I spent 15 minutes with my NHS provided rake yesterday, the fragrant Z and was informed that officially I had lost 9.2kg since I last saw her in January making a total of 20.5kg (or just over 45lbs) since I first saw her in October. All-in-all I've lost just over 113lbs since I registered with my current GP in September 2006, though I have only been officially 'dieting' since July 2008. From a weight loss perspective, I fully expect to hit my target weight by January 2010.
I'm not going to discuss the diet I follow, that's already been derided to death by all and sundry except to say that I believe I it falls into the moderate to high category as defined in Fergus' Good Guys thread.
When I was diagnosed I was put on medication straight away, 1500mg Metformin/day, quickly followed by a prescription for a statin and an ACE inhibitor. I suspect that one of the reasons for that was my weight. My HbA1c at that time was 11.5%. By October 2008 that had fallen to 6.5% and my last HbA1c in January was 5.7%. Since January I have been able to reduce my Metformin slightly to 1000mg. It wasn't until after diagnosis that I discovered my maternal grandfather and great-grandmother had diabetes and that it appears to have passed my mother by.
I'm one of the fortunate type 2s. I was given a meter by my DN on the day of diagnosis and a script for 50 test strips and told to test first thing in the morning and 2 hours after my main meal. Except to be warned that if my reading ever went above 25 mmol/L I was to go to A&E, directly to A&E, and not collect my £200 that was the only advice I was given and the Sunday after diagnosis it happened. By chance I discovered this forum and the link between diet and BG became clearer.
Weekly appointments with my GP where we discussed the previous weeks readings helped further clarify the dietary changes I needed to make - though I had to laugh when early on, I exclaimed surprise that after having eaten a couple of pineapple rings for dessert (more fruit you see and one of the few fruits that I will eat) that I had had such a high reading to be told, yes, pineapple will do that to you.
Having changed my diet radically upon diagnosis - it was very hard watching Dragon and Dragonette finish that last packet of Balsamic Vinegar and Red Onion crisps and I still get cravings for wine gums (and loads of them) it was nice to hear that broadly speaking I was following BDA recommendations for people with type 2 diabetes which is the advice I received from my PCT when diagnosed.
I have sympathy with the opinion that the BNF should be followed to the letter, however doesn't that carry the lack of individualisation that following NICE guidelines regarding HbA1c does? Time and time again, whenever I meet other people with diabetes I hear the same call, "I want to be treated as an individual, not as a condition".
So, back to to the subject, apart from a few failings I feel both my dietitian and GP have listened to my needs and have risen to the challenge to help me meet my expectations including the setting of an HbA1c target lower than NICE guidelines and aggressive weight loss targets.
At the risk of repeating myself expert patient programs should empower us to know enough about our condition to take the lead in our care, our healthcare teams should be recognising our position as leads in our care. I am appalled whenever I read of a forum member being managed by their GP or DN. Whatever the failings of the current system, I don't think they're restricted to diet, we need to disavow some of our GPs of their God complex and that our voices regarding our care should not only be heard but listened to as well.
Regards, Tubs.
I'm not going to discuss the diet I follow, that's already been derided to death by all and sundry except to say that I believe I it falls into the moderate to high category as defined in Fergus' Good Guys thread.
When I was diagnosed I was put on medication straight away, 1500mg Metformin/day, quickly followed by a prescription for a statin and an ACE inhibitor. I suspect that one of the reasons for that was my weight. My HbA1c at that time was 11.5%. By October 2008 that had fallen to 6.5% and my last HbA1c in January was 5.7%. Since January I have been able to reduce my Metformin slightly to 1000mg. It wasn't until after diagnosis that I discovered my maternal grandfather and great-grandmother had diabetes and that it appears to have passed my mother by.
I'm one of the fortunate type 2s. I was given a meter by my DN on the day of diagnosis and a script for 50 test strips and told to test first thing in the morning and 2 hours after my main meal. Except to be warned that if my reading ever went above 25 mmol/L I was to go to A&E, directly to A&E, and not collect my £200 that was the only advice I was given and the Sunday after diagnosis it happened. By chance I discovered this forum and the link between diet and BG became clearer.
Weekly appointments with my GP where we discussed the previous weeks readings helped further clarify the dietary changes I needed to make - though I had to laugh when early on, I exclaimed surprise that after having eaten a couple of pineapple rings for dessert (more fruit you see and one of the few fruits that I will eat) that I had had such a high reading to be told, yes, pineapple will do that to you.
Having changed my diet radically upon diagnosis - it was very hard watching Dragon and Dragonette finish that last packet of Balsamic Vinegar and Red Onion crisps and I still get cravings for wine gums (and loads of them) it was nice to hear that broadly speaking I was following BDA recommendations for people with type 2 diabetes which is the advice I received from my PCT when diagnosed.
I have sympathy with the opinion that the BNF should be followed to the letter, however doesn't that carry the lack of individualisation that following NICE guidelines regarding HbA1c does? Time and time again, whenever I meet other people with diabetes I hear the same call, "I want to be treated as an individual, not as a condition".
So, back to to the subject, apart from a few failings I feel both my dietitian and GP have listened to my needs and have risen to the challenge to help me meet my expectations including the setting of an HbA1c target lower than NICE guidelines and aggressive weight loss targets.
At the risk of repeating myself expert patient programs should empower us to know enough about our condition to take the lead in our care, our healthcare teams should be recognising our position as leads in our care. I am appalled whenever I read of a forum member being managed by their GP or DN. Whatever the failings of the current system, I don't think they're restricted to diet, we need to disavow some of our GPs of their God complex and that our voices regarding our care should not only be heard but listened to as well.
Regards, Tubs.
