15 January 2011

The Deadly Diets

Think what you are eating is healthy? This is a study that points out a lot of problems in the different types of diets. This only scratches the surface in my opinion and needs much more attention. Why this study choose the elderly is somewhat of a mystery, other that they were looking for death to happen for the success of their study.

Yes, I think that is the answer, by selecting adults between the ages of 70 to 79 their chances of saying deadly diets would have been a lot less accurate and they would have had to reach for some of their conclusions.

They do have some valid food groupings; however, they failed in their descriptions of the quantity of food consumed. If the food intake levels of calories were above normal, then the results may well be skewed.

All items considered, this study does not really solve anything and if this was rewritten from a press release, then the study was poorly constructed and gives us minimal reliance on their findings. The only thing giving this any credibility is the number of participants and the fact that the eating patterns were monitored by the researchers.

You may read the article here. I dislike reporting on this type of study, but felt that more should read this for the experience of seeing how studies can be set up to get desired results.

14 January 2011

Basics For Patient Empowerment

Trisha Torrey at about dot com is my favorite in writing about patient empowerment. She wisely covers many points and once in a while gets a little controversial. This is probably why I enjoy reading what she writes.

Her article is very interesting and everyone should take time to read it. Then take her eight tips and compare them with Ronald at the poor diabetic dot com. While some are nearly the same, they both have differences and are good basics to print and have available for reference or bookmark them as references.

Patient empowerment do not mean that you are overbearing and demanding of your doctor. It does mean the you are knowledgeable about diabetes and will not blindly take advice if you know that it is wrong. You will not be argumentative, but you will be polite and firm. Even this much can scare some doctors into asking you to go elsewhere. So be prepared.

In the above link on Trisha Torrey, she has a definition of patient empowerment. Quote: Patient empowerment has a handful of definitions. Most focus on the concept of the patient taking an active role in his own disease management, and supporting that participation by learning all he can about his disease or condition and treatment options. Unquote

This definition is good as far as it goes, but is not complete for me and I think needs refining. I would add that the “patient must also learn how to participate with the doctor to build a doctor-patient trust that will work to get the best treatment possible.”  This may create problems for some patients because their doctor will not do this. But the attempt must be made and slowly for the best results.

Please do take the time to read both links above and watch for more blogs about patient empowerment. Trisha has some history about patient employment and both have important messages in their tips for what an empowered patient does.

13 January 2011

Suggestions for New Diabetes Patients

I have written about this before, but thought it was worth repeating as there are people every day being newly diagnosed with diabetes. I am writing about my personal experiences. I am a person with Type 2 Diabetes. Any advice that sounds good should be discussed first and always with your doctor. The italics are from my earlier posts.

I was diagnosed in October 2003 while in the hospital with angina problems. The last (almost) seven years have been a learning experience and have not always been easy.

The first thing I had to learn and accept was - it was not my fault. The second lesson took a lot longer - I cannot change the past - it is the past and I have to learn to live in the present. Painful, yes, and at times harder than a real job. This requires my attention seven days a week and does not allow for a vacation.

The above statement is the first rule for anyone newly diagnosed with Type 2 diabetes. Many people spend years suffering because they cannot put the past behind them and still believe they are somehow at fault. If you are that way, please realize that you would have to blame all your ancestors. Yes, all, because they gave you the genetic possibility to develop the diabetes that you have. One may have given you a part and another something else, and then you did something that triggered the diabetes you have. This may be a simplification, but could well be what happened. Several generations may have had the setup for diabetes, but it was never triggered.

Once you have followed the first rule, then you need to start reading as much about diabetes as you are capable of reading. There is a lot of misinformation on the internet, so be cautious. There is also a lot of correct information and often the situation will easy to discern.

One of my fellow bloggers has an excellent blog on becoming a more informed advocate for yourself. His discussion is to the point and more people need to learn this art of patient empowerment. Doctors also need to learn to work with patients in a non-confrontational manner. This would be a win-win situation for both. The doctor would have more time for other patients and the empowered patients would get better treatment.

12 January 2011

The Press Media Today is Basically Inept

This includes radio, television, and internet media.

When I was in college, I took a few journalism courses just for the fun of it. I knew if I continued in my course of study, I would be dealing with the press and printed media, newspapers, magazines, radio, and other media and they would be holding the mike.

