There's no pleasing some people....

[silverbirch]

Had my 3 month b/g review with DNS at the hospital this week. My HbA1c is down from 130 to 51, and although they were pleased with this result I still got into trouble for low carbing. The dietician "tutted" and said you're not eating enough carbs, the DNS commented "I don't think she will ever change her diet". I felt their disapproval. Now I'm thinking should I get up and walk out, or challenge their way of thinking. No I thought you're on to a losing streak here, so I just replied that my diet has always been the same and what I eat now is the same diet I had before I was diagnosed Type 1 diabetic. It is what I have always eaten. I could have "lied" on my diary sheet and put in the amount of carbs they want me to eat, but no I was honest. But maybe next time I'll write on the diary sheet what they want to see. Will they know, whether I've eaten all of those carbs, of course they won't. They don't check. How can they.

At the end of the day it's brought my b/g down dramatically, and that is what matters. Sometimes you just can't win. Apologies for the small rant there.

 

[Squire Fulwood]

I think I would feel a little disappointed if you lied in order to please them although you are the one who has to do as you think fit. I decided to always be truthful to DN but in a respectful way. I remember the day she was giving me instructions on what to eat etc. When she got to the part where she said I was to buy semi skimmed milk I said "no". There was an uncomfortable silence since I don't think anyone had ever said that to her before.

"Why not" she said.

"Because it tastes 'orrible", I said.

Looking back with my new knowledge I wish I had interrupted her when she was talking about margarine scrape and fried food.

 

[DeejayR]

Any time any of us resists, however gently, the "old" line in diet from our health "experts" we help to break down the barriers. No doubt "they" feel under pressure from above and from all sides and they're only human. Well, most of them.

So well done.

 

[CarbsRok]

In my 50 years of diabetes I have only ever been asked once what I eat, my answer was food My dietary choice has never been discussed with anyone.

 

[Daibell]

If it was me I would refuse to see the dietician. I have never been asked to see one and I don't see the point as most talk rubbish. You have a right for at least an annual review using the NICE guidleines but there is no reason to see a dietician. You know you are right so keep on with the low-carbs as you are obviousy winning. Ask the DN why when carb-counting you increase the insulin as you increase the carbs to avoid high blood sugar and higher insulin levels in the body than needed cause weight gain.

 

[tim2000s]

The right answer to the Dietician and DSN is "I see your lips moving but all I can hear is 'Blah, blah, blah'."

And don't lie on your forms, just point out to them that they know nothing about your diabetes and what works for you. With all the focus on patient led care for diabetes, they shouldn't presume to know better than you when the results show that you are achieving what you need.

 

[Totto]

Getting HbA1c down from 130 to 50 I think they should have given you a medal AND asked how you achieved it in order for them to tell other patients about your success and how you did it.

Don't lie. There is no point.

 

[dawnmc]

I think you've done brilliantly Silver. I would be so proud., They do make you feel deflated and make you wonder if it is all worth it. But don't listen to them. I think its their job to put you down.
I dismissed my dietician when she mentioned carbs. She said if I thought they could help I can always go back to them, I just replied I wouldn't waste any more NHS money.

 

[Juicyj]

Sadly it's the luck of the draw who you see and what knowledge they have been fed.

I had a similar conversation with my DSN and dietician over my low carb diet with both telling me that I wasn't eating enough carbs, so I told them about my journey since diagnosis and highs and lows on trying to eat 'normally', depression from fluctuating BG, and how since eating low carb i'd improved both BG and moods - there wasn't anything else they could say after this. My consultant however was very pleased that i'd changed my diet and praised me.

No one knows you better than you - and what works for you, eating low carb means less insulin so the NHS are saving money. if they took more interest in understanding what works best for type 1's then they shouldn't be saying this.

 

[Juicyj]

Getting HbA1c down from 130 to 50 I think they should have given you a medal AND asked how you achieved it in order for them to tell other patients about your success and how you did it.

Don't lie. There is no point.

Agree completely - no need to lie, you would probably feel worse.

You have done an amazing job, so a huge pat on the back for doing so well

 

[Jaylee]

I'm with the others on this. They asked, answer with the truth... What you are doing is working. "The proof is in the pudding." Or in this case cutting it out..

They will eventually (if not already.) see a difference in Hba1c trends regarding the patients that follow the dietary guidelines set by the NHS & those that follow something else..
Why deny the positive by giving false data on your diet, thus "fudging" the the reason for the overall result findings.?

