More Support, less Advice for Newbies

[lucylocket61]

A slight digression but the eatwell plate, as explained to me by my DN, didnt tell me to eat carbs at the same rate as I had before. The portion sizes were explained, and although the proportion of carbs was, in my opinion, too high, the amount was reduced because I would be eating less food. Smaller portions and fewer calories.

Maybe because I need to lose weight, so others dont get the calories restriction part of the talk? And this was nearly 6 years ago so maybe the eatwell info has changed. My obvious carbs, had I listened to her and not this forum, would have gone down from about 350g a day to about 160g a day.

 

[Guzzler]

If that happens there is always the choice on the right side of the post you agreed with to undo your "agree" so not really a problem is it

I am aware of that but the point I am trying to make is that to edit to add should be apparent out the outset. Do we really need to be checking every 'agree' to make sure that we 'still' agree?

 

[Mbaker]

To add to my wish list for further information within Daisy's posts to newbies, I would add the video below and text from the NICE guidelines . The video features a couple are legends, Dr's Jen Unwin and David Unwin

which @Indy51 posted in another thread. This shows fours years worth of data for low carb healthy fats being used as a lifestyle choice:
​

The NICE guidelines gives some wriggle room for low carb HCP's
https://www.nice.org.uk/guidance/ng28/chapter/1-Recommendations#individualised-care

When I was a brand new shiny member I looked at all the advice given then made up my own mind. I had previously looked at 'the other' site but decided not to join because their advice per the eatwell plate just did not sit well with me and so I checked their recipe section. My jaw dropped! Even as a completely uninitiated noob it made no sense to me to carry on eating carbs at virtually the same rate (although I knew they were not countenancing eating the junk foods) post dx. So when I stumbled upon DCUK by the sheer habit of typing dotUK instead of dotorg I looked around and felt that approaches here were far more pro choice and I took the plunge.
I do not feel that I was overwhelmed with advice as a newbie. I did become overwhelmed after a short time because I discovered the sheer wealth of knowledge shared by members and I thought I had to learn everything. I was then advised by 'older' members to slow down a bit, to concentrate on listening to my meter as the first step, to learn the basics and to learn to walk before I could run. Six months on and two things have changed, firstly I am no longer in panic mode and secondly I am still learning but at a far more relaxed pace.
Let me be absolutely clear here, with a diagnostic level of 98 and a truly panic driven personality coupled with an inherent need to understand the mechanics of the conditions that affect me personally, was the reason that I jumped into the deep end. I need to know why something has gone wrong before I make decisions but with Diabetes what must happen is a sea change (in my opinion) to what is happening as soon as possible.
I am still learning, obviously, but the need to understand is still uppermost in my mind now that my numbers are far more controlled. I had the luxury of time to learn about my other conditions but Diabetes is different. The advice to lower one's bg must be given at the outset alongside support. It is my opinion that time is of the essence.

Ditto

 

[seadragon]

I do so like to be controversial . My point really is only the one about speed. I do think that anything we can do to help those arriving to avoid the medication treadmill we should try to do. Once on them its really hard job to get off them and the stronger the drug the harder the struggle.
My point about the starting 24 hour fast, was only that if one started with this then one would get the ketones kicking in much faster and at that point its easier to start making sensible future switches because the all consuming hunger starts to go away faster. It is always easier to make changes when standing on a burning deck. For years people have been told that medications will help various situations when in practise they really are not as effective as people think compared with eating a proper diet.

Havent got to end of thread but was interested in the responses to suggesting a 24 hour fast. I wouldn't suggest it as I don't think it's necessary, but by the time I got to the forum I was in such a state of food confusion having researched so much conflicting information, that I had probably fasted because I was too afraid to eat anything. If people had just said "there. there don't worry we are all supportive" I'd probably have died from starvation!

I needed someone to tell me it was OK to eat and make a firm suggestion of what had worked (and does work for the vast majority of Type 2's) and wouldn't make my BG levels worse. I don't think I actually posted on that first visit but reading responses to other newbies about low carb and testing were immediately invaluable.

