Low carb

[slikwipman]

After reading posts about low carb diets I am confused why so many people on this forum find it helpful in managing their diabetes but trained healthcare professionals are against it. Could someone please help me understand why the healthcare professionals don't recommend it when I read on here how the people on a low carb diet find it helpful.

 

[Rachox]

I don't really understand why NHS advice is only coming round very slowly to low carb dieting. I was diagnosed in May and was easily convinced, after stumbling on this website, that low carbs was the way to go. Carbohydrates turn to sugar, diabetes is an inability to process sugar, why would I want to over load my poorly system with sugars?
I started a low carb diet immediately after diagnosis, along with Metformin (the mildest of medication I believe) and I dropped my HbA1c from 70-45 in nine weeks. I have also lost 3 stone in 3 months

 

[bulkbiker]

A lot of "Trained Healthcare Professionals" were taught once often ages ago and don't keep up with more recent studies. Thus they regurgitate what they were told when they were at Medical School possibly up to 40 years ago. There are some (and thankfully a slowly increasing number) who are quite happy to support a low carb way of eating but at the moment they have to find a way to get this past NICE guidelines (which are again old science). So imagine you are a HCP and are expected to work within NICE guidelines but know they are wrong.. What do you do? Ignore the guidelines and risk the consequences or buckle under and carry on with your job maybe sending patients here to have a read?
The other thing I always say is that we have our diabetes not our HCP's so we need to learn more about it to help ourselves. Thankfully this forum is full of people who are constantly learning and reading new science to help us all.

 

[Engineer88]

Also they are used to people who don't help themselves and aren't willing to change. Remember your firmly in the minority just visiting this site....

 

[pleinster]

After reading posts about low carb diets I am confused why so many people on this forum find it helpful in managing their diabetes but trained healthcare professionals are against it. Could someone please help me understand why the healthcare professionals don't recommend it when I read on here how the people on a low carb diet find it helpful.

Hi. It is pretty basic really...three words - ignorance, arrogance and complacency. The fact that some (very good) medical professionals are completely up to speed with the benefits of a low carb high fat diet in relation to those seeking to get their blood sugar levels under control serves to demonstrate not that others are experts who disagree as a result of superior knowledge but that, sadly, they are doing the minimum and following guidelines that are outmoded or they are not updating their training (where NHS and council budgets can be a factor). I meet regularly with on of a team of four renal specialists since my transplant two years ago (which was NOT due to diabetes) and all of them are pleased with my diet as they can see the results..and they test my blood in all kinds of ways. I see a diabetes consultant too and he is extremely well informed...he tells me that the low carb approach is slowly starting to catch on and he personally thinks it is generally the best way to go for Type 2s at least, particularly if their BS is not ridiculously high, as part of a lifestyle change before trying meds. He is staggered by the sloppy approach of some others, particularly those who tell diabetics to eat plenty of carbs! It is nuts! Many who have been advising a "healthy diet" for so long are reluctant to now have to be seen to be changing their minds...some know very little about diet at all...others simply think they know best regardless. It is not good enough...but meantime, thankfully, we have access to the direct experience of diabetics who do very well indeed on a low carb diet (if they stick to it). One thing to partly explain a slight hesitancy to promote a low carb diet is that if it is adhered to strictly in conjunction with certain meds (such as Gliclazide) it can contribute to blood sugars dropping so low that hypos happen. There needs to be a greater drive from NHS management and in the design of training programmes..and while lack of financial resources is undoubtedly a factor, there is no real excuse for trained staff to issue advice that is completely wrong. I guess, you have to make your own mind up and keep your doctor/nurse informed. I found that keeping records of my meter readings and the food I was eating served me well in convincing any doubters, so I had the minimum of difficulty with medical staff. Also.. self testing meters...they also talk a lot of rubbish about how these are not required (ie. they cost money)...but meters are in my opinion the only way for us to identify the foods which have most impact on us as individuals and to take control and stay in control. Good luck.

ps. I tend to talk until someone hits me!

 

[Kristin251]

They don't have meters, aren't diabetic therefore don't test bs after eating. Just a small portion of why but I even told my doc insulin is t as easy as it sounds. He wouldn't know as he's not diabetic and trying to manage insulin and food.