 

[himtoo]

fantastic result on the A1c


always tell the truth -- and always go in prepared - it is hard to argue with written down results

well done !!!!!!

 

[Eldorado]

How silly. Surely it doesn't matter how much or little carbohydrate one eats if it's all carbo counted and insulin is injected to correspond. Well obv you wouldn't go bonkers with it, health wise. Must have spoilt your 'moment if glory' a bit. Anyway, well done from me.

 

[dancer]

If it works, do it and record it as usual. If similar comments are made in the future, just say, "It works for me." They can't argue with that!

Why get into the bad habit of telling lies? It may have changed but when I was diagnosed, over 30 years ago, the "professionals" often seemed to expect the patient to lie. I have always told the truth and have actually answered a doctor with, "It works for me." when he seemed to forget that I'm an individual with individual needs.

You've done well so keep up the good work and be honest about it!

 

[AndyS]

Excellent results.

Been there and seen it all. One year I walked in pleased as punch that I got my A1c down and the complained about my cholesterol being a little elevated.
The following year I had adjusted my diet and got my cholesterol down and they then complained that my blood pressure was high. When I pointed out that I was nearly wiped out by a truck on the motorway less than 10 minutes before that seemed to fall on deaf ears.
The following year I took the bus and had a nice cup of tea before I went in so my blood pressure was perfect (as was everything else above) oh that year they said I needed to loose weight (this from a Dr shorter than me and carrying more weight than me). That was the final straw and my response to her face was "Fine... You first!"
Since then I have ignored most of what they have to say, am brutally honest on my forms and with my diary, and basically tell them that every time I see them they find some fault and since they can't do better I will only pay attention when they have something constructive to say which they can back up with solid evidentiary science.

Oddly enough, I never had any trouble with my DSN's they keep telling me I am doing a great job and just to holler is I need any help. I haven't needed any help.

Low carbing is proven to work, fact. What they are spouting on seems to be a guideline. Well ignore it. What works for you works for you and that is excellent so I say stick with it. If they want to argue the toss then you can point to your evidence and tell em until they can provide seriously compelling evidence to refute it you will keep doing what works for you.

 

[noblehead]

No need to lie @silverbirch, if they don't believe that you've always eaten that way then take some old bg diary's in as prove.

Well done on lowering your HbA1c, that is some reduction

 

[JRW]

In my 50 years of diabetes I have only ever been asked once what I eat, my answer was food My dietary choice has never been discussed with anyone.

Although much newer to diabetes than you, my diet has never been discussed either . I also don't have a healthcare team lol, except Insulin and strips.

 

[donnellysdogs]

Shame that they can't see that lower carbs has enabled you to achieve such great results... In a T1 lower carbing is good as its less insulin and less rises or drops!!

Males me mad that they are so fixated on changing peoples diets that achieve good levels so quickly and they are so entrenched in NHS stuff carbs attitude.

Blimey..I'm a lower carber and my consultant and nurse are fully behind me... The first ones in 30 years that have actually asked about my food and agree that it is a good choice. Totally different from my awful GP Practicd Staff attitudes.

 

[JTL]

We have what is called a diabetic nurse at our surgery.
She ridiculed me for mentioning GL .... you mean GI there's no such thing as GL!
I tried to explain but stopped and told her she must be at least ten years out of date with her knowledge and the information she dishes out
I have never seen her since.
I simply refuse to have anything to do with her.
She tried to bully my daughter into an abortion which is another story.
An old lady asked could she sit next to me in the waiting room because this nurse was about to come out and she wouldn't dare bully her if she was sat next to me!
I see my GP and do blood tests through the surgery nurse who is so much more knowledgeable and has great people skills.

 

[Eldorado]

We have what is called a diabetic nurse at our surgery.
She ridiculed me for mentioning GL .... you mean GI there's no such thing as GL!
I tried to explain but stopped and told her she must be at least ten years out of date with her knowledge and the information she dishes out
I have never seen her since.
I simply refuse to have anything to do with her.
She tried to bully my daughter into an abortion which is another story.
An old lady asked could she sit next to me in the waiting room because this nurse was about to come out and she wouldn't dare bully her if she was sat next to me!
I see my GP and do blood tests through the surgery nurse who is so much more knowledgeable and has great people skills.

A letter to the Practice Manager is called for.