I definitely think the advice that low carb works for type 2's for the overwhelming majority of people, with a link to either dietdoctor.com or the low carb forum so people can immediately see what they CAN eat, is a vital first step for many people arriving in a state of shock and food confusion.

So for me the first thing I wanted was to know:
"What can I eat that will not make my BG levels worse?"
Later you can start being my friend and being supportive in any other way you like.

I appreciate everyone is different but that's why those who believe in giving info straight away, can and should give info and those who believe in support can give support and hopefully everyone will find posts of both types and can take from them what they need.

 

[seadragon]

I think this would help new members...In the Basic Information for new members it should say that any diet advice here is unofficial does not suit everyone and is not the recommended NHS guidelines but is just a personal choice It should be said so as not to mislead those who have not yet seen a nurse into thinking it is the official advice and they may start doing it when it could be unsuitable for them

I really can't agree with you here because the Eatwell plate is SO wrong - IMHO even for healthy people - that I feel we are duty bound to point out that the standard advice from GPs is not actually the way it has to be at all. The standard line (which I got) is that Diabetes is a progressive illness, there is nothing you can do, so I'll put you on metformin and statins and you'll end up on insulin. For me this came from the GP specialising in Diabetes and running the diabetes clinic. Horrifying and SO wrong. I was also told the Eatwell plate was what I should follow but for me this would have involved almost doubling my daily carb intake which is beyond stupid for a pre diabetic.

Anyone coming to such a forum as this should already be aware that this is obviously not advice from doctors (and all the better for it at present, with a few notable exceptions like Dr Unwin) but from people who have this condition and are dealing with it themselves very successfully for the most part.

As I put in my previous post what I most needed when I arrived here was someone telling me what I could eat immediately without raising my BG levels and I would suggest a list of low carb foods/couple of low carb meals (maybe with suggestions for adding in a bit of carb for those not ready to reduce carbs drastically would be helpful to be added on Daisy1's post) and is why I've always given a link to dietdoctor.com, as there are great meal ideas there along with all the science behind why it works.

 

[Mbaker]

Havent got to end of thread but was interested in the responses to suggesting a 24 hour fast. I wouldn't suggest it as I don't think it's necessary, but by the time I got to the forum I was in such a state of food confusion having researched so much conflicting information, that I had probably fasted because I was too afraid to eat anything. If people had just said "there. there don't worry we are all supportive" I'd probably have died from starvation!

I needed someone to tell me it was OK to eat and make a firm suggestion of what had worked (and does work for the vast majority of Type 2's) and wouldn't make my BG levels worse. I don't think I actually posted on that first visit but reading responses to other newbies about low carb and testing were immediately invaluable.

I definitely think the advice that low carb works for type 2's for the overwhelming majority of people, with a link to either dietdoctor.com or the low carb forum so people can immediately see what they CAN eat, is a vital first step for many people arriving in a state of shock and food confusion.

So for me the first thing I wanted was to know:
"What can I eat that will not make my BG levels worse?"
Later you can start being my friend and being supportive in any other way you like.

I appreciate everyone is different but that's why those who believe in giving info straight away, can and should give info and those who believe in support can give support and hopefully everyone will find posts of both types and can take from them what they need.

This is what makes us all individual. You and I are in complete ageement about the order of events, whereas others would be-friend first, this is why I push the Daisy route, as this carries weight being part of the management.

 

[Grateful]

I definitely think the advice that low carb works for type 2's for the overwhelming majority of people, with a link to either dietdoctor.com or the low carb forum so people can immediately see what they CAN eat, is a vital first step for many people arriving in a state of shock and food confusion.

Not long after diagnosis, someone said, "Try not to think of food as your enemy."

It was good advice, but only works if you get hopeful, positive pointers as to what you can eat.

It all seems relatively easy now, but back then it appeared virtually impossible. Fortunately I stumbled upon dietdoctor.com.

