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How irresposible are the current diet NHS guidelines for T2 and pre diabetics?

Discussion in 'Prediabetes' started by gardengnome42, Nov 8, 2017.

  1. ringi

    ringi Type 2 · Well-Known Member

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    Firstly a nurse can keep to what a doctor tells them to do, even if it is outside of the NICE guidelines. A nurse presenting the Xpert diabetes training is also covered as the handbook presents "low carb" as one of the options someone should consider. (Most CCGs have not noticed that Xpert training now pushes low carb and 5:2, as their GPs approved the course before it was updated..... But a lot of the trainers skip over the low carb bit of the Xpert training.)

    A nurse can also tell people about this forum as a source of support, as they are advised to point people towards support groups.... A nurse could also explain how best to use a BG meter, and let people discover low carb for themselves, but CCGs will not allow many people with Type2 to have a prescription for test strips.

    A nurse can also say "it seems that people who read XXX book" gets good results, but I have not had time to read to book myself yet....... Or just have some books on display on her/his desk without saying anything about them......

    The NICE guidelines say diet advice should be individualised according to the needs of the person, Dr David Unwin says his clients need to reduce their carbs....... (The NICE guidelines also say statins should be OFFERED, but that a GP can record someone has declined to take them. There is nothing stopping a GP offering statins along with explaining how limited the benefits are.....)
    [/QUOTE]
     
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    #61 ringi, Nov 10, 2017 at 11:35 AM
    Last edited by a moderator: Nov 10, 2017
  2. ringi

    ringi Type 2 · Well-Known Member

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    Research was done a long-term ago about this, people who were keto adapted having been on a VERY low carb diet for a long time could function with a much lower BG level than 3.5 mmol. The researchers injected the insulin while monitoring BG and having the victims do IQ type tests. The only signs of stress were seen in the doctors, as they know that people should be dead with how low their BG was being taken.....

    Details of this experiment are in the "Art and Science of Low Carb Living" book.
     
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    #62 ringi, Nov 10, 2017 at 11:43 AM
    Last edited: Nov 10, 2017
  3. woodywhippet61

    woodywhippet61 Type 2 · Well-Known Member

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    [/QUOTE]

    Whilst I do agree with nearly all of what you have said I do think that the comparison you made (now edited) was too strong. Mind you I have responded very robustly myself in the past. Given how some treat a lot of us it's hard not to be totally negative about them and to see them as 'the enemy' and I do get very cross/angry when I read about the latest load of information that has been advised to newly diagnosed diabetics.
     
    #63 woodywhippet61, Nov 10, 2017 at 11:50 AM
    Last edited by a moderator: Nov 10, 2017
  4. MikeTurin

    MikeTurin Type 2 · Well-Known Member

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    Exactly. For diet it'sw false that "one size fits all", so giving a boilerplate response on this it a surefire way to make people fail. In this forum the eatwell plate is downturned, but the biggest problem is that eatweel plate in explained wrong and followed worse. Maybe LCHF has more success because people that are on low carb diet have to be more food-aware? The fact that pepperoni pizza is not part of mediterranean diet maybe is not well understood by general public and ill-informed people with diabetes.
     
  5. Guzzler

    Guzzler Type 2 · Well-Known Member

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    Big Food and Big Advertising have created the stereotyoical Italian/Mediterranean diet. I suppose it comes down to education in the end.
     
  6. MikeTurin

    MikeTurin Type 2 · Well-Known Member

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    May I suggest that als bad school is to blame? I don't know about UK schools, but nobody ever told me at school eating and cooking tips.

    I've had awful experiences in school's canteens, both in public and private catholic schools. Trying to shovel in the throat of kids bad but officially healthy food is a sure fire way to make the kids absolutely love Mars bars. I remember the vast differences between say the canteen apples and peaches and the one bought at the farmer's market or the "fish" they served me and the trouts bought from the fishy guy near the river.
    Of course the advertising has a big slice on the problem, but it's also a general perception that is wrong.
    Heck, even I being in Turin, had a wrong idea about pizza. Then I found a tiny pizza parlor where the cook was from Naples that changed the idea about what proper pizza is.
    When I read about what UK and USA people think what is Italian style or typical Italian food I find that is really different on what we eat and what is considered Mediterranean versus actual regional foods.
     
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  7. DCUKMod

    DCUKMod · Moderator
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    Guys a small number of posts were edited or removed from this thread.

