[Diabetes-talk] question

[Ann Williams]

Paul asked: " My next issue has to do with whether
or not I should have a food plan.  I have met for 4 times with a cde, but
she hasn't said anything about this."

Yes!  You should have a food plan designed to meet your particular 
medical needs.  Furthermore, your meal plan should take into account 
your food preferences and your cultural background, if it affects what 
you eat and don't eat.  This is in all professional standards of 
diabetes care, which can be found on the web site of the American 
Diabetes Association at:
http://professional.diabetes.org/CPR_search.aspx

Paul also said, "The view seems to be that all blind people have sighted 
caregivers, and, I
don't have any idea where this comes from.  When I tell them that I don't
have sighted help, they throw up their hands in astonishment, and 
quickly fade away not knowing
what to do."

This is not acceptable, either legally or ethically.  Under the American 
with Disabilities Act, a CDE must provide reasonable accommodations to 
make sure that you can benefit from diabetes education services.  
Furthermore, the American Association of Diabetes Educators (AADE) has a 
very strong Position Statement about diabetes education for people with 
disabilities.  It states in no uncertain terms that diabetes educators 
must provide the same quality of care to people with disabilities as 
they do to people with no current disability.  An older position 
statement was published in 2002, and an update is due to be published 
this coming week or next.  AADE's Position Statements are available at:
http://www.diabeteseducator.org/About/position/position_statements.html
Scroll down to find the one about disabilities.

Now, to give your CDE the benefit of the doubt, I have to add that 
during their basic education, very few health care professionals have 
adequate preparation for working with blind people effectively.  (It's 
not right, but that is the way it is.)  So maybe your CDE needs some 
help knowing what she should do to serve you well.  You can tell her 
that AADE has a Disabilities Specialty Practice Group, with members who 
have experience working with people who have all kinds of disabilities.  
She can contact the Chair of that group (who happens to be me this year) 
to get hooked up with another CDE who can help coach her on appropriate 
ways to work with you and any other blind people who come to see her.

Ann Williams, PhD, RN, CDE