newstatesman T2D lifestyle choice

NoCrbs4Me

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This is a silly article.
 

JohnEGreen

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Was watching food truth or scare the other day and it seems Gloria Hunniford was told she was pre-diabetic and by cutting down on carbs she was able to avoid full blown T2 diabetes. So yes it it a shame if people are kept ignorant as if they know they can do something about it.
 

BarbaraG

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Is it just me, or does 'treat it as a lifestyle choice' mean 'blame the people who have it'?

Don't get me wrong - I am a great believer in the capacity of lifestyle change to prevent, control and even reverse T2. I am doing my best to reverse my own, even after 19 years with it. However:

1) The article repeats the 'obesity causes IR' model, whereas there is evidence showing the causal relationship is the other way round (IR causes obesity, given the right -or rather the wrong- diet)

2) The dietary advice you would generally get from the NHS under the proposed solution would be low fat, high starch. And while that's better than high sugar, high processed food, it is a long way from optimal.
 
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NoCrbs4Me

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Was watching food truth or scare the other day and it seems Gloria Hunniford was told she was pre-diabetic and by cutting down on carbs she was able to avoid full blown T2 diabetes. So yes it it a shame if people are kept ignorant as if they know they can do something about it.
I agree. Unfortunately, there's no mention of carbs in the article. They do mention diet, but there's no doubt they mean following the government low fat/high carb diet. Essentially the article recommends that efforts to get people to follow the standard advice should be increased. However, it's well known that following the standard advice doesn't work. I was told not long after diagnosis for type 2 that I should follow the low fat/high carb "healthy" government diet and exercise 30 minutes 5 times a week. If I did that, my diabetes would get worse and worse over time, I'd be on more and stronger meds, then insulin, then get complications, and probably die from diabetes complications. Needless to say, like most people on this forum, I didn't follow their advice, and have had normal blood glucose levels for a few years now.

So the problem with this article is that it assumes that people aren't following the standard advice or can't be bothered to because they're lazy/stupid. However, I suspect many are and when they deteriorate it is assumed that they are lying about about complying with the standard advice. Or, having been told, like me, that type 2 is progressive even if you follow their advice, they don't bother and hope the meds work.
 
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Type of diabetes
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Is it just me, or does 'treat it as a lifestyle choice' mean 'blame the people who have it'?

Don't get me wrong - I am a great believer in the capacity of lifestyle change to prevent, control and even reverse T2. I am doing my best to reverse my own, even after 19 years with it. However:

1) The article repeats the 'obesity causes IR' model, whereas there is evidence showing the causal relationship is the other way round (IR causes obesity, given the right -or rather the wrong- diet)

2) The dietary advice you would generally get from the NHS under the proposed solution would be low fat, high starch. And while that's better than high sugar, high processed food, it is a long way from optimal.
I noticed a culture in the NHS where pass the parcel of blame is the name of the game. This is not a new attitude and someone even wrote a song about it called It's Illegal, It's Immoral or it Makes You Fat.

Seriously though, I think that if a patient leaves the doctor's surgery with nothing then there is no point going there. Some get pills and some get a black cloud to depress them. Curing patients was not an option before Dr. Unwin helped us out.

I also am now aware that what I have learned that helps with the diabetes is precisely the opposite of the advice given to me by the NHS. Eat carbs with every meal, only put margarine scrape on your bread and never eat animal fat are some examples.

It might well be a lifestyle choice but it was chosen by the authorities and not by me.
 
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Diakat

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It is a stupid article. But if you consider the "dietary change" to be fewer carbs then it's pretty much got the solution.
 
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NoCrbs4Me

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It is a stupid article. But if you consider the "dietary change" to be fewer carbs then it's pretty much got the solution.

I do, but I doubt the author does. The government sure doesn't.
 
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It is a stupid article. But if you consider the "dietary change" to be fewer carbs then it's pretty much got the solution.

I think the important thing about the article is that it actually mentions diet. This word was not known to anyone in the NHS when I was diagnosed. It's true that someone might have said eat healthily but they didn't have a clue what that meant. The dietitian explained to me that it was like doggies and bunnies racing round a track. To this day I am not sure what she was on about. When she asked me if I wanted another appointment I politely declined.

I went to a diabetes induction course at the Paula Carr Foundation and asked about processed foods. They looked very uncomfortable and no-one answered any question.

The article mentions people being offered the choice of medication or DIY which is exactly the approach David and Jen Unwin developed so I suppose the author has discovered that.
 
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NoCrbs4Me

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I re-read the article and I noticed something he wrote that I didn't see before: "But many of our treatments (and our flawed dietary advice) actually cause further weight gain." Too bad he didn't expand on this and explain what he thinks is flawed about the standard dietary advice.
 

Diakat

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I was wondering if he meant low carb but could not outright say it for whatever reason?
 
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badcat

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Never been able to take the New Statesman seriously - any pulication that can have Boris Johnson as their editor ( no longer) is not to be taken seriously
 

ringi

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These days in most case the best a doctor provides is the words to type into google. If a doctor puts into someone minds the they can "reverse Type2" or "prevent type 2" then on most search engine this website comes towards the top of the results.

Shame doctors don't just write "low carb training" on a prescription along with a meter and 100 test strips.
 
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Bluetit1802

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Has this article already been posted? http://www.newstatesman.com/politic...start-viewing-type-2-diabetes-lifestyle-issue. Shame the NHS does not tell patients they are pre diabetic.

