Had an appointment with Diabetic Nurse Specialist and Dietician today......

[silverbirch]

I thought that having an appointment with the DNS and Dietician was to ask questions to ensure that I have understood, to enable me to manage my diabetes.

I was diagnosed 2+ weeks ago, (6th May), as Type 1. My Hba1c was 143, and ketones in the ++++ range. Being previously diagnosed as Type 2 alarm bells started to ring with the medics.

My first visit to the DNS was on the same day as diagnosis, because my Ketones were high. I returned to the hospital the following day and came home armed with insulin pens, a diary and copious leaflets.

Second visit was on Monday 11 May. My diary was checked and questions asked by the Dietician. What do you eat. Why is your carbohydrate intake so low. I went through previous diagnosis history and that I was Type 2 and struggling to keep blood glucose low.

My third visit to DNS and Dietician was today. My diary shows that I am keeping my b/g levels down and managing ok.

My questions were about:

Numbness in my leg and foot when injecting BI. Headaches, Water retention and Blurred vision.

Numbness, they'd never heard of before. Headaches were caused by dehydration. Water retention and blurred vision were effects of return to normal blood glucose.

I am to go on a DAFNE course soon, and whilst on this course they may change my insulin. I asked why they would do this bearing in mind my b/g is coming down. I was told "You do ask some funny questions and a lot of questions". I was asked what work I did before retirement. I worked for Social Services. "Oh you have to ask a lot of questions in that job", she said.

Apparently I'm not eating enough carbohydrates, and I am to eat more bread, pasta, potatoes, cereals, and rice.

It would seem that I have got this Diabetes thing completely wrong. Or have I?

 

[kesun]

Apparently I'm not eating enough carbohydrates, and I am to eat more bread, pasta, potatoes, cereals, and rice.

It would seem that I have got this Diabetes thing completely wrong. Or have I?

Well, somebody's got it completely wrong! But you'll probably find the DAFNE course useful: from what I've heard, even the ones that encourage you to eat lots of "healthy carbs" do also teach good lessons about carb counting and insulin matching.

Kate

 

[silverbirch]

Thanks Kesun. I am looking forward to the course and to learning about other carbs, apart from those starchy ones. I have 40% dysmotility of the oesophagus, which on eating any heavy laden starches, such as bread, pasta, potatoes, leaves me with pain in the oesophagus until it is digested. Not something I want to endure and would like to avoid. I know I need some carbs for energy and will, hopefully, learn about these on the course.

 

[noblehead]

Is the numbness in your leg just temporary? If you inject your basal in the leg try switching to your bum and see if this helps matters.

As for your carb intake, make your DSN aware of your oesophagus problem and this should be enough to make them realise you have problems eating certain foods like starchy carbs, but as Kesun says DAFNE is a really worthwhile course and goes into other aspects of type 1 management apart form carb counting.

 

[Charles Robin]

Look on YouTube for videos by Dr Troy Stapleton. Everything is explained there about carbohydrate (and why we don't need it).

 

[LucySW]

Patience, Silverbirch. You are actually the one in control.

 

[Ali H]

Lots of us low carb but they have to spout the NHS mantra about carbs. You do what works for you.

Ali

 

[Daibell]

Yes, you need fibre and some of the low-GI carbs such as lentils and such like are good in small quantities. Fortunately the meter proves the point and that's good science. It sounds like the symptoms you mention are possible other problems as has been suggested so those need to be kept an eye on.

 

[silverbirch]

Thanks everyone for the reassurance and support. It's difficult enough trying to manage without having to "fight" the NHS.
I was watching a repeat of "Call the Midwife" today, it dealt with a guy who had diabetes. He was in trouble with the nurses because he wasn't paying attention to his sugar levels. He was told he shouldn't eat, pies, potatoes and sugar. Interesting seeing as it was set in 1965. What year did that advice change I wonder.

 

[Heathenlass]

Welcome !

I believe the answer to your question is around the late 80's early 90's , but there are still pockets of resistance against the current dietry advice in some HCP's to this day As there is with some Type 1's

I just wanted to point you ( and any other newly diagnosed Onesie ) in the direction of JDRF , in particular to the ordering of the Adult Toolkit . It is free, but donations to the charity are very much welcomed

It's an excellent resource , especially the book in the toolkit " Straight to the Point "
https://www.jdrf.org.uk/shop/tags/For-adults

Signy

 

[tim2000s]

there are still pockets of resistance against the current dietry advice in some HCP's to this day As there is with some Type 1's

Seems to be more than a few Type 1s

 

[Heathenlass]

Seems to be more than a few Type 1s

I do like the subtlety of understatement .

