You guys were right...met the diabetic nurse!

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AndBreathe

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No no. I'm not trying to fall out with you or anyone. But disagreeing with you doesn't mean I'm wrong and should not tell my story because it basically disagrees with forum wisdom.

OK, one final attempt to make myself clear.

Your findings appear to be contrary of the vast, vast majority of T2s I have observed coming through these forum doors. Whilst at the point of diagnosis guidance is usually sought, bearing in mind my earlier point, it's a shame the guidance doesn't suit the majority of people we encounter here. Obviously, the sample of all of the population we see coming through here may not be completely representative of the T2 diabetic population as a whole, the fact that most HCPs (in my experience and observation) believe T2 to be permanent and progressive must surely mean that what they evidence is a progressive disease which is permanent. That suggests to me that, provided people are following the guidance they are given, that the guidance is not, in the vast majority of cases, returning the positive results we sometimes see here.

So, for me, it seems a shame that where any guidance is likely to effective at best for 80/20, or 90/10 of the population to whom it is delivered, the guidance doesn't return the most positive outcome to the higher proportion of its recipients.
 

mikej1973

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@mikej1973
I'm interested in the 5:2, how you spread your calories with 500g carbs and what you consider to be "active".....
Is that hauling in Tuna by the way?

Sorry! I've been all defensive and forgotten you! Most importantly the fish was an Amberjack caught in Mexico.. the big fish between my legs was a black grouper.

First off I may have over estimated by carbs as I said previous possibly 200-400 would be more accurate. However I'm going to measure carbs next week and see for certain. I have 2 600 calorie days a week. Usually Monday and Weds or Tues and Thurs. But not always. They are simply low carb because carby food has lots of calories. So typically I'll have a fruit smoothie for breakfast (nutri bullet made), apples and oranges for lunch and then two chicken breasts or 1 breast and salad for dinner.

One normal day I need to remain below my BMR (2900calories) to do things properly. I actually aim for around 2,500 because every little helps.

Typical breakfast: Porridge or Granola. If I treat myself I have a bacon and sausage bap at Clapham junction station en route. I do this no more than once a fortnight though.
Lunch: A couple of rounds of sandwiches and some soup. If I'm having a lazy lazy day then an omelette for lunch or a salad.
Dinner: Meat, vegetables and potato. Wedsnesday I had a Rib Eye steak with fried mushrooms and some pepper sauce and two small baked potatoes with some cheese. My take away treat is an extra large chicken kebab in pitta with chip.. although my smaller stomach and desire to feast less means I usually go for a large one instead! small steps!

In terms of activity I'm not hugely active.. but in terms of my blood sugar. If I need to walk somewhere for more than 20 minutes then I'll have sandwiches for lunch and the walk after lunch will keep my blood sugar normal. If I'm running a training course I'm on my feet walking for two days I'll eat what I please (unless it's a fasting day) and my blood sugar stays in check. If I'm at my desk, or at home in my pants watching TV then lunch will be something (not always low carb.. just low bread) different to allow for my lethargy.

I also walk to the station and back three or four times a week depending on my work schedule and that's a total of 3 miles. I'm generally out and about over a weekend and frequently hike 5 or 10 miles. But I don't do any cardio exercise and I only use a Gym if I need a vending machine. Exercise does have a positive impact on my blood sugar though.

Apparently i'm not allowed to say this... but it works for me!
 

mikej1973

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OK, one final attempt to make myself clear.

Your findings appear to be contrary of the vast, vast majority of T2s I have observed coming through these forum doors. Whilst at the point of diagnosis guidance is usually sought, bearing in mind my earlier point, it's a shame the guidance doesn't suit the majority of people we encounter here. Obviously, the sample of all of the population we see coming through here may not be completely representative of the T2 diabetic population as a whole, the fact that most HCPs (in my experience and observation) believe T2 to be permanent and progressive must surely mean that what they evidence is a progressive disease which is permanent. That suggests to me that, provided people are following the guidance they are given, that the guidance is not, in the vast majority of cases, returning the positive results we sometimes see here.

So, for me, it seems a shame that where any guidance is likely to effective at best for 80/20, or 90/10 of the population to whom it is delivered, the guidance doesn't return the most positive outcome to the higher proportion of its recipients.

