Dissecting an MD’s … ADA Minion argument


I’ve had many conversations with ADA Minion … my most recent (prior to this week) was with a PhD on twitter, here is that post,  “Primal Fun with a PhD“. What is an ADA Minion? In brief it is anyone who…. a) Promotes the ADA Way diabetes treatment of “Carbing Up and Shooting Up” b) Who profits from such ‘promotion’. I talk about it here in this post, “You Might be an ADA Minion” and clarify it here, “Reader Comment“.

The formating for this post is not the best, I had difficulty pasting from Google Plus… hope you can read and follow it. :)

 

Is ADA Minion meant to be a Derisive Phrase?

…. you bet.  BUT that does not mean that I believe ADA Minion meet behind closed doors and decide how they are going to keep diabetics on drugs and insulin… I do not. However that is THE outcome of their “carb up and shoot up” philosophy.  It increases drug and insulin usage for most diabetics….that’s a fact.

I do believe that ADA Minion do NOT promote a low carb paleo meal plan for one of these reasons…
a) Intellectual Laziness
b) Willful Ignorance
c) Greed
d) All of the above

Note:  As you read the following post(s) … keep this question in mind. Of the (4) responses … which one best describes his reasons? 

Meet the MD

Note: we ALL were high carb and low fat at one time… this post is not meant to belittle the doctor. The intent is to highlight the error in his logic, hoping the example will help a diabetic or a doctor to ‘see the light’ when it comes to low carb paleo living.
Also, I believe Dean Jenkins to be sincerely interested in helping diabetics.  Though we have never met nor spoken, I believe if we were to meet, I would say he was a ‘nice guy’.
From Google Plus “About Section”.
Note, this is only a partial listing, I pulled out those items pertaining directly to diabetes management.  A full listing would take up an entire post, the gentleman has many accomplishments and awards.

Dr Dean Jenkins DipMedEd, FRCP qualified from Cardiff and trained as a consultant physician (general medicine / geriatrics). He has developed interests in the care of people with diabetes (particularly the elderly) and the education of health professionals.

– Developing a distance learning diploma in diabetes (diabetesdiploma.com) on behalf of BMJ Learning and validated by Leicester University and is advising and negotiating on the development of other distance learning diploma / MSc courses.
Previously a Consultant Physician at Princess of Wales Hospital, Bridgend, he has also worked on the Consensus Guidelines for Diabetes Mellitus across Wales (Designed for the Management of Adults with Diabetes Mellitus across Wales: Consensus Guidelines. 2008) as chair of the sub-group for Standard 4 (Clinical Care of Adults with Diabetes)
As you can see… Dr. Jenkins is well suited to ‘argue’ diabetes management.  He has helped educate health professionals regarding diabetes, he’s even developed a distance learning diploma for diabetes.  He even worked on the Consensus Guidelines for Diabetes accross Wales…
… as far as ADA Minion go … this doctor is not a ‘newly minted CDE’  who just parrots what he’s recently learned…. or is he?

First Discussion

If you have difficulty reading this section due to formatting, here is the actual post on GooglePlus

https://plus.google.com/107432884544968913388/posts/5E83nnUyXuE

 

These discussions are copied and pasted into this post. Other than formatting the comments have not been edited… my ‘post comments’ will be in bold & blue.
1) Dr. Jenkins posted the article below…. 
Recent diabetes articles of interest. #diabjcTime spent watching television predicts cardiovascular mortality. Vegetarian diet better than conventional diabetes diet. Viewing foot ulcers in 3D telemedicine. And … is there a dose response curve to telephone interviews?

#diabjc July 31 2011
The week ending July 31st 2011 – newly published diabetes articles of interest
  –  Comment  –  Share
I noted the ‘vegetarian’ diet statement regarding diabetes and I asked an innocent and honest question.  I would LOVE to talk to a vegan type 2 who has weaned off drugs and insulin. I sincerely hope there are some… if so, in my opinion, that would be the ultimate experiment. :) 
steve cooksey's profile photo

steve cooksey – Are there any type 2 Diabetics who have weaned off drugs and insulin while eating a vegan diet? I would LOVE to talk to them.I know several (including myself) who have done so while eating a ‘low carb’ paleo meal plan.
Yesterday 2:33 PM  –  Edit
Dean Jenkins's profile photo