 

[CherryAA]

Unfortunately no one newly diagnosed is likely to be wearing a 24/7 glucose monitor.

If they did, they would see terrible numbers coming from carbs and no numbers at all coming from fat. It would be blindingly obvious within 24 hours of following the advice to go low carb that it works well to lower blood sugars and prevent spikes.

In the absence of being as rich as Bill Gates I'm not in a position to simply apply a monitor to everyone in sight and say " look" you must DO something to cut out the foods that cause this ( refined carbs plus om 6 seed oils) - It doesn't really matter whether you are diabetic or not ( yet) this stuff is lethal and it may get you in the end!

Until the medical profession has realised that it cannot continue to recommend a diet that is killing people, I think I am duty bound to firmly say yes I am not a doctor, but I am a sentient human being and I have experienced this and here is what I did to sort it.

 

[Pinkorchid]

It is our right to edit our posts where we feel it is necessary. If we have hit the "agree" button for a post

I am aware of that but the point I am trying to make is that to edit to add should be apparent out the outset. Do we really need to be checking every 'agree' to make sure that we 'still' agree?

I don't think many people would keep checking the posts they have agreed to see if they have been edited or had something added that they may not agree anymore. I will hit agree if I do agree but I would never check to see I do still agree in case it may have been edited ...bit extreme
I do not think we should have to give any explanation as to why we have edited a post as usually it is just a minor thing that would not affect the "agrees" If adding something changed our post or the subject into something totally different from the original which may affect the "agrees" then we should do a new post

 

[Guzzler]

It is our right to edit our posts where we feel it is necessary. If we have hit the "agree" button for a post

I don't think many people would keep checking the posts they have agreed to see if they have been edited or had something added that they may not agree anymore. I will hit agree if I do agree but I would never check to see I do still agree in case it may have been edited ...bit extreme
I do not think we should have to give any explanation as to why we have edited a post as usually it is just a minor thing that would not affect the "agrees" If adding something changed our post or the subject into something totally different from the original which may affect the "agrees" then we should do a new post

I was not suggesting that people should keep checking. I am suggesting that having edited to add a poster should make it clear that they have done so. And I was certainly not suggesting that members be disavowed of the right to edit at all.

 

[Mbaker]

Unfortunately no one newly diagnosed is likely to be wearing a 24/7 glucose monitor.

If they did, they would see terrible numbers coming from carbs and no numbers at all coming from fat. It would be blindingly obvious within 24 hours of following the advice to go low carb that it works well to lower blood sugars and prevent spikes.

In the absence of being as rich as Bill Gates I'm not in a position to simply apply a monitor to everyone in sight and say " look" you must DO something to cut out the foods that cause this ( refined carbs plus om 6 seed oils) - It doesn't really matter whether you are diabetic or not ( yet) this stuff is lethal and it may get you in the end!

Until the medical profession has realised that it cannot continue to recommend a diet that is killing people, I think I am duty bound to firmly say yes I am not a doctor, but I am a sentient human being and I have experienced this and here is what I did to sort it.

I think the eating habits of "normal" persons would change if they understood, fbg and post prandial numbers. For example this lady Kate Quilton normally is in the late 4's for her BS, after 6 (might be 7) slices of trimmed white bread she jumped to 7.5, whilst not a massive problem it was > 2:

The Diet Doctor had a massive spike over 9 after eating a meal at an exhibition, and Dr Unwin recently posted spikes after eating bananas.

 

[paulus1]

ive just had to try and stop another poster on the on the DUK website that was promoting type 1st to stop taking insulin and just rely on the lchf diet. im a fan and its doing well for me but that advice could kill someone. and then there was another poster selling mushrooms that would repair our pancreas. im seriously worried that they could hurt folks by allowing such posts. diabetes uk need to get there forum sorted out.

