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SPECIAL FEATURE: Readers Respond to Dr. Richard Kahn’s Statement: “Diabetes Prevention is a Waste of Resources”

Feb 16, 2012

For Dr. Kahn’s comments and the Joslin Diabetes Center’s response, see our article in last week’s newsletter: Joslin Replies to Dr. Richard Kahn’s Statement: “Diabetes Prevention is a Waste of Resources.”


Responding to Dr. Kahn

Having been in diabetes education for more than 25 years, I can tell you that one of the most difficult barriers to overcome in attempting to educate people with diabetes is attempting to combat the negative and in many cases inaccurate statements made by members of a patient’s health care team. When a trusted physician or other health care professional doesn’t approach diabetes management with enthusiasm for positive outcomes, the patient carries that negativity into every aspect of their self management.


Comprehensive education appropriately delivered to someone with diabetes can make a huge difference in their long term health. We should all be shouting the praises of diabetes education from the roof tops to everyone who will listen and even to everyone who won’t listen. We should replace the term “non-compliant” with the term “empowered” for each person with diabetes. It is a complicated disease that baffles most people with medical degrees. Yet, we expect our patients to miraculously get infused knowledge about it and to care for themselves without any support.

Of course weight loss helps pre diabetes or existing diabetes. Losing 2 to 4% of your body weight helps anyone who is above their desired body weight with or without diabetes. Learning about how your body profits from small life style changes helps even more. Understanding how the job of getting glucose into your cells is made so much easier by weight loss and activity can be all the person with pre diabetes needs to attempt to make some changes.

Education is never a waste of time or money!!! Call me. I’ll bore you with our success stories.

Kathleen Siciliano, RN, CDE


Good morning,  First, thank you for the newsletter – I do read it and it often causes me to think about issues that we are confronted with on a daily basis, either through our patient load, discussion with colleagues or in our personal lives. What strikes me about all of this discussion, is that why we are not looking at the root cause of obesity beyond what one eats?

Once the GLP1 discussion hit the public fan as well as what insulin resistance causes or is related to, I wondered why aren’t we treating the root cause of type 2 diabetes so far as we know it to be.?  GLP1 therapy is expensive but if it assists our clients to lose weight, as well as have beneficial effects on the multiple organs systems involved in diabetes, why aren’t we doing more there?   AND in the pre-diabetic state or early onset diabetes, could these drugs have a beneficial effect on the beta cell? 

My thought is that even though it is expensive, would it not be less expensive in the long run, to prevent one CABG or BKA or the societal costs associated with blindness???? 

Just a thought.
Sincerely, SP

Please let us know what you think — send your response to publisher@diabetesincontrol.com.