Dad, Diet and Diabetes. (A bit long)

In My Humble Opinion
1

Around January of this year, blood test revealed that my dad was (borderline?) diabetic. After his first meeting with his Primary Care Physician, he was prescribed 500mg of Metformin twice per day (for type 2 Diabetes) along with 20mg daily of Lipitor (to lower Cholesterol levels).

From my rather cursory research, it appeared that diet was also an important part of diabetic treatment. I therefore asked my father what his PCP had said regarding this. His answer: “Nothing at all.”

Now, both my parents were born and raised in Mexico and therefore eat very authentic style foods (IOW, things like pigs feet and beef tongue!) Add to this the Lipitor script and it makes it quite surprising his PCP didn’t discuss diet at all. Despite my constant reminders, my father always “forgets” to mention to his dr. what dietary changes he should be making.

The final straw was his last appointment. When I saw him afterwards I asked how it went. He said fine but was curious about something. Apparently, the doctor told him that things looked good so he should continue with his meds. and stick with his “diet”. Did my father then mention that no diet had ever been discussed? Nope. (At a different appt., his dr. suggested he take a daily dose of aspirin. Did my dad ask the reason for this? Nope. He decides to ask me why, his son with the Poli.Sci. degree.)

It’s not that I don’t believe my dad that diet has never been discussed. My grandfather also has the same PCP and often complains about the dr. Unfortunately, he was the only Spanish-speaking one available through his insurance and local medical group.

So, I’d like any thoughts/opinions/suggestions, especially with the following:

How important is diet in treating/living with diabetes?

Anyone see a problem in my plans to contact the dr. directly and remind him, in the nicest way I can, that he has kind of forgotten something important in regards to my dad’s treatment?

If in a similar situation, would you tell your father beforehand, afterwards or not at all about talking to his dr. directly?

Any other IMHOs welcome. Thanks!

2

Diet is really important in treating diabetes. All the medication in the world won’t help enough to overcome a really poor diet. There is some debate as to what constitutes the best diet for diabetic people, but generally some form of carbohydrate counting comes into play.

Your dad might want to ask his doctor if he can either give him some dietary recommendations, or refer him to a nutritionist, or see if there are any diabetes education classes offered locally. Sometimes those can be really helpful, especially for the newly diagnosed. There’s also a really excellent book out called “The First Year – Type 2 Diabetes” by Gretchen Becker, if he or you wants to read up more about this.

I’m frankly not too impressed with your dad’s doctor for just giving him a scrip for some meds and not giving him any additional info. Diabetes typically means making some pretty drastic lifestyle changes for most people, mostly involving changing your diet and getting more exercise. Going on medication can be really helpful, but it’s only part of the story.

As for when you should tell your dad, I think that depends a lot on your dad’s temperament and your relationship with him.

Good luck, and I hope some more people come along to offer information and advice. I’ve been living with Type 2 diabetes for going on three years now, but I’m no expert. All I can do is share what info I’ve managed to glean through the reading I’ve done.

3

Some people can control their diabetes through diet and exercise alone, no need for medicine. Many diabetics can’t. I’m not sure what, exactly, authentic Mexican style food is…mostly I eat Tex-Mex, and I KNOW that’s not really Mexican style food.

A diabetic diet generally restricts calories and carbohydrates. It’s a pretty healthy diet. The American Diabetes Association used to have diet handout sheets, I don’t know if they still do.

I have no idea how your dad will react to you talking to his doctor, so I can’t tell you one way or the other.

4

Chiming in to agree with MsWhatsit and Lynn, and to suggest that Spanish diabetic education must be available throughout California, and your dad seems a prime candidate for some basic diabetic training to learn how to best manage the disease on a daily basis.

Is your dad insured? If so, you might want to suggest to him that he contact his insurer, as they often have programs of this sort themselves, and can slot him into the “continuity of care” needed to make sure that his disease is properly managed. Some insurers are now assigning case managers to those who are newly diagnosed with chronic disease, especially diabetes. Those case managers take care of scheduling appointments, setting up education, making sure that there are standing scripts for meds and testing supplies and the whole schpiel. It would be beneficial for your dad to find out if such services are available to him.