 

[CherryAA]

I think the eating habits of "normal" persons would change if they understood, fbg and post prandial numbers. For example this lady Kate Quilton normally is in the late 4's for her BS, after 6 (might be 7) slices of trimmed white bread she jumped to 7.5, whilst not a massive problem it was > 2:

View attachment 24551

The Diet Doctor had a massive spike over 9 after eating a meal at an exhibition, and Dr Unwin recently posted spikes after eating bananas.

I believe Dr Unwin is himself diabetic so his changes are to be expected . It is interesting what true excellent insulin sensitivity can actually look like - I did do a test for one guy, young, ripped, clearly very fit. He binged chocolates and sweets for an hour, later tests showed his blood glucose just remained at 3.6 before, during after.

I do think that once apple etc find way to add blood glucose to fit-bits etc, we will see a big change in people's perception of the problem.

 

[woodywhippet61]

ive just had to try and stop another poster on the on the website that was promoting type 1st to stop taking insulin and just rely on the lchf diet. im a fan and its doing well for me but that advice could kill someone. and then there was another poster selling mushrooms that would repair our pancreas. im seriously worried that they could hurt folks by allowing such posts. diabetes uk need to get there forum sorted out.

You reported it. Then it's down to the mods to sort out and they can and will.

 

[CherryAA]

Here's one case of providing "support" and putting off the "treatment" part until a more appropriate time later.

After my most recent diabetes appointment, as the doctor and I were walking down the corridor on the way out, he told me about a patient he had seen recently, who like me had been well-controlled with diet only. But at the most recent test, that patient's HbA1c had come back at nearly 13% (119).

Patient: "What am I going to do? I'm getting married in a few days and going on honeymoon!"
Doctor: "Congratulations! Get married, go on your honeymoon. I'll see you afterwards and we'll sort it out!"

Which is lovely assuming that with an Hba1C at 13% the patient was actually able to stay awake during the days of his honeymoon and was not suffering from erectile disfunction in the evening. Both all too likely with blood sugars at that level. If either were the case the patient may well have enjoyed his honeymoon more had he had a strict week of not eating carbs before the marriage. I would certainly not have been wanting to party at my 10.3% on diagnosis!

Its all too likely that the reason he asked that precise question was actually driven by erectile disfunction. That being one of the prime reasons many men are driven to seek help.

 

[CherryAA]

ive just had to try and stop another poster on the on the website that was promoting type 1st to stop taking insulin and just rely on the lchf diet. im a fan and its doing well for me but that advice could kill someone. and then there was another poster selling mushrooms that would repair our pancreas. im seriously worried that they could hurt folks by allowing such posts. diabetes uk need to get there forum sorted out.

I do think that there is a case for diabetes.co.uk to look at the way new people join up. In essence adopting lower carb will reduce insulin usage for everyone T1 or T2 but the context with which that can be put into effect is very different in terms of consequences and appropriate actions.

I wonder if something could be designed to be delivered automatically on joining as part of the joining confirmation that makes it more easily clear that very many of the people on the website choose to improve their condition through limitation of carbohydrates to varying degrees and the context.
Those who do not take such drugs or are on metformin can easily make dietary choices to simply lower carbohydrates.
However those taking insulin or insulin like drugs will find that they need less insulin/ drugs if they lower carbohydrate . Taking too much insulin for their needs is dangerous. Taking too little insulin is also dangerous especially for those diagnosed with T1 diabetes where they produce no insulin themselves. Thus for anyone on these type of drugs ( list) any changes to their diet should only be done after careful thought and understanding of the consequences of lowering carbohydrate intake on their insulin/ drug requirement and in collaboration with their health team. All posts should be read in this context. ?

