Preventing Type 2

[HappyasLarry]

My personal view is this - in relation to type 2 - age 25 or so, it should be advised (even compulsory?) for EVERYONE to have a blood test to check for diabetes or pre-diabetes. That way so many people could be "caught" in time and given the right diet and exercise advice before it got to the stage of them developing full-blown diabetes , plus complications and the possible health implications and cost of treating complications that would ensue. The test should be repeated every 2/3 years and this should be mandatory. There would always be some who slip through the net but I think for many, that warning at a young enough age would be enough to kick-start them into looking after their health. If it is the case, as we are told, that Diabetes 2 will "bankrupt the NHS" then surely something drastic must be done now.

 

[JohnEGreen]

And the the NHS could maybe force feed them the well plate eat your carbs or we will lock you up.

 

[chalup]

That is a very good idea in theory but the big problem with it is that the dietary advice given is wrong. If a pre-diabetic follows the advice given they will become full blown diabetic even faster in a lot of cases while happily going about believing that they are doing the right things to prevent it happening.

 

[pilch]

Perhaps if the "national" guidelines could accept the fact, that by following them, probably causes all the issues observed in obesity/diabetic real life, and actively deviate from the USA led nutritional dogma, our national health would be in a far better shape

 

[ladybird64]

"Compulsory"? "Mandatory"? I'd like to see any medical professional try and force me to have any sort of test against my will...and I'm twice that age!
And what would be the penalty for refusal?

 

[Bluetit1802]

It is already done for everyone aged 40 and over. Not mandatory of course, but everyone is invited. I wonder what percentage take up there is?

 

[HappyasLarry]

"Compulsory"? "Mandatory"? I'd like to see any medical professional try and force me to have any sort of test against my will...and I'm twice that age!
And what would be the penalty for refusal?

No penalty, Other than a missed opportunity to maintain one's health I suppose. Trying to think in terms of awareness and prevention. If not mandatory then at least advisory! I am just trying to think of prevention rather than cure. Many people think type 2 wont ever happen to them. I have a friend who is unable to work due to diabetic retinopathy. He is nearly blind, and would have loved the chance to try to avoid or lessen his symptoms. I am a science teacher and many teenagers do not have the first clue about nutrition or healthy eating. I am trying to think of stepping in and acting to try to at least educate to avoid some cases of Type 2. I have been Type 2 for 6 years. I try to follow lchf and am aware that this is not currently in line with NHS guidelines. I am trying to think in terms of an ideal world. I had honestly not expected such hostility to my comments.

 

[chalup]

I don't think the hostility is aimed at you, at least not in my case. I live in Canada and the advice here is just as bad as what is given in the UK. The attitude from the medical profession that people are too stupid or lazy or hopeless to change their lifestyle and that this is absolutely progressive is the same here as well. My husband is teetering on the edge of diabetes according to his A1c but as long as he is under that magic number he is told everything is fine. The hostility is towards the system, not you.

 

[Terryrhino]

Pretty sure nobody is mad at you @HappyasLarry it's just many people have been let down by our GPs in one way or another!! I agree with you in principle and I would of been grateful of a pre test in hindsight but really how many young people would bother plus we as humans are told so much of what we can and can't do now most people's attitudes is screw the system I'll do what I want!!! But please as a teacher mention it in your classes and maybe bring other teachers onboard get the message out there that diabetes is a serious issue everything starts somewhere maybe it's with you and your pupils??

 

[MikeTurin]

My personal view is this - in relation to type 2 - age 25 or so, it should be advised (even compulsory?) for EVERYONE to have a blood test to check for diabetes or pre-diabetes.

Except the tiny fact that when you're worried from blood test results with a borderline glicemic fasting level and a bit high LDL and triglycerids level the toctor gives you statins and says that all is A-Ok.

I was a blood donor, I've got a lot of blood exams and told that because 97 mg/dl is less than the 100 mg/dl threshold, all is ok but is better to take a low fat diet with plenty of fuits and low in fats and statins. By the way the firs kind of statins got me a liver intoxication, the GP changed the type of statin...

 

[lovinglife]

I understand your reasoning but to be honest at my 25 year old self would a blood test telling me in 30 years time I may get a condition so stop doing what your doing now have worked? I doubt it - at that age I knew the perils of drinking too much and smoking but it didn't change what I did - now if I'd been offered a non compulsory test say in my forties I strongly suspect I would have had a whole different mind frame

 

[sally and james]

We used to follow public health advice - look where it got us!
Sally

 

[TorqPenderloin]

"Compulsory"? "Mandatory"? I'd like to see any medical professional try and force me to have any sort of test against my will...and I'm twice that age!
And what would be the penalty for refusal?

It's actually a good question. Perhaps instead of a penalty for refusing it should be a tax credit (or similar) for accepting?

That's basically what private insurance companies do here in the USA. They offer discounts for getting annual check-ups and basic results for things like cholesterol, a1c, blood pressure, fasting glucose, etc. The company I work for also offers things like free Apple Watches to promote people to be more active. I can get nearly $1000 a year if I complete a checklist of activities that show I'm at least trying to be healthy.

Unfortunately, our government is the one who "Penalizes" people for refusing instead of rewarding people for accepting, and many of you probably hear about how our government-sponsored healthcare certainly could be better (to say the least).

Big difference between rewarding people for doing good, and penalizing people for not doing going.