I wouldn’t bother calling the doctor or insurer yourself, though. If they take HIPPA (the new privacy laws) seriously at all, they won’t even confirm to you that your dad is their patient/client, even though it’s something that you already know. If your dad gives his okay to them talking to you, though, that’s another matter. You can act as an advocate for him, but only with his prior knowledge and approval.

Talk to your dad, and tell him that you’d like to work with him to be sure that his disease is well-managed because you want to be sure that he’s around and well for a good long time.

I wish you and your dad the best, El Gui.

5

In re-reading my post, please understand, El Gui that I wasn’t suggesting that your dad would need special assistance because he is a Spanish speaker. My reference to Spanish diabetes education was only because I know that most people are more comfortable receiving important, complex information in their native or primary language, and I assumed that this would mean Spanish for your father since he is from Mexico and sees a Spanish speaking doctor.

I may be overreacting on myself, but I wanted to be sure that it was clear that I meant no condescension or aspersion.

6

Like everyone else has stated, diet is extremely important in managing diabetes. I just wanted to add that if you call our dad’s doctor, he’s likely not going to be able to talk to you about your father’s condition – HIPPA laws and all that. Probably the best thing would be to accompany your dad to his next appointment, if possible. You could pose your questions to the MD then, and you might also ask for a referral to a diabetes educator. I think most hospitals employ them, and they teach patients everything from how to check their blood sugar to how to take care of their feet. I’d be willing to bet they’d have info on a proper diabetic diet as well.

7

All of my doctors have agreed: The less insulin or oral hypoglycemics you take, the better off you are. If your diet is out of whack, your need for the medications increase greatly. Then your resistance to them increases, which increases the need for more…

Diet and exercise are crucial.

8

Oh my. Yes, I’ll chime in and say that diet is extremely important. My uncle and grandfather both have Type 2 diabetes. When they are careful to eat well, they quite literally are allowed to stop taking any sort of meds for the diabetes. I think that calling the doctor directly to ask about diet recommendations would not be out of line.

9

Thanks to everyone for the suggestions. (I apologize for the slight delay . . . )

TeaElle: I had forgotten about HIPAA and the stricter privacy requirements. I’ll also check up on his insurance and see what diabetic education options they might have available. (And no worry; no condescension or asperion inferred on my behalf.)

Lynn Bodoni: At least in the area my parents are from (around the geographic center of Mexico, about 300 miles N of Mexico City. State of Guanajuato), authentic for them would be lots of meat (fried, boiled) and very little vegetables. Stuff like chicharrones (fried pork rinds). Very unhealthy stuff overall. Plenty of mandarins and guavas, though. Thankfully, my mother gave up using lard many years ago when my younger brother and I refused to eat her cooking if she kept using that gross paste of death. I’ll look into obtaining some info. online from the American Diabetes Association.

And thanks to all for the other suggestions (such as the exercise part). The importance of diet in the treatment of diabetes is much clearer.

Although I was ready to contact his dr. directly, I think I’ll hold off and instead, as Nightingale suggested, ask my dad if I can accompany him to his next appt.

I’m sure he wouldn’t have a problem, especially since I was present while he underwent a prostate exam administered by a non Spanish-speaking Urologist and was also present when he went to the ER with a urinary tract blockage problem and had to translate the proper cleaning procedures of a catheter (that he was “wearing” at the time. The ER medics saw no need to use a colorful diagram of a man’s privates or a freshly unpacked catheter since a live model was already there!) :eek: :smiley:

10

Dabetic chiming in here. Pork rinds don’t have carbs, potato chips do. My nutritionist told me that I could have pork rinds as something to nosh on, but not to over do it. For me, at least, carbs are more important than anything else except sugar. That is a direct quote from my nutritionist. With diet and exercise I may, emphasize may, not need medication. Tell your dad from me, I was diagnosed in July, he can learn to live with this. Its much better than the alternative.