Dean Jenkins – I think the whole philosophy of the paleolithic diet is very interesting. Would make for a great debate about the genetics of type 2 diabetes! I feel the different ‘diets’ vary because with them come different cooking techniques and ingredients. Efficacy comes from the quantity and the glucose excursions they incur. Modern diets have ‘calorie’ pollution. However, we live longer than our paleolithic ancestors – long enough to get Type 2 Diabetes.There are a number of people who have reversed the metabolic features of Type 2 Diabetes through sheer determination to lose fat, gain muscle (and insulin sensitivity) and exercise. Bariatric surgery is very effective at weaning off drugs as well.Before the discovery of insulin extremely low carbohydrate diets (The Frederick Allen diethttp://centennial.rucares.org/index.php?page=Dietary_Therapy_Diabetes) was used with some short term success (in keeping people alive) with Type 1 Diabetes.
Yesterday 6:32 PM
 I ignored the topic of lifespan of paleolithic man … debating how long our ancestors lived was secondary. I am a veteran of “online discussions”, a frequent debate ploy is to sidestep the real issue by creating diversions. 
Dean Jenkins's profile photo
Dean Jenkins – Found this review and link to the literature on the ‘paleo diet’.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2787021/
Yesterday 6:47 PM
A nice gesture on the doctor’s behalf, posting a link he’d discovered.
The doctor did ignore my request for someone who was a vegan and who had weaned off drugs and insulin…
My reply…. 
steve cooksey's profile photo

steve cooksey – +Dean Jenkins I don’t need proof that paleo diet works for diabetics… (and many other inflammatory diseases).I’ll ask again, do you know any Type 2 who has weaned off drugs and insulin eating a vegan meal plan?I really would like to know. I LOVE to experiment with different nutrient ratios … I am thinking of doing a vegan ‘experiment’ … but I want to talk to at least one person who has done it. I have asked many times over many different social platforms… and have found no one. … I seriously have my doubts.Many vegans are ‘controlling’ blood sugars etc… but are still taking drug +/or insulin.
The doctor never replied to my comment above…. but I was not deterred.
 
The doctor did however post an article regarding a ‘low carb’ diet for Type 1’s. This is a separate post and began our second ‘discussion’. 
———————

Second Discussion

Here is the post in GooglePlus if you have difficulty reading this here.
https://plus.google.com/107432884544968913388/posts/U9dBe8g7prS


Dean Jenkins  –  Yesterday 6:37 PM  –  Public
The Frederick Allen diet was used for the treatment of Type 1 Diabetes before the discover of insulin in 1922. It involved very, very low carbohydrate diets that left patients alive but on the brink of starvation.Not to be recommended! Insulin is much more effective.
  –  Comment  –  Share
Note the doctor’s commentary… it show’s his bias against low carb diets. It’s restated below…it shows a total ignorance for facts.  Low Carbohydrate meal plans will not starve a patient… as long as they receive enough protein and fats. 
“It involved very, very low carbohydrate diets that left patients alive but on the brink of starvation.”
My Reply is below.
steve cooksey's profile photo

steve cooksey – Do you know the specific nutrient ratio of his meal plan? It appears you have misrepresented the study and the facts.Low Carb does not cause starvation… the article states that his plan was “a restricted-calorie diet that provided mainly fat and protein, with the minimum amount of carbohydrates needed to sustain life. “Many days I eat less that 20g of carbs… but it is NOT calories restricted. I’m in the best shape of my life at 50 yrs old.I eat sub 30g of carbs most days.. but always sub 50g… not only am I not ‘starving’ but I am THRIVING.
Yesterday 9:21 PM  –  Edit
YOU SEE… the article the doctor was quoting stated  ‘a restricted-calorie diet’ … yet the doctor failed to mention that…. 
The doctor replied….
Dean Jenkins's profile photo

Dean Jenkins – Good for you! Not many people have the determination or nutritional skills to be able to achieve the same.I’m not entirely sure of the exact content of the Allen diet but this review article might help.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2315645/It suggests that 2% of the daily 1795 calories came from carbohydrate. What that equates to in grams I’m not sure.
4:58 AM
…. the doctor trains other doctors on diabetes care and develops a diabetes diploma… and has no idea what ‘that equates to”…  AND YET … no mention of a Type 2 Diabetic who eats a vegan meal plan and has weaned off drugs and insulin… my reply. 

