I was in suburban Chicago recently one morning, hoping to get something to eat for breakfast. I’d heard that the Panera chain was now serving breakfast that you could order any way you wanted. It’s called “Panera Bread,” but I thought I’d give it a try, as I’ve safely consumed their salads in past.
At the counter, I placed my order for 3 eggs over easy, sausage, and bacon—not perfect, given our inability to scrutinize foods and ingredients in such places, but I was willing to try. Obviously, I turned down the breads/toasts that were included. The middle-aged Hispanic woman behind the counter raised her eyebrows and asked, “Why no bread?”
I replied simply, “Bread makes you fat and diabetic. I was a type 2 diabetic 25 years ago. I’m not anymore.”
“Really? I am diabetic, too, but I cannot give up my tortillas.”
A brief, casual encounter, but I am nonetheless always surprised by such responses based on comfort and habit, people who are unwilling to leave their comfort zone. We all know what a future of type 2 diabetes looks like:
- Marked increase in heart disease, heart attack
- Increased risk for stroke
- Peripheral vascular disease
- Diabetic retinopathy and cataracts
- Kidney disease and failure
- Peripheral neuropathy
- Foot and leg amputations
- Gastroparesis
- Increased risk for dementia
- Life shortened by about 8 years
- $10,000/year added healthcare costs
It also makes me wonder if people who provide such responses really understand the gravity of their condition, or maybe choose to ignore it. During my over 30 years of cardiology practice and training after medical school, I witnessed countless people with kidney failure from diabetic kidney disease, often resulting in dialysis, a miserable experience; thousands of strokes and heart attacks; oodles of peripheral neuropathy with loss of sensation and chronic pain, resulting in gangrene and amputations; and, of course, I’ve seen many, many diabetics experience premature death.
We all recognize that the wrong response to an encounter like the one above is to press hard and try to persuade someone that they are throwing their health and life away for a disease that is nearly always completely reversible back to normal, or at least minimizable. I believe that all we can do is set the example of health and answer the occasional question, hoping that each person hears the same message from others as more and more people realize that type 2 diabetes is an easily reversible disease.
SSDD…I don’t even try to persuade others to not eat grains anymore. It just causes more grief. Belief in yourself and be satisfied.
Dan wrote: «I don’t even try to persuade others to not eat grains anymore. It just causes more grief.»
People are hardened to anything they perceive as selling (usually click-bait secret sauce patented potions), or crusading (e.g. militant ‘ism evangelists).
re: «Belief in yourself and be satisfied.»
As the dialog in the article suggests, you are going to continually encounter people complaining about their health. What we need to clarify with them is: would you like to make that problem go away, or are you just seeking a sympathetic listener? You can lead with: can I ask why you are telling me this?
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That’s how I have handled it. Wheat/Grains appear to be too powerful an opioid for most to kick.
Dan wrote: «Wheat/Grains appear to be too powerful an opioid for most to kick.»
Just consider the quote of what the counter clerk said:
“Really? I am diabetic, too, but I cannot give up my tortillas.”
When I hear this, my reaction is: Whoa. Did you hear what you just said?
It’s the gliadin/zein and the cleaved amylopectin-A talking, plus perhaps neuro-active metabolites of some adverse gut microbes that don’t want the substrate stream to subside.
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It would help if doctors educated people about the gravity of the disease as soon as they started trending toward it instead of waiting until a person crosses an arbitrary threshold where damage has already been done. The requisite ‘dietary education’ for those diagnosed that is forced on people in order for their insurance to cover any treatment for the disease amounts to nothing less than malpractice. Thanks to a few doctors who are willing to research and think on their own we are becoming aware of just how bad our food supply is for us and what we can do to heal ourselves without medicine and becoming beholden to the medical industrial complex.
Linda wrote: «It would help if doctors educated people about the gravity of the disease as soon as they started trending toward it…»
That might raise the question of: well, doc, how do I prevent that? And today’s consensus sick care providers, for the most part, haven’t a clue. Plus, if they did, it would be bad for business, so they are incented to not find out.
We need to be blunt about this. T2D is no more a “disease” than ALD (alcoholic liver disease). Both are largely predictable biologic responses to chronic metabolic insults (excess carbs in T2D, excess C₂H₆O in ALD). T2D is trivially avoided, and usually straightforward to reverse (to the extent that any developed complications are).
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I just say that I don’t like bread, which is not a lie. If the person is super confrontational, I just affirm my belief in “Natural Selection” and let it go at that.
We can blame the medical community and the drug companies and they certainly at aren’t innocent, but let’s face it.
You can’t fix a problem without uncovering it and all its dirty little secrets.
We patients have played our part in the fiasco that is diabetes treatment.
We’ve allowed the powers that be convince us that medication is the only way. The diabetes associations to convince us that high glucose is ok and there’s no need to feel left out.
We’ve turned to our doctors for a tourniquet and been given a band aid and we’ve accepted it as though it were gold.