You are clear. You always have been. I'm not even disagreeing for a lot of what you say. But my experience is different and it may help someone in their battle. My statements aren't hard or fast. We're presenting different view points, both are legitimate and positive stories.

I've done a huge amount of work with the old PCTs providing support and consultancy to help epidemiologists understand how people engage with their healthcare services. Who and why some people engage with not just their health, but with their GPs. Helping PCTs understand how and where to provide services etc. less now since the end of the labour government, the public sector can't afford it now. I don't know about diabetes, but from my experience with COPD, Obesety, smoking and mental health I can almost guarantee that the people who come through here are not representative of the population has a whole. They're here because of a thirst for knowledge. One thing they'll learn is that cutting carbs will reduce BS so they'll have a go and it will work for them. Which is great!! However 80% of those diagnosed won't come to places like this. Of those 80% I don't know how many, but lots of them will ignore the fact they have diabetes and that's why it will damage them. EVERY SINGLE PERSON on this forum is completely engaged with diabetes. That's why they're here! Those that follow the NHS rules but are engaged with diabetes will fare better than those that ignore it. The comparison needs to be made between the LCHF possie and the NHS but engaged possie! I don't think there is any firm research? If there isn't how can the NHS draw a conclusion? I'm playing devils advocate a bit here. I suspect LCHF would win that battle, but "because the forum said so" doesn't cut in epidemiological research. It seems HCP are changing their attitude over time, it shouldn't happen overnight without resistance.
 
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NoCrbs4Me

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I'm still enjoying this thread. I have a few comments:

1. I think losing weight will go a long way towards reducing insulin resistance, regardless if it's done through calorie reduction or LCHF or intermittent fasting or some other way.

2. I wouldn't say that mikej1973 is really following NHS standard advice - he is self testing (which is generally not recommended) and he is doing 5:2, which I've never heard of being recommended by the NHS. Also, (forgive me if I'm wrong on this), the examples of his typical meals don't quite seem to conform to the "healthy" plate guidelines (high carb/very low fat).

3. I would say that he is more following what type 2s on this forum have tried successfully and what is very often recommended, which is eating to his meter. Although it seems he can tolerate more carbs than many here, he can't tolerate any type/amount of carbs.

4. The big unknown for most of us is our level of insulin resistance, since it's very uncommon to have insulin levels tested. Just because my blood glucose is in the normal range after eating a carby meal doesn't mean I didn't release a massive amount of insulin to get there. Long before we get blood glucose in the diabetic range, our insulin levels have been sky high. Eventually the insulin resistance gets too much and our pancreas can't release enough insulin to reduce the blood glucose and our blood glucose levels become high enough for a diagnosis of type 2. Anyway, that's one reason I stick to low carb, even though I seem to be able to tolerate higher carb intake. I am going to ask my doctor for a fasting insulin test this summer, but I have a new doctor that I haven't met yet, so who knows if he'll do it. I know my last one wouldn't have.

5. Personally, I don't think the NHS dietary advice works at controlling type 2 diabetes for the vast majority of patients. Otherwise, why would they tell everyone that even if they follow the advice their type 2 diabetes will get progressively worse?
 
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donnellysdogs

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The NHS advice leads people into diabetes......
 
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tim2000s

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I've followed this thread with interest as a T1. It raises some interesting points.

Unrelated to the discussion, but maybe pertinent to @mikej1973, your daily calorie intake is surprisingly high when not fasting.

As a 14.5 stone 6'4" guy with 10-12% body fat that does a decent amount of wrights, I consume 2700 calories a day to bulk up and to trim down, 2000 per day.

Your 2500 is what most body builders would consider quite high for someone that was weight reducing.

The point I'm making is that, in line with many other comments on here, your stats appear to be one of those that is an outlier and doesn't fit the considered norms. Given a population is distributed on a bell curve, and you appear to be towards a more extreme end of it, your experiences seem to lie outside of those of most on here.

Keep doing what you are doing. It works for you and that's the important thing but I suspect that you are not representative of the wider population, and that's why people are finding your feedback difficult to make sense of.
 