steve cooksey – Thanks Dean.
1) I’ve asked you twice for the name of one Type 2 Diabetic who has weaned off drugs and insulin eating a vegan meal plan. … I’m assuming you don’t know of any since you ignore the question.
2) Let me address each point. I am not intending for this to be mean-spirited nor personal…. it’s just frustrating to see the lack of knowledge … even from people who are associated with the ‘diabetes industry’.
a) My determination? Granted, I have a high level of determination but how many MORE diabetics could do this… if they knew about it? How many MORE WOULD do this … if their so called ‘diabetes educator’ even MENTIONED IT. How many MORE would / could do this if they were encouraged to go low carb paleo??? In the overwhelming majority of cases, diabetics are never told about low carb paleo … and if mentioned, it’s ridiculed. Even with your background in diabetes … your lack of knowledge highlights this issue.
b) Nutritional Skills?
… it’s basic Diabetes Management 101 … carbs = glucose = drugs and insulin
Cut the carbs and you ‘naturally’ reduce glucose.
c) You do not know how many grams of carbs 2% of 1795 calories is,… given you background and interest in diabetes management…
Let’s round up to 1800 calories. 1% would be 18 …so 2% would be 36 calories or @ 9 grams per day. (carbs are @ 4 calories per gram.)
My historical ‘average’ since diabetes diagnosis is @ 20 grams per day. I average 2400 calories so I eat a lot of fat and protein… I am not starving… I am THRIVING.
Our bodies need @ 120 g of GLUCOSE per day… we do NOT need to consume CARBS TO LIVE… nor to THRIVE.
The body makes all the glucose we need via gluconeogenesis, that and ketones provide us with our energy requirements assuming we eat enough fat and protein. What I tell you is the truth… Here is my story and a few others… everyone that goes low carb paleo reduced drugs and insulin.
Why not treat the disease instead of the symptoms?
Start today…
.
.
The doctor’s reply.
.
 1) I do know quite a few patients who have ‘reversed’ their diabetes with lifestyle changes even for a number of years. Since I’m a practising physician I’m not going to divulge who they are without their permission. I wasn’t avoiding your question just … eh … not answering it. :-)
.
2)
a) fair enough but not all patients have the capabilities to follow diets
b) in an ideal world yes but not all people can
c) thanks for the nutritional analysis. I’m sure I could have worked it out if I had tried but I rely on dietitians to do that. Good learning point for me. Carry on your advocacy for diabetes! Low carb diets are being researched and appear safe (and beneficial) for people with diabetes. I suppose the ethos of diabetes management has been to use the technologies we have to enable people with diabetes to live a normal life.
8:19 AM    
…. so the main reason the doctor does not share “Low Carb Paleo” to diabetics???
…. drumroll please….
“not all patients have the capabilities to follow diets” ??? 
My reply should have been… so we should stop going to doctors since going to doctors doesn’t always work???

… my REPLY.

You seem to be sincerely interested in diabetes treatment… but you must stop looking at it from that of a doctor… a pill or drug prescriber. Look at it from the patient stand point.

High carb meal plans tax the pancreas in Type 2’s… eventually leading to pancreas failure. Nothing good comes of eating a high carb meal plan… nothing.

1) You are still AVOIDING the issue. The question was not if someone was “reversing”. Please…Just answer yes or no… do you know anyone who is following a vegan meal plan who has weaned off drugs and insulin AND who has normal blood sugar? If the answer is yes and they are willing to do so… please have them email me at [email protected]

2)

a) “not all patients have the capabilities to follow diets.” … tsk tsk. So the ‘diabetes industry’ plays god and decides… we’re not going to tell the majority of diabetics about low carb because some can’t do it??? Don’t worry… you are the first to come up with this excuse.

b) “in an ideal world yes but but not all people can. ”

 

Since not everyone can… the “diabetes industry”…tells almost no one about it??? This can not make sense to you.

How many lives could be saved if MORE were told and encouraged to go low carb??? And <gasp> even encouraged and coached how to do so…. c) re: Dietitians… yes… that’s probably the saddest part of this ‘exchange’. .. Dietitians pushing grains and carbs… how’s that working out for diabetics?

90% failure rate according to industry report.

http://www.diabetes-warrior.net/2011/03/04/is-90-failure-rate-good-enough/

So the answer is to have them continue eating the same ‘diabetes diet’ … that IS the definition of Insanity.

Think critically … for yourself. Carbs = glucose = need for drugs and/or insulin. Concerning your comment about “live a normal life” … do you know how ridiculous that sounds? Seriously? re: normal … 90% of diabetics FAIL … amputations, organ loss … neuropathy… all rampant.

What the hell is normal about that???

 

I eat meats and vegetables and I thrive! … In your version of normal … it means taking more and more drugs and insulin… just so a person can eat grains and sugar.

I do appreciate this opportunity for exchange.

Above was my last comment, I’ve not heard back from the doctor in a couple of days.  Should he reply, you shall have it.

 

Summary

To be honest I was very disappointed… it really was more of the same old ‘excuses’.

“Not all can do it” and “they deserve to be eat like normal people” …

EVEN if that’s true and it’s not… don’t ‘they’ deserve a choice?

Don’t diabetics deserve to HEAR about low carb paleo meal plans and the successes?

Above all … STOP RIDICULING THOSE THAT DO IT!

Damn it… give them a fighting chance.