Signy

 

[mrspuddleduck]

I have the same problem - before diagnosis, I had to (and still have to) follow a low fat diet due to pancreatic disease/malabsorption, already a vegetarian it wasnt really that much of a problem. Last year diagnosed as LADA, so decided to go the Low Carb, Low Fat route and again didnt really find it a major problem except I love potatoes!! Sent off to the dietician who is obsessed with low GI diets - told to eat pasta, bread, potatoes etc etc - tbh I just smile say ok then ignore everything and continue with what works for me. And I think I will scream if one more health professional asks me why I cant eat fish.............!!!!!
In fairness to the health professionals, their hands are tied as they have to work to government/nhs guidelines, but I dont have to!! ;-) Sue xx

 

[Daibell]

I have the same problem - before diagnosis, I had to (and still have to) follow a low fat diet due to pancreatic disease/malabsorption, already a vegetarian it wasnt really that much of a problem. Last year diagnosed as LADA, so decided to go the Low Carb, Low Fat route and again didnt really find it a major problem except I love potatoes!! Sent off to the dietician who is obsessed with low GI diets - told to eat pasta, bread, potatoes etc etc - tbh I just smile say ok then ignore everything and continue with what works for me. And I think I will scream if one more health professional asks me why I cant eat fish.............!!!!!
In fairness to the health professionals, their hands are tied as they have to work to government/nhs guidelines, but I dont have to!! ;-) Sue xx

Yes, HCPs seem to think that they have to follow central advice but that's not what a professional does; it's what a clerk does. I'm a professional engineer (now retired) and I was expected to make my own decisions based on good science wherever I worked. I know HCPs are leaned on to follow 'Group-think' but they can diverge to some extent if they want to. How many GPs have been sacked for not following the flow-chart?

 

[CarbsRok]

Thanks everyone for the reassurance and support. It's difficult enough trying to manage without having to "fight" the NHS.
I was watching a repeat of "Call the Midwife" today, it dealt with a guy who had diabetes. He was in trouble with the nurses because he wasn't paying attention to his sugar levels. He was told he shouldn't eat, pies, potatoes and sugar. Interesting seeing as it was set in 1965. What year did that advice change I wonder.

It was changed in the early to mid 1980's when ever it was that synthetic insulin became available as did home blood testing. So it was a case of eat what you like, shove the insulin in to make the numbers on your meter look good.

 

[silverbirch]

Is the numbness in your leg just temporary? If you inject your basal in the leg try switching to your bum and see if this helps matters.

As for your carb intake, make your DSN aware of your oesophagus problem and this should be enough to make them realise you have problems eating certain foods like starchy carbs, but as Kesun says DAFNE is a really worthwhile course and goes into other aspects of type 1 management apart form carb counting.

@noblehead. The numbness in the leg is temporary, but in the foot it has been there for a while. The DSN has referred me to the podiatrist and I have an appointment next week. I'll post on here their findings.

 

[marilynafrost]

I thought that having an appointment with the DNS and Dietician was to ask questions to ensure that I have understood, to enable me to manage my diabetes.

I was diagnosed 2+ weeks ago, (6th May), as Type 1. My Hba1c was 143, and ketones in the ++++ range. Being previously diagnosed as Type 2 alarm bells started to ring with the medics.

My first visit to the DNS was on the same day as diagnosis, because my Ketones were high. I returned to the hospital the following day and came home armed with insulin pens, a diary and copious leaflets.

Second visit was on Monday 11 May. My diary was checked and questions asked by the Dietician. What do you eat. Why is your carbohydrate intake so low. I went through previous diagnosis history and that I was Type 2 and struggling to keep blood glucose low.

My third visit to DNS and Dietician was today. My diary shows that I am keeping my b/g levels down and managing ok.

My questions were about:

Numbness in my leg and foot when injecting BI. Headaches, Water retention and Blurred vision.

Numbness, they'd never heard of before. Headaches were caused by dehydration. Water retention and blurred vision were effects of return to normal blood glucose.

I am to go on a DAFNE course soon, and whilst on this course they may change my insulin. I asked why they would do this bearing in mind my b/g is coming down. I was told "You do ask some funny questions and a lot of questions". I was asked what work I did before retirement. I worked for Social Services. "Oh you have to ask a lot of questions in that job", she said.

Apparently I'm not eating enough carbohydrates, and I am to eat more bread, pasta, potatoes, cereals, and rice.

It would seem that I have got this Diabetes thing completely wrong. Or have I?

I have given up on my diabetes nurse. She tells me off for doing low carb diet even though it keeps my blood sugar levels good. She insists that I should live on high carbs and also low fat yoghurts. and tells me off for using the internet to research info.

 

[silverbirch]

I have given up on my diabetes nurse. She tells me off for doing low carb diet even though it keeps my blood sugar levels good. She insists that I should live on high carbs and also low fat yoghurts. and tells me off for using the internet to research info.

I'm on a DAFNE course all this week. I have been in trouble, with the dietician, for the last two days for not eating enough carbs. I have to take some carbs in for lunch tomorrow. I'll do it just to keep everyone happy. It's only for one week and then back to my usual diet, which like you is keeping my blood sugar at the recommended levels, as required by the DNS. How do I manage to keep them low, well I think we all know the answer to that one, except maybe the dietician. lol

Little hint of sarcasm there... who me.... nah

 

[zjed]

The dose adjustment part of DAFNE is great, every T1 should do it. The FNE is debatable.

 

[silverbirch]

@zjed You're are right, the DAFNE course is informative and enlightening. But have to agree the FNE hasn't quite caught up with what the rest of us.