Type 2 Carbs And The Doctor/dn

[zand]

@zand They will probably say that the brain " needs" 138 g carbs every day for optimal function. This has been the catchcry at almost every T2D information session I have ever attended. And if you ask about the evidence for this, they haven't any.

lol. Well very many of us on this site can't have optimal function then.

 

[DCUKMod]

Loving this thread, I'm off for my first visit to the DN after being diagnosed at the end of January. I'm terrified, she is the nurse from hell.

I've done a lot of research, thanks mainly to this forum, I've tried different diets and I've decided low carb is the way for me.

I shall go tomorrow, smile sweetly, agree with everything she says then go my own way.

Thank you for giving me that confidence.

Wendy - Could I ask you to consider something prior to your review.

In my view, when someone listens, mutely to information, fibs (either directly or by ommission), they are perpetuating the issue.

Nurse suggests the person should be eating starchy carbs. Person nods, but eats LC; rejecting most starchy carbs. A1c falls. HCP has been told by the person they have been eating carbs, as the HCP directed, therefore that advice works.

In that circumstance what reason would there be for the HCP to reconsider their approach?

Wendy, you have to decide how you'll play your review.

 

[xfieldok]

Between DX and an appointment to discuss diet I had a good amount of time to do my own research, buy a meter, go lc.

At the appointment she opened her mouth to discuss diet and I forestalled her. I showed her my graphs, food diary, told her about the forum and LCHF.

When I finished there was a long pause and then she gave me a meter and a prescription for 100 strips per month.

I love my DN!

 

[kokhongw]

Do doctors still believe that they are the high priests, that patients today are clueless and mindless? Don't rely on what we say...get your own glucometer and test, it is not rocket science.

The plain fact is that for decades prevailing medical care and advice had dismal results when it comes to T2D reversal. I doubt our risk of mortality increases with normal glucose levels.

 

[Mr_Pot]

I have a question, a bit off subject,
Would ‘anyone’ eventually get diabetes if they consumed a large amount of carbohydrates daily throughout their life?

If you mean would everyone get diabetes if they consumed a large amount of carbohydrates daily throughout their life then obviously not, as lots of people do just that and never get it. There must be some additional factor, probably genetics.

 

[Wendy18480]

Wendy - Could I ask you to consider something prior to your review.

In my view, when someone listens, mutely to information, fibs (either directly or by ommission), they are perpetuating the issue.

Nurse suggests the person should be eating starchy carbs. Person nods, but eats LC; rejecting most starchy carbs. A1c falls. HCP has been told by the person they have been eating carbs, as the HCP directed, therefore that advice works.

In that circumstance what rereason would there be for the HCP to reconsider their approach?

Wendy, you have to decide how you'll play your review.

This is my first review so I'm not sure what to expect.

When I was diagnosed with the doctor she handed me reams of paperwork and said it was up to me to sort out how I was going to follow it. I mentioned 800 cals a day (I'd heard about it on TV just prior to my appointment)
"Huh" she says, "that's the Newcastle diet, nobody ever sticks to that".

I'm seeing the nurse from hell who doesn't respond to friendliness or small talk and if I mention Low Carb I'm sure she'll belittle the idea and say it can't possibly work.

I think I'll probably say something along the lines of how much research I've done and how many different ways there are and how when I was doing Slimming World I did much better on red days (protein) than green days (carbs) so I may well try that again to see how I get on.

 

[Resurgam]

Are you saying that statins help with musical ability, that is a little known benefit.

No, quite the reverse - five weeks on statins, total obliteration of decades of musical achievement, and all those hours of practice.

 

[Petaluk]

Oh okay, thank you @bulkbiker @britishpub @ickihun @Mr_Pot
I was confused because when I attended a DESMOND course, they said pancreas doesn’t rebuild/ repair itself, unlike the liver.
Also, that the pancreas wears out after producing insulin from carbohydrates, that’s why people get diabetes.

 

[Resurgam]

@zand They will probably say that the brain " needs" 138 g carbs every day for optimal function. This has been the catchcry at almost every T2D information session I have ever attended. And if you ask about the evidence for this, they haven't any.

Yes - I tell them that I have stuck to a maximum of 50 gm of carb a day for months at a time, and my intelligence seems to be intact, my intellect is sharpish and my brain still functioning - 'can you explain that?' Sometimes they try - release from the liver- but I ask if that doesn't run out after a while. That is usually when the subject is changed. I have been low carbing since the 1970s so I have had a lot of rather battering interviews with drs and nurses.

 

[Guzzler]

Oh okay, thank you @bulkbiker @britishpub @ickihun @Mr_Pot
I was confused because when I attended a DESMOND course, they said pancreas doesn’t rebuild/ repair itself, unlike the liver.
Also, that the pancreas wears out after producing insulin from carbohydrates, that’s why people get diabetes.

Well, all I can say is that I'm glad I chose not to attend a DESMOND course.

 

[kokhongw]

Also, that the pancreas wears out after producing insulin from carbohydrates, that’s why people get diabetes.

What they likely did not mention is that many T2D actually still produce 2-3x more insulin than those who are not diabetic. But that extra insulin is unable to clear the glucose, they ends up holding back and stuffing all the fats in our liver and pancreas.