 

[MikeTurin]

It's actually a good question. Perhaps instead of a penalty for refusing it should be a tax credit (or similar) for accepting?

Should we make the same reasoning about vaccinations?
Unfortunately "bribing" someone to do something health related could generate some unintented effects, like making not useful or fake exam only to get the money and transferring funds from the public budget to some scamming entities. Something similar happened here with tax refunds on warehouse building: the net result was now in the countryside we have zones with a lot of empth, rotting and half built warehouses that nobody will use, but the compaines that built them got a lot of tax refunds

Unfortunately, our government is the one who "Penalizes" people for refusing instead of rewarding people for accepting, and many of you probably hear about how our government-sponsored healthcare certainly could be better (to say the least).

Big difference between rewarding people for doing good, and penalizing people for not doing going.

I think the biggest problem in UK, and partially here in Italy is that the neoliberist idology that is followed by both the biggest parties says the goverment is bad and the public is good and tries to actively sabotage the public agencies that are doing a decent work. I think that education of GP and general public is a thing that doesn't give back a direct cash flow but gives a good general return.

 

[ickihun]

I should have been tested at 6yr old when taken to gp in the 70s with reocurring thrush and weight gain.
My kids get tested.

 

[Peachbelle]

I fully agree...... I was diagnosed with type 2 as a result of routine bloodwork that was looking for something else. I'm in my mid 30s so this could've gone on for years undiagnosed causing damage.
I'm waiting to be referred to a dietitian but I do find that the nurse in my practise is not taking me seriously due to my age and low a1c results but surely now is the time to be doing something about it?

 

[Brunneria]

I was tested for diabetes (glucose tolerance test) as soon as they (NHS) realised quite how screwed up my hormones were.

Trouble is, the doc surgery didn't do it with any intention of giving me good diet advice, or suggesting I change various aspects of my life.
They did it because an endocrinologist sent them a letter telling them to run some checks. Which they then filed, ticked a box, and forgot about rescheduling the same test annually, for ever.
Turned out I wasn't T2 then.
They actually did it every 3-4 years - when I reminded them.
Still no Diabetes 12 years later (largely because I had been eating low carb and taking care of myself as best I could for my whole adult life, not from any advice given to me by 'experts')
Changed docs, and it took another 4 years before this surgery realised that they should have been doing all sorts of monitoring, and proceeded to do so... complete with referral to endocrinologist, heart ultrasound, belated medication reviews and very red faces.
I eventually hit diabetes a few years back, but you know what? Because I do still take care of myself, and manage my blood glucose, the last time I saw my doc he told me 'your HbA1c tells me your aren't even pre-diabetic.'

Moral of the story: the NHS is overworked, underfunded and staffed by fallible human beings. On the other hand, we are the people living in our own bodies 24/7 and need to be taking responsibility for that fact all our lives, not just when things start breaking down.

And no @HappyasLarry none of those comments are aimed at you but I do feel frustrated and let down by 'the system'.
I basically have to self fund, self monitor and look after 2 or 3 different health conditions. I get support for one condition. That is one appt a year, with a recurring prescription. Nothing to do with diabetes.

NHS is set up to handle T2s who who have deteriorated enough to depend on medical support. The money goes on damage limitation instead of damage prevention.
If T2s were given non-NHS diet advice, and informed properly about how to handle their T2 from the outset, then they wouldn't need to reach that stage of deterioration.

 

[Jay-Marc]

I was supposed to be tested every year for blood sugar as part of a suite of annual tests related to other conditions.

Somehow the blood sugar tests 'dropped out' of the package - I didn't notice as the doctor only highlighted the areas in them with issues and he couldn't have noticed it either. Two years later I developed the classic symptoms of diabetes and a test at the time showed Hba1C of 111 mmol/mol and fasting sugar of 14.1 mmol/l. It was at this stage that the 'missed out' tests came to light.

Of course no one can say whether diabetes was developing through those 2 years that could have been detected earlier or whether it had happened quickly.

 

[kokhongw]

My personal view is this - in relation to type 2 - age 25 or so, it should be advised (even compulsory?) for EVERYONE to have a blood test to check for diabetes or pre-diabetes.

Your view is very much in line with the growing trend of younger Type 2 diabetes around the world...
https://www.sgh.com.sg/about-us/new...s/Pages/type-2-diabetes-patients-younger.aspx

In Singapore, the percentage of diabetics with young-onset type 2 diabetes was higher.

“We didn’t expect the figure to be 30 per cent, and the average age that diabetes was diagnosed in this group was 30. That’s quite young,” said Dr Goh Su-Yen, Senior Consultant and Head, Department of Endocrinology, Singapore General Hospital (SGH)

But detection is next to useless if the recommended course of action is the conventional move more and eat less, but continue with 5 meals a day, low fat grain base 'balance" plate, "evidenced" based intervention...because the evidence is that those intervention have "low compliance" and marginal effects.

 

[MikeTurin]

But detection is next to useless if the recommended course of action is the conventional move more and eat less, but continue with 5 meals a day, low fat grain base 'balance" plate, "evidenced" based intervention...because the evidence is that those intervention have "low compliance" and marginal effects.

I think also that the request to eat better or to make a diet is normally derailled do be a "buy more costly processed foods" like gluten free, lactose free, low fat or "diet" food. In small fine gray print there's also a "eat more fiber". So people think to eat healthier when they take a gluten free pasta, a lactose free cheese and a banana...