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Rectifying Confusion from Outdated Information

Mar 22, 2018

Happy spring to you all!

A brief update on my life: Last year about this time I left the VA (after 17 years) and took a part-time position with the UTHealth system. The University of Texas Medical School has a new seven-story facility where faculty see private patients. I am the RN/CDE for the entire facility, with referrals from three staff endocrinologists as well as more than 20 family practice providers. During my nursing career, I worked the private sector in a hospital setting running a 30-bed Diabetes Unit for 15 years, a county facility, a federal facility and now a state facility. I find it interesting how they blend and merge, but keep very separate identities and funding sources. But that is a totally different topic.

Today, I wanted to share today one of my observations about the clients I encounter. In my travels through these systems, I often expect the next group that attends diabetes class will perhaps have new and updated information on how to manage their diabetes. That is just the optimist in me. Unfortunately, this has not been the case.


I have to reassure them that oatmeal is surely better than Frosted Flakes but it is not a “free” food and it still “counts” toward their carb intake for that meal.


Even with the knowledge explosion on the internet, people with diabetes arrive to see me confused due to outdated and/or erroneous information. The main concept that I spend a lot of time rectifying is one that apparently their provider has told them regarding their food choices: “Just don’t eat anything white and you will be okay.” When I show the client my white bread food model which I use as my benchmark for beginning the lesson on carbohydrate content in foods, they always assure me that they would NEVER eat a piece of white bread. They only eat wheat bread and quite a bit of it, as “wheat bread is good for you.” The same goes for oatmeal in the mornings. Most have a look of shock and disbelief on their face as I share with them the label showing that white bread and wheat bread have a pretty similar carb count. We also discuss the carb content of oatmeal. I have to reassure them that oatmeal is surely better than Frosted Flakes but it is not a “free” food and it still “counts” toward their carb intake for that meal.

I try to reinforce frequently that they can eat whatever they want but within moderation especially if they have a dietary carb restriction. We also discuss the concept of being consistent with carb intake at meals. We discuss the importance of taking into account how many carbohydrates they consume, particularly if they take pre-meal insulin. I am not sure where providers got the idea about just limiting “white” foods, but I think it is something we need to address when educating providers. I certainly bring it up in my meetings with my providers which is often most enlightening – for both of us. 

Don’t forget to register for AADE18 and take advantage of the early bird discounts. I hope to see you in August.

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