 

[slikwipman]

I don't eat a lot of carbs but find that their effect on my bg levels are minimum anyway compared to other factors. The main ones being able to work and actually stay awake all day. So I don't try to cut down on carbs as a high dose o levemir at night seems to be best for me rather than carb counting and adjusting novorapid

 

[slikwipman]

A lot of "Trained Healthcare Professionals" were taught once often ages ago and don't keep up with more recent studies. Thus they regurgitate what they were told when they were at Medical School possibly up to 40 years ago. There are some (and thankfully a slowly increasing number) who are quite happy to support a low carb way of eating but at the moment they have to find a way to get this past NICE guidelines (which are again old science). So imagine you are a HCP and are expected to work within NICE guidelines but know they are wrong.. What do you do? Ignore the guidelines and risk the consequences or buckle under and carry on with your job maybe sending patients here to have a read?
The other thing I always say is that we have our diabetes not our HCP's so we need to learn more about it to help ourselves. Thankfully this forum is full of people who are constantly learning and reading new science to help us all.

To answer your question about HCPs I expect them to act like responsible adults and give out the best information they can. Sadly responsible adults are short on the ground and childlike women seem to be all I ever get. I wouldn't ask my doctor to plaster my house, so in the same way I expect to be able to trust what I am told by HCPs, sadly in my experience most of the NHS does not give a **** about its patients or what they are going through

 

[serenity648]

To answer your question about HCPs I expect them to act like responsible adults and give out the best information they can. Sadly responsible adults are short on the ground and childlike women seem to be all I ever get. I wouldn't ask my doctor to plaster my house, so in the same way I expect to be able to trust what I am told by HCPs, sadly in my experience most of the NHS does not give a **** about its patients or what they are going through

In their defense, those who are working for the NHS have to toe the NHS line and give out the accepted information to their patients. They are not trained in low carbing, nor are they allowed to promote it. Blame those who make the guidelines, but please dont blame the staff on the ground, struggling with the restrictions of their job. In all my many years of having medical intervention, I have only ever met one person at ground level who didnt care and didnt try their utmost to help me.

 

[slikwipman]

In their defense, those who are working for the NHS have to toe the NHS line and give out the accepted information to their patients. They are not trained in low carbing, nor are they allowed to promote it. Blame those who make the guidelines, but please dont blame the staff on the ground, struggling with the restrictions of their job. In all my many years of having medical intervention, I have only ever met one person at ground level who didnt care and didnt try their utmost to help me.

I really couldn't care less what opinions they have on low carb diets. I have been met with apathy and a couldn't give a **** attitude on much more serious problems. If they are acting on guidelines when they know they are wrong they shouldn't be there. Having the courage of your convictions is a basic trait every adult should possess especially ones in a responsible job. Trying to make excuses for such people is not on. If your not prepared to do your best in whatever job you do is unacceptable. It is not the fault of the person that has to deal with people's disgusting attitudes

 

[Mark_1]

Also they are used to people who don't help themselves and aren't willing to change. Remember your firmly in the minority just visiting this site....

I think you've hit the nail on the head with this. The general population like biscuits more than their feet and the eyes. The people on this site are in the minority. Attend one of the educational courses and you will see what I mean. The NHS doesn't want to waste time giving out advice that will be ignored anyway so eat a healthy diet is usually all the information given with no real expectations that it will be followed.

 

[slikwipman]

I think you've hit the nail on the head with this. The general population like biscuits more than their feet and the eyes. The people on this site are in the minority. Attend one of the educational courses and you will see what I mean. The NHS doesn't want to waste time giving out advice that will be ignored anyway so eat a healthy diet is usually all the information given with no real expectations that it will be followed.

You don't need feet to eat biscuits.

 

[pleinster]

Generally, I have nothing but good things to say about the NHS here in Scotland. The care I received at every level when I had my transplant was superb. The ideal we all want is, in my view, only hampered by political agendas and by bad management and short term vision. I have no reason to doubt the good intentions of the medical staff BUT, @Mark_1, to say that "the NHS doesn't want to give out advice that will be ignored anyway, so eat a healthy diet is usually all the information given with no real expectations that it will be followed.." just isn't good enough. I wouldn't dream of stating the case for the NHS, but if it is "their" (management? senior staff? who?) policy to deliberately issue incorrect or totally inadequate advice because of "their" view of what "the public" might take on board or not, "they" are not providing the care they are empowered to provide (and by law is their obligation to provide) to those they serve. A "let them eat cake" mentality is both arrogant and judgemental and I for one expect those in power (government) to ensure that those in power (hospital management from budget control to care policy) do their utmost to train staff adequately and to ensure that the "clients" (us) are not dismissed en masse as idiots because of perceived common attitudes. I would add that training IS available (not all training courses are considered part of compulsory updating of skills) and that a number of the staff I have had the benefit of seeing ARE trained and DO know about low carbing AND favour it AND do advise it. What is perhaps a more accurate statement is that the NHS in this one area (though I am sure in others too) needs to ensure that it treats us as individuals based on our individual circumstances. The last thing we need to do is to lie down and accept that it's okay for doctors (or their managers) to assume we are all stupid. I would add that I don't even think that is the reason for the lack of proper advice - poor management and inadequate resources are likely the biggest factor alongside some complacency. I would stress again...I value the NHS greatly but let's not simply excuse some less than perfect areas because "they" know what's best for us..when in some cases "they" clearly don't. I do, however, take @slikwipman 's horribly amusing point and would add...some people really are stupid enough to be watching Deal Or No Deal with no feet and a big tin of biscuits!