They do these days. The National Diabetes Prevention Programme started last year and is being rolled out. New members on here have mentioned being sent on it. We have many new members arriving here weekly, even daily, with pre-diabetes "diagnosed" by their GP. Everyone over 40 is now invited for a health check which includes an HbA1c. I have no idea what percentage of these people actually take up the offer. This is an extension of the previous system of inviting the over 60's. (That's how I was diagnosed)

I agree the article is silly. It doesn't really say anything, and the science behind the cause of T2 is incorrect.
 

covknit

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They do these days. The National Diabetes Prevention Programme started last year and is being rolled out. New members on here have mentioned being sent on it. We have many new members arriving here weekly, even daily, with pre-diabetes "diagnosed" by their GP. Everyone over 40 is now invited for a health check which includes an HbA1c. I have no idea what percentage of these people actually take up the offer. This is an extension of the previous system of inviting the over 60's. (That's how I was diagnosed)

I agree the article is silly. It doesn't really say anything, and the science behind the cause of T2 is incorrect.
Not my GP that is why I said it. I had a blood test April 16 which sad I was but GP never acted on it. I had my first free NHS test in May 17. I am 60.
 

covknit

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Interesting comments. This is an abbreviation of the full article published 27 July and I have not read the full article. Whittaker does say he is referring to type 2 only and if their diabetes is caught early enough exercise and diet can reverse diabetes but :- We’re surrounded by cheap, delicious, energy-dense foodstuffs. For too many people, “exercise” equates to the walk from the car to the supermarket door. It’s gradually dawning on the medical profession that we have to stop treating type 2 diabetes as a disease; we can’t keep turning millions of people into long-term patients.
surely he is pointing the finger at carbs.
but then I quite liked his synopsis of the statins argument http://www.newstatesman.com/politics/health/2016/10/when-it-comes-statin-wars-its-patients-i-pity
 

Bluetit1802

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Not my GP that is why I said it. I had a blood test April 16 which sad I was but GP never acted on it. I had my first free NHS test in May 17. I am 60.


The over 40s health checks are the responsibility of the Local Authorities which have a legal requirement to do this. They can be done at the surgeries, health centres or in mobile units and are performed by the NHS.

The Local Authorities Regulations 2013 set out legal duties for local authorities to make arrangements:

  • for NHS Health Checks to be offered to each eligible[1] person aged 40–74 years once every 5 years and for each person to be recalled every 5 years if they remain eligible

  • so that the risk assessment includes specific tests and measurements, as well as to ensure the person having their health check is told their cardiovascular risk score and their other results

  • for specific information and data to be recorded and, where the risk assessment is conducted outside the person's GP practice, for that information to be forwarded to the person's GP.

  • People diagnosed with the following are excluded from the programme: coronary heart disease, chronic kidney disease, diabetes, hypertension, atrial fibrillation, transient ischaemic attack, hypercholesterolaemia, heart failure, peripheral arterial disease and stroke. Also excluded are people who are being prescribed statins or who have previously had an NHS Health Check, or any other check undertaken through the health service in England, and found to have a 20% or higher risk of developing cardiovascular disease over the next 10 years.
https://www.nice.org.uk/advice/lgb15/chapter/Introduction
http://www.nhs.uk/conditions/nhs-health-check/pages/what-is-an-nhs-health-check-new.aspx
http://www.nhs.uk/Conditions/nhs-health-check/Pages/NHS-Health-Check.aspx
 

covknit

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The over 40s health checks are the responsibility of the Local Authorities which have a legal requirement to do this. They can be done at the surgeries, health centres or in mobile units and are performed by the NHS.

The Local Authorities Regulations 2013 set out legal duties for local authorities to make arrangements:

  • for NHS Health Checks to be offered to each eligible[1] person aged 40–74 years once every 5 years and for each person to be recalled every 5 years if they remain eligible

  • so that the risk assessment includes specific tests and measurements, as well as to ensure the person having their health check is told their cardiovascular risk score and their other results

  • for specific information and data to be recorded and, where the risk assessment is conducted outside the person's GP practice, for that information to be forwarded to the person's GP.

  • People diagnosed with the following are excluded from the programme: coronary heart disease, chronic kidney disease, diabetes, hypertension, atrial fibrillation, transient ischaemic attack, hypercholesterolaemia, heart failure, peripheral arterial disease and stroke. Also excluded are people who are being prescribed statins or who have previously had an NHS Health Check, or any other check undertaken through the health service in England, and found to have a 20% or higher risk of developing cardiovascular disease over the next 10 years.
https://www.nice.org.uk/advice/lgb15/chapter/Introduction
http://www.nhs.uk/conditions/nhs-health-check/pages/what-is-an-nhs-health-check-new.aspx
http://www.nhs.uk/Conditions/nhs-health-check/Pages/NHS-Health-Check.aspx
tee hee that explains it. My gp must think the checks are only done for patients on the excluded list and waited until I was diagnosed diabetic before carrying one out. This morning I received the results of the MRI scan carried out 18 June. I have arthritis of the hip. My cup of joy runneth over. At one point it was diagnosed as a sprained wrist!!. Now I have got to add arthritis to my already long list of family medical challenges. Pleased to have a name for the problem at last.

I would hope that other GP'swould be more on the ball and try to reduce their patients risk of diabetes. How the financing of clinical trials affects their enthusiasm to actually do that is for others to discover. I guess the campaign to improve diet and exercise would need to be taken up by newspapers in another "stable" of opinion. Those that are mostly behind paywall for instance.
 

JohnEGreen

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I have arthritis of the hip. My cup of joy runneth over. At one point it was diagnosed as a sprained wrist!!.
Yes I sometimes wonder about GPs my mother's diagnosed her with a strained groin so she ended up walking around for twelve weeks with a fractured hip.
 

covknit

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Yes I sometimes wonder about GPs my mother's diagnosed her with a strained groin so she ended up walking around for twelve weeks with a fractured hip.
OMG she must have been in complete agony. I just cannot understand why it is such a challenge to get the basics diagnosed.