Friday, 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!

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