Diabetic patient: I don’t have access to insulin, or a fridge, or ability to watch my sugars.

Harvard med student: you should try a keto diet, I wrote a book about it. Did you know every 30 seconds a diabetic leg is amputated?!

THIS IS WHY PATIENTS HATE US.

You won’t be shocked to know those with low income are 10x more likely to have diabetic amputation than higher income brackets.

https://ph.ucla.edu/news/press-release/2014/aug/amputation-rates-10-times-higher-diabetics-living-californias-low-income

Also won’t be shocked to know that when given healthcare access, through Medicaid expansion (I.e. better access to insulin), there are fewer amputations and less overall healthcare cost.

https://www.diabetes.org/newsroom/press-releases/2020/study-finds-minority-patients-in-states-with-medicaid-expansion-experience-fewer-leg-amputations

So truly telling a diabetic patient to just “eat a keto diet and take insulin” is kind of like saying “just pay cash for med school upfront”.

Unless you’re wealthy, it’s not gonna happen.

Stop blaming patients for access to healthcare problems.

Finally: friendly plug to actually ask pharmacists, RD (dietitians), and social work about options.

Example: there is a lot of resources in Minnesota, including fresh produce at reduced cost for diabetics, free insulin programs, etc.

https://mn.gov/boards/pharmacy/insulinsafetynetprogram/

And by the way: this is an article that same student posted about how the pandemic of metabolic syndrome is worse than covid.

“Disaster of Covid is still infinitely less than true pandemic of metabolic syndrome”

within the article there is a disdain for krispy kreme free donut campaign for vaccinated people.

The way in which fast food is stigmatized compared to rich people food is astounding, especially when same nutrition.

Just say y’all hate poor people.

My point is it was not just one tweet but a stigma associated with not meeting patients with where they are at. And stigmatizing fast food and free options.

You want better diabetes control: get Medicare for all, reduced insulin prices and access to wound care.

LOL. This thread mad some physicians who push keto diet very upset.

Apparently my “lazy America centric woke worldview armchair social media approach to medicine is appalling”

I literally made this one thread.

Maybe a donut would make him feel better

LOL and I did read the literature.

Here’s a BMJ study that looked at 14 of most popular diet fads, and they, shockingly didn’t work.

This is not a thread on medical advice. It’s a thread on not being pricks to our patients.

Link: https://pubmed.ncbi.nlm.nih.gov/32759278/