We want to eat what we want to eat and to Hades with the consequences.
We’ve played a part in our own room and it’s only when we tire of the same old same old, that we begin seeking answers.
That’s the time to strike!
I never tell folks anything until I see they’re asking, not simply making conversation.
When someone tells me they have diabetes, I simply say
You don’t have to live that live.
You can largely fix this and it’s easy.
They’ll be back if they’re really interested.
I can give them statistics
Truth
Instruction
But until it’s wanted, it’s just hype
It’s just my story and it may not help them (another myth)
But on the other hand
If we sit idly by, we surrender those in this situation to the status quo.
Strike when the iron is hot
Let them see your results
Let that be the driving force behind their curiosity.
Dwayne Robinson wrote: «We patients have played our part in the fiasco that is diabetes treatment.»
Avoid any temptation to blame the victim on this, although the remainder of your approach is excellent.
And also keep in mind the presumptions that the typical victim has. As I put it in a subscription site forum discussion lately, most people think that:
• T2D is a real disease,
• is random,
• has nothing much to do with diet, and
• that the sick care system expertly addresses it optimally.
That all of that is false is a bit much for some people to chew on.
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I think the medical community is in denial. I have a cousin that developed diabetes 4 years ago .She was told to be careful with sweets, but no to avoid them… just check your blood levels ant inject as much insulin as you need. She’s eating pastry and then she goes to the bathroom to check her blood levels. Well, the thing is that the doctors say that’s okay. When she looks at me she’s surprised that I’m not eating any Wheat just to prevent to become a diabetic. She thinks I’m crazy to avoid such a tasty treats and to be so strict for nothing. If I try to educate her she doesn’t like it and of course she doesn’t believe me… the doctor says different.
Toby Lime wrote: «I think the medical community is in denial.»
There’s little doubt of that. In addition to owing apologies to millions of disabled, maimed and deceased victims of their care, there’s also liability to consider.
Part of the process is going to be competing liabilities. Dr. Richard K. Bernstein, self-directed healthcare pioneer (and T1D victim), is convinced that the main reason most care providers won’t discuss low carb in T2D is because they are terrified of liability for hypoglycemia if the diabetic mismanages the med wind-down. On the other hand, the consequences of hyperglycemia (e.g. heart disease, cancer, dementia, blindness, neuropathy, amputation) are merely “expected” consequences of “incurable” T2D, for which the MD is not liable.
Well, lawyers get T2D also, and some of them are going to discover that it’s a trivially avoidable optional ailment, usually easy to reverse, and always ideally managed via diet—exactly none of which they hear from their sick care providers. Sooner or later the legacy liability fret is going to be balanced by an emergent liability threat.
re: «If I try to educate her she doesn’t like it and of course she doesn’t believe me… the doctor says different.»
Here’s the deal there. People either take responsibility for directing their own healthcare, or they abdicate it. Abdicating it to you is just the other side of the trusting-the-doc coin. What needs to happen is to get victims to decide to no longer be victims, and get into the driver’s seat. That mindset paradigm shift is actually a different challenge than the details of the optional ailment at hand.
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Everyone on this planet needs more of this discussion, as well as more folks like Dr. Davis, willing to speak in clear terms about what supports wellness. Yes, the rest of us need not to be preachy but, at the same time, to sense when there is genuine interest, and support efforts toward real health.
I like that Panera Bread offers some pretty decent salad options, and they are moving toward more “real” menu choices. We can support THEM, too, for that.
lia wrote: «I like that Panera Bread offers some pretty decent salad options, and they are moving toward more “real” menu choices. We can support THEM, too, for that.»
The brand name is an issue. If they wait until the word “bread” no longer automatically implies gluten-bearing and/or sky-hi-gly-carb-GF, it may be too late.
But they have apparently made some progress since the “secret menu” days of 2013. They still can’t assure FDA spec “gluten free“, though. This is an issue for anyone with celiac disease, and as I understand the back-story on that, the secret menu arose because a corporate principal had a spouse with that ailment. Oops.
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I wouldn’t say is preaching to tell somebody the truth. I feel responsible to do so. I believe it’s not fair to avoid the conversation that can save somebody’s life. I wish the doctors were the same. Instead of sticking to their stupid prescription medications I wish they advise how to avoid those prescription medications. I used to ask about alternatives to their prescription. Looks like they’re very skeptical to tell you whatever they know to fix you. I think this is an irresponsible and unethical. I’m trying to fix my health problems by educating myself because I lost my trust in doctors. But most of the patients don’t ask so many questions they just follow the advice of the doctor and they suffer the consequences. It’s a shame that somebody will be afraid of lawsuit even though they can save somebody’s life. Maybe we should promise them not to sue them just tell us the truth. LOL!
On this note , if somebody knows a decent endocrinologist in Indiana or PCB Florida please advise. Thanks.