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Saturday, November 10, 2012

Should diabetics eat grapes?


I was listening to an acquaintance of mine talk about her mother who was recently diagnosed with diabetes. She was debating with her whether or not grapes could be part of the diabetic diet. Where to get an answer on that one? Yes, make an appointment with a professional dietician, which is what she recommended to her mother.

But what do most people do? Right, they google. And, what do they find? Research has shown that most people will click on the first five search return links that come up (thus the lucrative power of Search Engine Optimization or SEO). But when searching for health information, which is one, if not the highest usage for internet searching, do most people know if they are getting reliable or trustworthy information? Anyone even heard of Health on the Net?

I just searched on "should diabetics eat grapes?" and I did not see some of the more trustworthy internet health sites out there, like mayoclinic.com or medline. I don't know if Canadians automatically go to their provincial health authority website to seek this information. There is a lot of research on health information seeking behavior, and what patients print off before they visit their family physician.

What I am getting at, is that the trend towards personalized medicine should be able to answer this question in the context of their personal health record system (which ideally has been prescribed or recommended to them by their personal family physician).  You could have a Dr. Watson type search engine answer the question. You could have data crunchers analyzing health information in the health record, comparing to the ocean of health data that could be analyzed. Genetic information could be a factor for grapes, blood type, and insulin levels. Socio-economic factors loom large, for example, what is a grape in a food desert?

But what I think the reality is, most people don't have personal health records or know how to set them up, and the personal health records that do exist, won't be able to automatically answer this type of question, though we all speculate that it should. The family physician should be answering this question, either through a referral to a nutritionist, or a diabetes guidance counsellor. 

And this has made me think that what we need are more self-tracking stations. These would be counselling services where people can go to learn and maybe even procure self-tracking technologies, like fitbit, personal health records, mobile smartphones with blood pressure cuffs, etc.  What if there could even be fMRI, ultrasound, and Transcranial Magnetic Stimulation machines in these stations. This would be one way to deconstruct medicine, and I would like to venture on this idea in a future post on practising medicine without a license. There are so many medical and other devices which can be used to support healthy living. Maybe the model of the York University "Health Coach" would fit this idea, or the Self-Tracking Station counsellor.