 

[Mark_1]

The problem is that the general population are idiots. When the 5 a day message came out it should have been 10. In this country it was decided that 10 wasn't a realistic number to get the public to aim for so they went with 5. That's how the NHS/government see diet advice and this is not just in the UK.
I think that my health is my responsibility. I also think that for the general population eating less, exercising more getting to a healthy weight and following NHS diet guidelines would improve most peoples health even if it isn't the best option for me. The NHS has limited funds and time. They also work on evidence based medicine. It will take lots of studies to prove that diet can be the answer but who will fund these, not the drugs companies. So at the moment the advice is to try a little better than you have been doing, maybe start by having one less biscuit.

 

[pleinster]

The problem is that the general population are idiots. When the 5 a day message came out it should have been 10. In this country it was decided that 10 wasn't a realistic number to get the public to aim for so they went with 5. That's how the NHS/government see diet advice and this is not just in the UK.
I think that my health is my responsibility. I also think that for the general population eating less, exercising more getting to a healthy weight and following NHS diet guidelines would improve most peoples health even if it isn't the best option for me. The NHS has limited funds and time. They also work on evidence based medicine. It will take lots of studies to prove that diet can be the answer but who will fund these, not the drugs companies. So at the moment the advice is to try a little better than you have been doing, maybe start by having one less biscuit.

I don't eat biscuits. My blood sugar is well under control. I also believe that I am responsible for my health as far as is possible. None of which excuses those running the NHS from failing to ensure that appropriate staff are issuing correct information...or at least to ensure that they are not issuing potentially damaging information. That is their responsibility...legally as well as morally.

 

[Mark_1]

I guess they think they are giving out the correct information. The eatwell plate would still improve the diets of most of the population. One third whole grains, one third protein/dairy, one third veg/fruit, avoid processed foods. Until there are long term studies showing that low carbing is clearly a better option this wont change and even when there is it will still take a long time to filter through.

 

[slikwipman]

I guess they think they are giving out the correct information. The eatwell plate would still improve the diets of most of the population. One third whole grains, one third protein/dairy, one third veg/fruit, avoid processed foods. Until there are long term studies showing that low carbing is clearly a better option this wont change and even when there is it will still take a long time to filter through.

I don't accept the argument that the NHS is under funded, just wasteful and top heavy. Changing ones diet is challenging for most people, I was myself ignorant to what a carb was until diagnosed with secondary diabetes.

 

[Jaylee]

Hi @slikwipman ,

Great thread! However it appears to be in the wrong subsection...
I would quite happily move it for you to diabetes discussions if that's OK with you?

 

[catapillar]

diagnosed with secondary diabetes.

Your avatar says you are type 1. Type 1 can't be secondary diabetes. What is your diabetes secondary to? Would you mind clarifying?

Personally, I can't really understand why a type 1 diabetic would be so emphatically distressed with the medical advice on carbs because the advice for type 1s is: eat however many carbs you want just so long as you are appropriate adjusting your insulin. So however many carbs you want to eat is entirely your personal choice. It's a little odd to be wanting or expecting medical advice on diet choices as a type 1 because the condition is not caused by, or managed by, diet. Any dietician input is usually on how to count carbs and how to anticipate the timing of the carb action, not whether or not to eat them.

 

[Mark_1]

I don't accept the argument that the NHS is under funded, just wasteful and top heavy. Changing ones diet is challenging for most people, I was myself ignorant to what a carb was until diagnosed with secondary diabetes.

I think its underfunded, wasteful and top heavy. A nations health should be any governments number one priority.
If someone ever comes up with the answer to how to make healthy eating easy they will become very rich and a Noble prize winner. Hence why two thirds of the population are overweight or obese. The diets of most people are shockingly poor, but that has now become the norm. The idea that there would be many more shops selling fast food rather than meat, veg etc not so many years ago wouldn't have been entertained.