11

Cut down on dairy products. My mother had stomach problems for years until it was realised that the Metformin was reacting with milk.
Also, in England, you’re automatically put on insulin after 10years on Metformin whether you need it or not.

12

My dad was sent to a nutritionist when he was diagnosed with diabetes 3 years ago. It was very helpful. He started out on the oral meds, but through extremely strict adherence to the diet plan recommended by the nutritionist he lost 40 pounds and was actually able to go off the drugs about 9 months after beginning them. He has kept his weight down and his numbers low for 2 years now. He also exercises regularly. The diet plan recommended by the nutritionist was a low-carb, 6 small meal a day plan. Sugar wasn’t completely prohibited (the rule of thimb nowadays is that carbs are more worrisome than sugar for type-2 diabetics), but Dad chose to just go off sugar entirely. My mom has been beyond helpful in this lifestyle change – in fact, he calls her his live-in nutritionist. She read dozens of books on diabetes management and low-carb cooking. She doesn’t buy sugar – only Splenda, which she uses for everything, including cooking. She’s constantly on the lookout for new low-carb staples and recipes. She switched over to diet soda herself, so he wouldn’t accidently pick up and drink a regular soda. She exercises with him and keeps a close eye on what he eats. She reminds him to test his blood once a week and plans their meals around his numbers.

My father-in-law was diagnosed at about the same time. He has lost no weight and made no noticable changes in his eating or exercising habits. His house is full of sugary, high-carb treats and, although their health plan allows for a visit to a nutritionist, neither my father-in-law nor my mother-in-law got anything out of their consultation. Except to be able to point out (when my husband noted that Dad was drinking regular Coke) that it is a “myth” that diabetics shouldn’t have sugar; he can have “a little” if he wants – no mention of anything about carbs from either of them and when I chimed in, “That’s right, Honey. Dad’s doctor says that controlling carbs are more important than boycotting sugar.” I got blank looks from both Ma- and Pa-in-law. He drinks at least 3 regular sodas a day – hardly “a little.” Plus cookies, pie and ice cream. Every day. When they visit here, I’m careful to make low-carb snacks available to him (the same things I keep on hand for my own dad) – the low-carb goodies sit on the shelf while he goobles the high octane stuff. When we visit at their house, there’s no evidence whatsoever that a diabetic lives there – other than the test kit and Metformin in the medicine chest. I have no doubt he will be on Insulin within the decade. And I’m very afraid he may eventually have “Diabetes” on his tombstone, as well. :frowning:

So, please, El Gui, do go with your Dad to his next appointment. Try and get a consult to a nutritionist and tag along on that appointment as well. Good luck!

13

Tell your dad that my friend’s mother didn’t follow her diabetic diet and they took her legs, one toe at a time, half a foot at a time, until she had two stumps and was wheel chair bound and in diapers. And blind. Then she died. It was lovely. THAT’s how important diet is with diabetics.

14

When I was diagnosed with diabetes, small changes in my diet made a big difference. I started with cutting out all refined sugars and starches.

No sugar! Anything sweet is bad. That may be the hardest adjustment. Sugar hides in a lot of foods, too, especially commercial ones like catsup and canned salsa.

Fill up on protein. Meats, cheeses, beans. And the more meat and cheese you eat, the more you crave fresh veggies… which are the best things for a diabetic to eat.

Limit starchy foods like potatoes, rice, and bread. Corn masa and tortillas should be OK in moderation.

Eat fresh. Fresh salsa, fresh tortillas, fresh meat, fresh veggies. Avoid things from cans and jars, they contain extra salt and sugar.

This has helped me a lot. Except that by eliminating so much sugar, I formed a craving for sweets. End a meal with a small, favorite sweet, like a piece of chocolate or candied fruit, or even a sweetened cup of coffee. Just a small amount can go a long way to relieveing the craving, and it helps tells the brain that the meal is over.