Infographic; trying to get the message over in a picture. feedback please

SunnyExpat

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I'd read the link, read the tables in the appendix, look at sugar having a GI of 58 per 50g, not 100g, read the GL, make no sense of the comparison, and bin it to be honest.

I still don't know why a T1 would need more insulin with bread than sugar, so I think it needs to be made easier, if you intend to hand it to every patient you have in your surgery.
 

phoenix

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But you still have to take into account the amount of carbohydrate in your 100g portion,
I use the GI and have good control, partly because of it but I don't use it to compare apples with pasta. or bananas* If I choose to eat rice then I would go for a lower GI rice ,I would compare the effect of 100g of one sort of rice with another. I could even compare it with other cereals because they all have almost the same percentage of carbohydrates.

150 g (cooked) of Jasmine rice has a GI of 108, higher than glucose. By comparison 150g of Uncle Ben's converted rice has a GI of 38. Both have a similar carb content .The GI helps me to choose between these very similar grains .(though as someone who cares about nutritional quality, I would go for a slightly higher GI rice that was whole grain)

It would be daft though to compare that with 150g of new potatoes because 150g of new potatoes contain slightly more than half the amount of carbohydrates ie 21 g of carb compared with 40g in 150g of rice.


That's where your chart is wrong; you need to compare similar amounts of available carbohydrates.

*Bananas are really difficult to assess because their GI depends on ripeness, unripe bananas contain a lot of resistant starch which is not digested in the small intestine. This will have an effect on postprandial glucose and RS might even be beneficial to people with diabetes.
 

donnellysdogs

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I personally would like to see something similar to the "swap this for this".... Ie pasta or a rice dish swap to a lovely pictured steak n green veg dish or a swapsie from two pieces of toast to a bacon and egg with say tomatoes.

I just wish that all of the info was headed towards the population as a whole.. Not just the diabetics or prediabetics.

I had a good chat with a lot of medical staff yesterday and basically they do say that people do not realise that obesity also lends itself to increased cancer risks...one example was made on a one to one basis to me that nowadays a lot of obese persons choose to get mobility scooters. They are no longer used by persons with needs such as MS, missing limbs, car accident injuries. I was talking to radiologists, surgeons, consultants, oncologists and they all see obesity as being the biggest damage to human health and well being.

Southport GP has to be able to get his message and pictures out to the population as a whole... Otherwise its not just diabetes but a whole range of illnesses that are just going to kill the NHS off.

I hugely admire southportgp and being exact and precise is a necessity but I still wish our population worldwide from childhood could change its thinking. To me it has to be something that is suitable for all GP Practices as well.

Our GP Practice will not put up any literature about diabetes unless it comes ftom disbetes.co.uk.... Until they back change and southportgp the nations are still doomed to the eatwell plate.
 
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Southport GP

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@Southport GP - Thanks for responding. Having given the original image a quick look, and asked my questions, I then tried to express my feedback from a couple of standpoints. Firstly, how I felt when first diagnosed, and what information I needed and wanted at that time, then secondly overlaying that having considered the sorts of questions we've seen from newly diagnosed/new members we have see come through the virtual doors to the forum.

My first comment would be that the new image is better, in that most people would contentedly eat most of the items in the graphic. On the earlier one, I think almonds might not be a big day-to-day feature for your newly diagnosed individual. When you have your composition finished, I’d consider your staging background, as I don’t think the brown background with beige carpet presents the images in their best light. It’s all a bit brown, and maybe says 70’s, rather than 2015 to me. Finally, on the image itself, I would recommend you have your source of data in the footer, so that it’s easy for anyone with an enquiring mind to validate and/or explore for themselves.

Moving forward. As a newly diagnosed patient, whilst I was in shock/angry/frustrated, I was also a sponge for information. I wanted to know everything, in simple messages, so that I could apply it quickly, and develop my battle plans. For me, I’m certain the glycaemic index wouldn’t have hit me between the eyes. I’d have written down those numbers, or photographed your image on my phone, then gone to check it out. When I tried to do that last night (without using any of my existing bookmarks or knowledge), it took me a while to pin down information that matched your graphic. When I Googled, “how much sugar is in brown bread”, Dr Google told me, link, on link, on link, 4.1gr (per 100gr). OK, that isn’t the whole picture either, but maybe you see where I’m coming from? In my time of frustration, my confidence would have been dented, there and then. My thoughts would have been along the lines of “How hard should this be?”