 

[CherryAA]

To add to my wish list for further information within Daisy's posts to newbies, I would add the video below and text from the NICE guidelines . The video features a couple are legends, Dr's Jen Unwin and David Unwin

which @Indy51 posted in another thread. This shows fours years worth of data for low carb healthy fats being used as a lifestyle choice:
​

The NICE guidelines gives some wriggle room for low carb HCP's
https://www.nice.org.uk/guidance/ng28/chapter/1-Recommendations#individualised-care

View attachment 24541

Ditto

Interesting that under 1.3.9 of the guidelines all T2 diabetics have the right to expect consistency of carbohydrate content. One assumes so as not to disrupt their medication regime. Thus if one's medication routine is to severely limit carbohydrates and thus not need medication, the under 1.3.9 one has the right to expect consistency of carbohydrate in hospital commensurate with one's pre-existing control regime. i.e. no-one should have to put up with having to increase medication or increasing blood glucose as a consequence of a hospital diet.

 

[JohnEGreen]

Interesting that under 1.3.9 of the guidelines all T2 diabetics have the right to expect consistency of carbohydrate content. One assumes so as not to disrupt their medication regime. Thus if one's medication routine is to severely limit carbohydrates and thus not need medication, the under 1.3.9 one has the right to expect consistency of carbohydrate in hospital commensurate with one's pre-existing control regime. i.e. no-one should have to put up with having to increase medication or increasing blood glucose as a consequence of a hospital diet.

A very convincing argument one all here would agree with but low carb apple pie in the sky in the real world I'm afraid.

 

[Grateful]

Which is lovely assuming that with an Hba1C at 13% the patient was actually able to stay awake during the days of his honeymoon and was not suffering from erectile disfunction in the evening. Both all too likely with blood sugars at that level. If either were the case the patient may well have enjoyed his honeymoon more had he had a strict week of not eating carbs before the marriage. I would certainly not have been wanting to party at my 10.3% on diagnosis!

Its all too likely that the reason he asked that precise question was actually driven by erectile disfunction. That being one of the prime reasons many men are driven to seek help.

I thought about that. But (knowing the doctor quite well, having unfortunately seen him far too many times this year) I think it very likely that the patient, had he been concerned about this, would have felt empowered to ask the doctor to intervene immediately -- with drugs or whatever -- and the doctor would have been more than happy to help in whatever way appropriate.

The doctor did tell me that the patient took the news of his elevated A1c as being totally unexpected. To me this implies that the patient was fairly unlikely to be suffering T2D symptoms or complications, but again, I don't have details and it would have been inappropriate to ask any questions. (You could fault the doctor for indiscretion, although obviously no identifying details were given.)

As for "a strict week of not eating carbs before his marriage," I am too new to diabetes to know how this works. Let's say his A1c had recently risen to nearly 13%, and assume for the sake of the argument that he really did have ED, is it really possible that a week of strict low-carb would have "cured" the ED? Furthermore, the doctor did tell me that this patient was fully diet-controlled until the latest A1c. In that case, my assumption is that the guy was one of the less lucky T2Ds who could need drugs/insulin to buttress the low-carb diet given that he did manage a period of diet-only control which has now "failed." Or, alternatively, that (as an earlier poster speculated), this guy "fell off the wagon" of his low-carb diet in recent months because of the momentous change of getting engaged and preparing to get married.

Again, please forgive me if I am off-base here. I was diagnosed less than 10 months ago and am still learning.

 

[librarising]

Interesting that under 1.3.9 of the guidelines all T2 diabetics have the right to expect consistency of carbohydrate content. One assumes so as not to disrupt their medication regime. Thus if one's medication routine is to severely limit carbohydrates and thus not need medication, the under 1.3.9 one has the right to expect consistency of carbohydrate in hospital commensurate with one's pre-existing control regime. i.e. no-one should have to put up with having to increase medication or increasing blood glucose as a consequence of a hospital diet.

Interesting take on 1.3.9. but I suspect this means a level of carbohydrate content the HCP (hospital dietitian ?) recommends.In a sort of Harry Enfield 'loadsacarbs' approach.
Doesn't say consistent with patient's previous dietary choices
Especially when they're also talking low-fat, controlled fats, and 'encouraging' carbohydrates.
https://www.nice.org.uk/guidance/ng28/chapter/1-recommendations(1.3.3.)
Geoff