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mrspuddleduck

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As usual I'm now going to probably over simplify things! I don't think anyone is dictating a specific diet for diabetes EXCEPT the majority of health care diabetes specialists. And there for me, lies the rub. Over and over again we have reports of diabetic 'patients' being demoralised, demeaned, and treated appallingly when they attempt to have an intelligent discourse with a professional in order to glean BALANCED information regarding the options for their diabetes management.
Its simply not about one size fits all. But my expectation is I expect the professional who claims to be an expert should be fulfilling my rights as the patient and providing me will the appropriate information for ME to make the decision about my body.
Oh and do pcts still exist?
Sue x
 
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donnellysdogs

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No, PCT's are now CCG's.
 
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Totto

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Thing is that @mikej1973 isn't diabetic at all as his OGTT came back at 4.something. As we all know, including mikej and his HPCs, this effectively excludes a diagnosis of diabetes. The cut-off is at around 12, depending on testing method so he has a lot of work in front of him to cause enough damage to his pancreas to qualify as diabetic. His carb intake seems promising though so I'm sure he will succeed eventually. .
 
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Totto

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If this is true and this man isn't diabetic at all, why is he trying to make out that he is and spouting all this useless verbage. sad.
He did have a HbA1c of 60 before the OGTT so at one point he actually was diabetic. Apparently this was due to eating huge amounts of sugar, if I have understood his posts correctly. Since he has cut out sugar, lost weight and got 4,8 or there abouts on OGTT. Lucky him.
 
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satindoll

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He did have a HbA1c of 60 before the OGTT so at one point he actually was diabetic. Apparently this was due to eating huge amounts of sugar, if I have understood his posts correctly. Since he has cut out sugar, lost weight and got 4,8 or there abouts on OGTT. Lucky him.

I'm tempted to say one high reading dose not make you diabetic, hubs had a shocker after a piece of daughters Christmas cake, but it doesn't make him diabetic either,
 

mikej1973

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If this is true and this man isn't diabetic at all, why is he trying to make out that he is and spouting all this useless verbage. sad.
How is a Hba1c of 60 not diabetic? I'd love to be non diabetic. But im.diabetic just like you. Difference is I don't believe the earth is flat and I'm reasonably certain santa doesn't exist too!

I'll come back to the grown up discussion tomorrow.
 

mikej1973

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Thing is that @mikej1973 isn't diabetic at all as his OGTT came back at 4.something. As we all know, including mikej and his HPCs, this effectively excludes a diagnosis of diabetes. The cut-off is at around 12, depending on testing method so he has a lot of work in front of him to cause enough damage to his pancreas to qualify as diabetic. His carb intake seems promising though so I'm sure he will succeed eventually. .

But a.Hba1c of 60 confirms a diagnosis of diabetes. You need to look at the big picture.
 
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mikej1973

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I'm tempted to say one high reading dose not make you diabetic, hubs had a shocker after a piece of daughters Christmas cake, but it doesn't make him diabetic either,

A Hba1c isn't a single high reading. It's 3 months of high readings rolled into one. The test could've been wrong. But how do we confirm that? I take things at face value.
 

Winnie53

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@mikej1973 First off, I read every post in this thread, so I've heard both yours and other's views.

I believe you have diabetes, also that once we're confirmed through testing over time to have diabetes, we have it for life.

As for your view that testing isn't useful after the first six months or so, here's something to think about...

Our life circumstances, health status, weight, and what and when we eat are constantly changing, also how much insulin we're producing and how insulin resistant our cells are also is changing.

For this reason, I believe it's important for all of us to continue testing. One specialist in diabetes treatment suggested scaling back to three days a week, four times a day, one day on a non-work day, two days on a work day, which I think anyone can afford out of pocket. (For me that cost would be $2.50 a week or $10 a month; my test strips cost 20 cents each).

Only through some level of regular testing will be able to catch dangerous trends and make appropriate adjustments.

I agree with others here that you are an "outlier". I also am an outlier. I'm just on the opposite end of the spectrum. Not fun, and a real set-up for defensiveness because we differ from the main group.

