g (not counting fiber) to get an A1c=5.5% and I started at 12.3%. I'm eating lower than 150g now because I found out I feel better with less carb than that and my A1c was 5.2% the last 2 times and I'm not taking anything but Metformin, now.