Newly diagnosed, I wanted to know what to eat, and how to choose, fairly promptly, when shopping. And, I had to translate whatever I was learning about diet, to my partner, who is chief cook on Planet Breathe. I’m sure that’s a common occurrence, one way or another. For me, the answer has always been to read the labels, and most packaged foods these days have nutritional information on them. Looking at the nutritional information label for brown bread, on any of the big supermarket websites, I don’t ever see any reference matching the numbers you had posted on the original image. That would have confused me more, and I would have felt it to be an unhelpful image.

From the second standpoint, of new member queries: Quite a few arriving (or maybe it’s by the time they register to ask a question), they’ve read that they need to trim carbs. The two most common quantitative questions we see are, I feel, Is it total carbs or surely it’s sugars we’re counting?”, or “How many carbs do I start at?” We rarely have anyone asking about glycaemic index. We do in a roundabout way where individuals have converted from white to wholemeal pasta (and the like), but aren’t seeing the results they expected.

I’m sure your images are being created to inspire or reinforce an action. If you want individuals to take an action they can carry out easily in their day-to-day lives, then I’m not sure your image gives them a fast track. In order to do that, they need a handle on the GI, and probably a resource – either by an app or a hard copy book, and surely shopping becomes even more of a nightmare, going around the supermarket, looking up items in their book or app, when there is great information on the packaging of almost every item.

Whilst using the product labelling doesn’t give an indication of absorption rates, it’s a quick start way of getting the drift. For me, GI is almost finessing, and something to tackle, once someone has the hang of the big baddies.

Obviously, I’m swimming against the tide of the other feedback, but if I’m to respond, I have to respond honestly. If GI is how your studies have worked with patients, then I am even more impressed by the results you have achieved. It feels to me to be the harder route.

Please challenge, rubbish or whatever. My shoulders are broad, and my chin has taken the odd blow, over the years.
THANKYOU for this and all the other comments which have made me think
Yes you are correct who is it aimed at ?
With newly diagnosed DM I usually start by explaining that diabetes means you struggle to deal with glucose and the so the need to drastically reduce Then I move onto where it is hidden in surprisingly large amounts; bread etc etc
I experimented asking a group of folk with Diabetes the other night They liked this info as more of a quiz Matching the glucose cylinders with the foods. But I suppose they are now a very experienced group.
Tried the photo on a number of doctors: they really struggle to believe its true which is good because it generated a lot of debate and serious thought about the low carb diet

Again thanks for all the intelligent comment and debate My paper on improvement in liver function on the low carb diet will be available any day and I hope you will all help get it out there !
 
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AndBreathe

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THANKYOU for this and all the other comments which have made me think
Yes you are correct who is it aimed at ?
With newly diagnosed DM I usually start by explaining that diabetes means you struggle to deal with glucose and the so the need to drastically reduce Then I move onto where it is hidden in surprisingly large amounts; bread etc etc
I experimented asking a group of folk with Diabetes the other night They liked this info as more of a quiz Matching the glucose cylinders with the foods. But I suppose they are now a very experienced group.
Tried the photo on a number of doctors: they really struggle to believe its true which is good because it generated a lot of debate and serious thought about the low carb diet

Again thanks for all the intelligent comment and debate My paper on improvement in liver function on the low carb diet will be available any day and I hope you will all help get it out there !

Unfortunately, my approach to my own practise didn't go the course. The GP I usually consult with was keen, but the Partners rejected the idea, which was disappointing. However, I have since made a couple interesting contacts, who are actually at the nucleus of specialist diabetic care in my county, so I'm not finished yet. The Consultant I was talking to, in a social context, was familiar with Professor Taylor's work, but described it as "utterly brutal", but hadn't seen your paper. He will do very soon. An email is on my to-do list for the weekend. :)

I don't give up easily!
 

Serena51

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I think the picture is really clear and easy to understand. I have some cognitive disfunction and can't always understand the technical type posts. To be able to look through pages of photos would be much better to assimilate the information.

Thank you Southport GP, would your final result be available online?