The first principal I remember was that we must cover the who, what, where, when, why, and how. If these were not present in a story, then we heard about it. Back then professors could get away with techniques that today don't seem to be allowed.

Today news is headlines and very little else. Seldom are the hard facts even presented. It is more about opinion and agenda that the reporter wants to present. For TV news it is all about ratings and thus we get sensationalism and very little factual news. This is not what I listen for and as a result I seldom do. I even have problems with most printed media. Regardless of the facts, it is sensationalism that sells.

Jon Barron reminded me of this in his article on Vitamin D. His comment on the media was this: “Unsurprisingly, the mainstream press simply parroted back a summary of the report with the usual over-the-top headlines. But enough of picking on the press! It is now perfectly clear that the mainstream media no longer has the budget to support "investigative" journalism, with the possible exception of one or two major stories a year. All that can be expected when it comes to health and nutrition is that they parrot back the "news" they are given. That means that when a credentialed organization such as the IOM issues a report, the press will merely rework the press release issued by the researchers, add a "sexy" headline, and publish it as fact -- unquestioned, unexplored, and unchallenged. Unfortunately, that means that a lot of nonsense gets reported as "health fact" since credentials don't guarantee competence. In fact, they often mean corporate ties, hidden agendas, and huge bias. That means that if you want to truly understand the real story, you have to dig deeper and look at the underlying facts yourself or turn to alternative sources of information that you trust.”

This says a lot and is so true. Since I do not have the budget for more investigative reporting, I am also forced to use what I can find. Occasionally, I am able to get to the underlying facts of a study and then I find out how bad the study really is and seldom finish.

11 January 2011

Report on ADA Standards of Care

Well, the latest standards of care defining the types of diabetes did not change much. I have to wonder about those serving on the board or panel making these decisions. They have had the opportunity to make some significant changes and better identify the types of diabetes, but they seem to wallow in the past and so nothing substantial to clarify and make some generally accepted changes that are needed have even been attempted.

I know that I have no medical training and probably being looked down some noses that are in power, but when people are so entrenched in dogma and not interested in the progress of diabetes, then I say it is time for changes. These are times when the problem of diabetes is becoming a pandemic world-wide and needs action.

I may have rocks in my head, but my ire is directed at the American Diabetes Association where the powers that be have their heads buried in the sand.

The only change of note in the standards of care presented in September 2010 and published near the end of December 2010, is the change in how gestational diabetes should be diagnosed and treated. This is at least one thing that did need updating for that I am glad.

There are some minor changes to other provisions and I will try to cover them in the future.

Read the January 2009 standards here and the December 2010 standards here. The press release article is here.

10 January 2011

Shared Medical Appointments SMAs

When I first wrote about this back on 29 May 2009, I was quite skeptical and a little unbelieving in the usefulness of this. Now I realize that this may have some value and may be quite helpful in certain groups. Again I must say this is not for every physician and patient.

Studies are proving that this can work and after talking to a couple of people that have been involved in SMAs, I am beginning to see the value and how it can work. There are some rules laid out here (near the end) that should be followed to make these work. When they are an integral part of the program, and in the hands of a knowledgeable and caring physician they do seem to work quite well.

While talking with two people is not very representative, I can report that both said they were very apprehensive when introduced to the idea. After several meetings and slowly getting to know others in the group, they found that there were benefits they had not considered. Both agreed that just knowing others had the same problems and concerns was part of what bound them together as a group.

They both felt that some people did not belong in their SMA, but most of the group seems to be doing a lot better and some were staying in touch outside the SMA. This SMA was not about diabetes.

The latest study chooses to call SMAs diabetic group visits (DGVs) probably because they are for people with diabetes, Type 2. It was led by an MD from Flint, Michigan and only included 51 participants divided into two groups. I will let you read about the study here.

I am not an advocate of small studies and I do wonder why they cannot find more for these studies. Even with this the more of these studies they do, the more evidence that will build showing whether or not SMAs will work and how well or poorly.

I will be very interested to see if this is something that will ever happen in this area. I have met a few very interesting people while waiting for endocrinologist appointments and it would be interesting to find out if SMAs would work.