This spring I begrudgingly attended the American Diabetes Association Diabetes Professional Educators Conference in Middleton, Wisconsin. This is an annual conference to earn continuing education credits required to keep my certified diabetes educator credential.
I attend in anticipate that “things” have changed and this will be the year I am inspired and hopeful for the future of diabetes care. Sadly, this wasn’t the year.
Let’s start with the food served. The American Diabetes Association’s mission is to “prevent and cure diabetes and to improve the lives of all people affected by diabetes.” Why not start with improving the lives of the educators by serving food and beverages that do not cause soaring blood sugar and contribute to this chronic disease that afflicts 29.1 million Americans or 9.3% of the U.S. population?
Being that this wasn’t my first rodeo, I knew the food options are deplorable for a dietitian/diabetes educator like me that does not subscribe to the party-line hype of eating healthy whole-grains, nor carbohydrate-laden meals. I enjoyed eggs before I arrived for day one of the conference. Glad I did! As I entered the breakfast area, tables full of pastries, muffins and fresh fruit greeted the conference participants. This type of carbohydrate-laden breakfast would be the exact opposite of anything I suggest for an individual trying to prevent or manage diabetes.
The afternoon break included snacks of you guessed it, more carbohydrates: lemonade, iced tea, popcorn and pretzels. Seriously!
The American Diabetes Association (ADA) nutrition guidelines state, “Evidence is inconclusive for an ideal amount of carbohydrate intake for people with diabetes. Therefore, collaborative goals should be developed with the individual with diabetes.” I don’t think you will find a shred of evidence that the amount of carbohydrate served at this ADA conference is conducive to managing blood sugar, weight, or other metabolic imbalances. Nonetheless, let’s keep the sugar train coming for our attendees!
My other point of contention is many of the conference speakers and breakout sessions have ties and conflicts to the pharmaceutical industry, which make billions off the disease, not the cure.
As the number of our friends and family members living with type 2 diabetes continues to increase, the “let’s throwing more medications after the diagnosis plan” is working fantastic for those in the business to make money off the disease. Stark contrast, I am in the business of helping clients achieve health and wellness. I happily accept coaching clients on prevention and reversal of type 2 diabetes is bad for my return business.
On day one, there was an optional lunch lecture sponsored by a pharmaceutical company. In other words, to get the free lunch you had to listen to a presentation from a physician speaking about a particular medication. Really? Isn’t this conference for educators to get accurate information to “prevent and cure diabetes and to improve the lives of all people affected by diabetes” not propaganda from the industry? This was a paid attendee conference with several hundred diabetes educators in attendance. Wasn’t there enough money generated to include a promotion-free lunch with the price of admission?
I would speculate more dollars come into the conference from exhibitors (sponsors), which lined the exhibit halls peddling their products, than attendance fees. It’s just a guess based on the deep pockets of the sponsors.
Conflicts of interest were ethically and rightfully disclosed prior to any presentation. Interestingly, the presenters who were on a speakers bureau for the pharmaceutical or diabetes supply industry spoke very little about self-empowerment or the positive impact lifestyle changes can have to improve lives of those living with diabetes. Instead they focused on when to start medications, how to adjust and when to add the next medication.
For example, an endocrinologist who presented on the topic of insulin resistance was on the speakers bureau for two diabetes medication manufactures. It was fitting this speaker had two slides discussing, “Always encourage diet and exercise as first line therapy for insulin resistance” but the remainder of 75 minute presentation was focused on pharmaceutical interventions. The power of exercise and diet to reduce insulin resistance was a huge missed opportunity.
Another endocrinologist disclosed a conflict of interest due to being on the speakers bureau for a pharmaceutical and two diabetes supply companies. Do you think endocrinologists on the payroll for Big Pharma truly have a vested interest to recommend nutritional approaches over pharmaceutical interventions in their 15 minute office visits?
Leads to me ponder, when education is offered at the hands of the industry that thrives off the disease, how successful will the ADA be at finding a cure? Particularly, when research supporting lifestyle interventions outperforming medication and returning blood sugar levels to normal has been available for over a decade? Is the “cure” [lifestyle] underneath their nose and not promoted as there is no money to be made without Big Pharma support?
One may argue that people need these medications to control the disease and educators needs to understand the medications and diabetes management devices. Of course, front-line diabetes educators need to understand the medications that their patients are taking and for those with type 1 diabetes, such as my brother Tim, insulin is required to live.
I’m talking here about type 2 diabetes, which is the large majority of new cases each year. What about sharing information such as non-conventional yet effective approaches, like a low carb, wheat-free diet that have remarkable success improving the lives of those living with diabetes? What happens when we remove the food triggers that cause sky high blood sugar in the first place? What about practical tools to assist with adequate sleep, exercise, gut function, and stress management to name a few?
Indeed, the American Diabetes Association has many programs in place throughout the country “to improve the lives of all people affected by diabetes”, but there is substantial room for improvement, from my perspective, with education offered.
The reality is the diabetes epidemic is much larger than what this one organization is doing or not doing. My point is the model of medicating us out of our current type 2 diabetes strangle hold is not working, nor will it work. Thus, the sole focus of education should not be on medication in the field of healthcare.
In other words, it is VERY possible to govern this disease in many cases without medication. Yes, reduction of insulin and oral medications substantially and in some cases even complete elimination. Results I’ve seen people experience time and again, reducing HgA1c from double digits to normal. Of note, one’s beta cell function is a key aspect to the ability to discontinue medication with lifestyle changes, such as diet.
The total costs of diagnosed diabetes in the United States in 2012 were $245 billion. According to the American Diabetes Association, “After adjusting for population age and sex differences, average medical expenditures among people with diagnosed diabetes were 2.3 times higher than what expenditures would be in the absence of diabetes.” This is simply not sustainable nor a desirable way to “control” the condition for those living with diabetes.
The challenge can be finding a physician and nutritionist/dietitian who are open-minded and experienced with such medication and nutritional matters. I have experienced countless people expressing their utter frustration and anger that they did not know they had other successful “options”. It’s no wonder diabetes is sky rocketing when life-changing information is chastised and the information that educators and physicians receive is sponsored by the pharmaceutical and diabetes supply industries.