I don't know what percent our of pre-diabetics and type 2 diabetics are helped by the current healthcare system in the US and the UK. However, from everything I've read so far, it doesn't appear be many.

The problem I and others here have with the current healthcare system is that the majority of us, likely 80% - (but I'm pulling that number out of thin air) - are being advised to do the opposite of what works best for us.

I'm angry, not with you Mike, I'm angry with the current healthcare system's current treatment of pre-diabetics and type 2 diabetics.

The day after I found out my blood glucose levels had been high, and out of control, likely for years, in mid February, I was devastated.

The next day, something wonderful happened.

I came across an article by David Mendosa in which he described he how he normalized his blood glucose levels without medication with guidance from the book Dr. Bernstein's Diabetes Solution. I bought the book, started the LCHF diet, and marveled at how quickly my numbers came down, though it did take a month, and my numbers are still not in the normal, non-diabetic range...yet...which makes me an outlier.

When I was diagnosed and treated for pre-diabetes 10 years ago, I was shown how to use a meter, told to keep my blood glucose under 120 mg/dL, and told later, when I started to eat meat and vegetables only that I would cause brain damage. At that point, I lost all hope, but continued to eat as healthy as possible and I stopped testing.

I was very clear with my healthcare team from the beginning that medication was not an option that I would consider, yet they withheld information on the LCHF diet from me.

Why?

As a result, my blood glucose steadily and silently climbed for the next 10 years. During those years, it appears that little or no damage was done to my eyes, kidneys, or liver, though not sure about my cardiovascular system which is a bit scary.

How did that meet my healthcare needs?

There's one more point I want to make. As I continued on the LCHF diet, I began reading about the low or no fat, high carb diets for type 2 diabetics. I never was able to find an active online support forum for those folks.

My question for you Mike is have you been able to find an online support forum that supports you as a type 2 diabetic on a high carb diet, where you're not an outlier?

Edit: I just realized that this discussion was originally posted in the Type 2 area of the forum. One of the challenges with posting on Diabetes.co.uk is that I'm not always sure where to start a new discussion, and I've had at least one discussion I started moved from the Low Carb Diet area to the Type 2 Diabetes area. Perhaps this discussion would fit better in the Low Carb Diet area of the forum, since it's written from a Low Carb Diet perspective.
 
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CollieBoy

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I manage a hbA1c in the 30's, and my OGTT was 5.1 @ 2 hours and a fasting bg ~5 but consider myself diabetic as I control via a HCLF diet and spike on carbs! I am D but I hope, a well controlled one:cool:
 

phoenix

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There seems to be a bit of I'm more diabetic than you going on.
There are a lot of people on here that would be classified as non diabetic if it were solely their current glucose results that counted. They may be controlled but they are still susceptible and if they put on weight, stop exercising, get sick or get old (or any combination which means they require more insulin to be produced) then they are unfortunately likely to see hyperglycaemia return.

If you eat very few carbs in your diet and you eat a high carb load then you will spike. It would happen even if you didn't have diabetes . That's not controversial, it's been known for almost 100 years.
(see Himsworth about 1935 ; he was the guy that invented the glucose tolerance test in the first place. The paper is online somewhere. )
But the DUK info in leaflets has, I agree been confusing. Here's a summary of what Jim Mann, the chairman of the committee that devised the present European diabetes dietary guidelines said about carb quality (and DUK type advice)
http://scepticalnutritionist.com.au/?p=1069
(the DUK website has changed since the lecture in it's advice on starches)

Re whether most people do follow the guidelines is doubtful.There's one study from a British clinic, some years ago. Out of 96 people almost no-one actually reported a diet that complied with them.http://onlinelibrary.wiley.com/doi/10.1111/j.1464-5491.1992.tb01756.x/abstract

If high carb diets per se couldn't work then why is there a seeming success with a 70% carb macrobiotic diet ?
or the buckets of raw veg and fruit diet from http://www.mangomannutrition.com/reversing-type-2-diabetes/

If you want to see a mirror image of some of the threads on here have a look at the Mcdougall forums .
https://www.drmcdougall.com/forums/search.php?keywords=diabetes

edit: I'm not a vegan, and would question someone who said that it was the only way also.
 
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