Chopsticks, Please!
By Janis Roszler, RD, CDE, LD/N

I just returned from an amazing, four-day trip to China!  I was invited by Diabetes New World, a Chinese diabetes magazine, to speak to educators and physicians about some of the techniques American educators use to teach about diabetes.

The conference was held at a stunningly beautiful resort just outside of Beijing.  500 Chinese diabetes physicians and educators came to learn about Western and Chinese approaches to diabetes care.  Many lecturers presented information about the medications that we use in the West, while others highlighted the benefits of acupuncture and Chinese herbs. 

I woke up early Friday morning to give my talk.  A group of about 80 educators and doctors were seated, listening politely to the first speaker of the day. Then it was my turn.  I don’t like to speak at a table.  I love to get right into the audience and connect with everyone.  This isn’t a style that they normally see, but they immediately embraced it. I began my talk by uttering the Chinese greeting I had been practicing for 2 months – “Ni hao!” (hello). They cheered!  We were off to a great start.

I presented several things including:

The American attitude toward teaching – I explained that we have moved away from telling our patients what they must do and when they must do it, which is the approach currently used in China. Most American educators now try to encourage patients to take charge of their diabetes and choose their own goals. 

Meal planning strategies – Most Chinese educators teach their patients to monitor the percentages of fat, protein and carbohydrate they consume.  I pointed out that while some American educators use calorie counts and the Food Guide Pyramid, many patients enjoy the flexibility of The Plate Method and carbohydrate counting to help keep their blood sugar level (glucose) in a healthy range.  The Plate Method uses a simple dinner plate to estimate food portions.  The patients fill their plate as follows: 

·         ½ of the plate with low-carbohydrate vegetables (lettuce, broccoli, tomatoes, etc.)

·         ¼ of the plate with starches (potatoes, peas, corn, rice, pasta, bread, etc.)

·         ¼ of the plate with protein foods (meat, cheese, eggs, tofu, poultry, etc.).

·          A small amount of fruit and 1 cup of skim milk or yogurt can be added as well.

At the end, I passed around several unique tools that I use to teach diabetes concepts.  Many patients don’t understand the changes that can happen to their blood when their blood glucose level runs high. To show this, I use two clear sticks that contain red-colored liquid that represents blood. The red liquid in the normal stick flows nicely.  The liquid in the high blood glucose stick moves much more slowly.  This is what happens in our bodies – excessive glucose in the blood slows down the delivery of healthy nutrients to all of our cells.  That is why many people feel so fatigued, have blurred vision, and experience tingling or pain in their feet when their glucose level is too high – their cells are not getting what they need.

When I finished my talk, everyone ran up to me to take photographs.  I felt like a rock star!  We took pictures for about 45 minutes.  Hospital administrators invited me to their hospitals and educators asked me to come speak at their centers.  I was asked to write a regular column for their Chinese diabetes magazine, Diabetes New World, and was invited to speak again next year.  Yes, pass the chopsticks!  China…here I come!