    I appreciate this topic can rouse very strong responses, depending on each of our personal experiences, but please do remain civil in expressing your opinions, without implying deliberately criminal intent.

    Many thanks.
     
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  8. Brewers23

    Brewers23 Type 2 · Active Member

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    [/QUOTE]
    The other day I had a patient with a high BM and associated symptoms of thirst and polyuria and as part of the assessment I did suggest this website and possibly reducing carbohydrates etc. Their BM was high, but not spectacularly so; no dangerous levels of ketones in capillary blood test, they’d been directed to A&E by their GP because of a raised venous blood glucose, unfortunately I couldn’t just send them home without a medical review as they’d sen their GP.
    On a personal level I no longer take statins as the benefits are questionable when compared with the risks.
     
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  9. kokhongw

    kokhongw I reversed my Type 2 · Well-Known Member

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    I believe you could be referring to this 2009 study done by the Yale School of Medicine. It would seems that MCT oil/VCO could provide some level of protection during acute hypoglycemia.

    Medium-Chain Fatty Acids Improve Cognitive Function in Intensively Treated Type 1 Diabetic Patients and Support In Vitro Synaptic Transmission During Acute Hypoglycemia
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2671041/


    [​IMG]
    I also noted from Dr Keith Runyan's blog that he made the following point:-
    https://ketogenicdiabeticathlete.wo.../44-october-2017-update-on-my-t1d-management/
    The main problem with the mainstream dietary guideline appears to be that they all geared towards hypo/DKA avoidance by ensuring there is more than enough glucose in our system, yet not high enough for DKA...because that is what they often have to deal with at the A&E.

    But if we reduce carbs/insulin needs significantly, as per Dr Bernstein's law of small numbers, it actually takes out much of the glucose variability and fluctuations.
     
  10. gardengnome42

    gardengnome42 Prediabetes · Well-Known Member

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    Who are the dinosaurs that make these rules I wonder. I've still got an awful lot to learn and it is all so confusing and often conflicting.
     
  11. gardengnome42

    gardengnome42 Prediabetes · Well-Known Member

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    I do so agree Guzzler though some of the sites [thankfully not this one] are allied to the NHS and their crazy guidelines: the other main diabetes site in the UK for starters!
     
  12. bluecurlylegend

    bluecurlylegend Prediabetes · Well-Known Member

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    Well, those "poor" French geese actually struggle to jump the queue to get to the corn poured into them. They are not forced.
    Watch it some time and you'll probably come to the same conclusion as myself.....geese are birdbrains !
     
  13. Guzzler

    Guzzler Type 2 · Well-Known Member

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    I hear that things might have started to change over on the other site. Fingers crossed for the members, eh?
     
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  14. ringi

    ringi Type 2 · Well-Known Member

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    @kokhongw No they went a lot lower than that study, sorry I can't provide a link, you will have to read the book as they study is too old to have made it to the web. The study you posted in interesting in that MCT oil/VCO seems to work without a long term very low carb diet.
     
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  15. kokhongw

    kokhongw I reversed my Type 2 · Well-Known Member

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    How much lower did it go? In present day, it would likely be difficult to get approval from ethics committees to go much lower than 2.8 mmol...
     
  16. ringi

    ringi Type 2 · Well-Known Member

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    Sorry can't remember, but the book does point out that no ethics committee would approve a study like it these days.
     
  17. bulkbiker

    bulkbiker Type 2 · Well-Known Member

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    This is mentioned in a video I have seen of Dr Phinney who I think said that they got the subjects down to 1.5 mmol with no ill effects in the 1970s' . He I think said that these results had never been published because it was unethical even then. Unfortunately I have watched so many Phinney videos that I can't remember which one it was... I'll have a quick look around and see if I can find it.
     
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  18. bulkbiker

    bulkbiker Type 2 · Well-Known Member

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    I think it is either in this one


    or this one..


    but I have a dodgy internet connection and it's a total of 2 1/2 hours of video so I'm afraid I can't point to the exact point sorry!
     
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  19. kokhongw

    kokhongw I reversed my Type 2 · Well-Known Member

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    @bulkbiker Thanks. Will go thru the video again. :D
     
  20. kokhongw

    kokhongw I reversed my Type 2 · Well-Known Member

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    Found it from Reddit, Phinney narrates Cahill's starvation experiments in 1972-73....
     
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