Last week I was at a workshop to teach health care professionals how to do focus centred behaviour change for diabetics. It was run by two psychologists. One of the “documents you may wish to use with patients” was a list of self -care behaviours and next to it a grade of how good you think you are doing it.
These are the dietary based entries:
The food I choose to eat makes it easy to achieve optimal blood sugar levels.
Occasionally I eat lots of sweets or other foods rich in carbohydrates.
Sometimes I have real “food binges” (not triggered by hypoglycaemia)
The third one is assessing emotional eating. But the first two are squarely advocating a low carbohydrate diet. Nada about dietary fat in the whole thing.
I was surprised and delighted but decided to stay silent. There were three dieticians in the room. I saw one bridle as she read the document. She asked, “Where did this come from?”.
Here is its source.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3751743/
This is a German/UK collaboration with a good scientific basis.
Table 1
Diabetes Self-Management Questionnaire (DSMQ)
| The following statements describe self-care activities related to your diabetes. Thinking about your self-care over the last 8 weeks, please specify the extent to which each statement applies to you. | Applies to me very much | Applies to me to a consider-able degree | Applies to me to some degree | Does not apply to me | |
| 1. | I check my blood sugar levels with care and attention. ☐ Blood sugar measurement is not required as a part of my treatment. |
☐3 | ☐2 | ☐1 | ☐0 |
| 2. | The food I choose to eat makes it easy to achieve optimal blood sugar levels. | ☐3 | ☐2 | ☐1 | ☐0 |
| 3. | I keep all doctors’ appointments recommended for my diabetes treatment. | ☐3 | ☐2 | ☐1 | ☐0 |
| 4. | I take my diabetes medication (e. g. insulin, tablets) as prescribed. ☐ Diabetes medication / insulin is not required as a part of my treatment. |
☐3 | ☐2 | ☐1 | ☐0 |
| 5. | Occasionally I eat lots of sweets or other foods rich in carbohydrates. | ☐3 | ☐2 | ☐1 | ☐0 |
| 6. | I record my blood sugar levels regularly (or analyse the value chart with my blood glucose meter). ☐ Blood sugar measurement is not required as a part of my treatment. |
☐3 | ☐2 | ☐1 | ☐0 |
| 7. | I tend to avoid diabetes-related doctors’ appointments. | ☐3 | ☐2 | ☐1 | ☐0 |
| 8. | I do regular physical activity to achieve optimal blood sugar levels. | ☐3 | ☐2 | ☐1 | ☐0 |
| 9. | I strictly follow the dietary recommendations given by my doctor or diabetes specialist. | ☐3 | ☐2 | ☐1 | ☐0 |
| 10. | I do not check my blood sugar levels frequently enough as would be required for achieving good blood glucose control. ☐ Blood sugar measurement is not required as a part of my treatment. |
☐3 | ☐2 | ☐1 | ☐0 |
| 11. | I avoid physical activity, although it would improve my diabetes. | ☐3 | ☐2 | ☐1 | ☐0 |
| 12. | I tend to forget to take or skip my diabetes medication (e. g. insulin, tablets). ☐ Diabetes medication / insulin is not required as a part of my treatment. |
☐3 | ☐2 | ☐1 | ☐0 |
| 13. | Sometimes I have real ‘food binges’ (not triggered by hypoglycaemia). | ☐3 | ☐2 | ☐1 | ☐0 |
| 14. | Regarding my diabetes care, I should see my medical practitioner(s) more often. | ☐3 | ☐2 | ☐1 | ☐0 |
| 15. | I tend to skip planned physical activity. | ☐3 | ☐2 | ☐1 | ☐0 |
| 16. | My diabetes self-care is poor. | ☐3 | ☐2 | ☐1 | ☐0 |
It is very refreshing and welcome to see that prioritising eating based on the effects on glycaemic control for diabetics is being adopted over following dogma with no scientific basis.
Diabetes Diet 