Cut the carbs to lower the insulin and gradually we get access to those fats and burn them out.

 

[Pinkorchid]

I have a question, a bit off subject,
Would ‘anyone’ eventually get diabetes if they consumed a large amount of carbohydrates daily throughout their life?

No I do not believe they would my parents were born in the early 1900's and ate high carb food all their life but never had diabetes, No family history of it on either side of my family yet I have T2. I am not typical for it I have been slim all my life and as an adult never had a really high starchy carb diet or a sweet tooth and certainly not a ready meal, takeaways or junk food eater I am old school and cook meals from fresh. My husband also has T2 again not typical never any weight problem but his is thought to have been caused by the steroids that he takes

 

[Pinkorchid]

Hmmm. I was merely asking. I feel my DN has absolutely no idea about carbs and effect on BG levels. I’m sure there are some amazing nurses out there but mine, although lovely and caring is a bit clueless about nutrition generally. I, and I’m sure others,do not mean to offend, but it is frustrating that I’m told to eat bread and pasta because it is good for me (and that’s how they’ve been trained) whenI know I can’t eat like that. I literally can’t go over 20g a day. Every HCP just wanted to put me on meds.
I’m not asking to go to my doc or DN, these are routine appts requested by them so please don’t accuse me/is of wasting their time.
We all support our medical staff and you are very lucky that ‘their way’ works for you, but if I followed the advice given, I’d be in medication and probably insulin. Doing it my way I feel better and I feel human , as you say.
There is no disrespect here but I do feel everyone wants to shout from the rooftops about how there are other ways of helping your condition and do your own research. I for one am hugely grateful to everyone here for answering questions, the amazing amount of info and the amazing support xx

I just told my nurse I did not eat much bread and never pasta, rice and cereal because I do not like them.. which is true I never have..she didn't questioned it and as my HBa1c is always in the low 40's she is happy

 

[Dr Snoddy]

You could always ask them how long they studied nutrition for at University?
Although if there is a pet dietician somewhere around that one could misfire..

It was actually a young dietician who suggested to me to eat no more than 35g of carb per meal and who also suggested ways to do this e.g. put 1 tablespoon only of rice on the plate first or one small potato. She was the only HCP who advised something sensible and do-able!

 

[Daibell]

Reading your comments in this thread and some others I get really angry. The number of disparaging remarks about your doctors and nurses is astonishing. Talking about educating them?!?!? Who the hell do you think you are? If you are so sure of your ways, why are you going to your doctor, nurse, etc. Go and treat yourselves and don't waste the professionals time which could be spent on other patients.
This forum has turned to a forum for low carbing. And in my experience if you dare to express different opinion, they jump on you and make you feel tiny. Well No. I'm a nurse and I completely support the nurses, dieticians and doctors who are helping me. They try their best and their advice helps me live as normally as possible. So I control the diabetes, not it me! They help me live with minimal restrictions and feel good. And they are succeeding. My sugars are normalising, I feel better and feel human again.
So go on, make your choices. Either you treat yourselves or let professionals do it.

Hi Sani. It's important to realise that the majority of GPs and nurses are generalists by definition and the majority do a great job. They do, however cover an extremely wide range of conditions which it is impossible to keep up with on all fronts. If you think they can then surely that mis-understands that range and depth. We are obliged to go to our GP or nurse with a medical problem and in most cases that works out well. My excellent GP who now covers diabetes refused to accept I was T1 and not T2 and said she was the expert and refused me insulin when I was desperate for it. I found out later that she had only just come off diabetes training. Meanwhile I had had the condition for 10 years and used this forum, NICE documents and other sources so knew more than her at that time on that specific area. That doesn't mean she is a bad GP but can't be an expert on all things all the time (I've had good service from her on other problems since). I'm a professional engineer by training and always look for the science behind any relevant discussion. I've found NICE to be very scientific in their approach and their diabetes stuff is very good. However, the 'advice' that comes from PHE, BHF, DUK, BDA and so on is highly questionable at times and is often driven by a distinct lack of science or muddied by commercial interests. Sadly the NHS is a vehicle for some of this 'advice' and staff are then obliged to pass it on to the patient; diet being the biggest problem as well know.

 

[bulkbiker]

It was actually a young dietician who suggested to me to eat no more than 35g of carb per meal and who also suggested ways to do this e.g. put 1 tablespoon only of rice on the plate first or one small potato. She was the only HCP who advised something sensible and do-able!

Yep indeed as I said elsewhere on this thread here are exceptions but it is such a shame that they have to be that.
My main problem is that there are never any options it always seems to be "my way or else"
Dr Unwin reports asking questions of his patients like "would you like to try dietary changes before we move on to medication" the vast majority seem to leap at this and then with a bit of support carry it through.

 

[Chronicle_Cat]

I would have to say (as with everything) it depends...
Although I would imagine the likelihood must increase over time.
Some people seem to be able to cope with a high carb diet (maybe their pancreas is up to producing all that extra insulin and mine got a bit knackered). Maybe people's tolerances are higher. A fasting insulin test might show the chances of developing it but that seems an unlikely thing to happen.

A friend of mine mentioned a theory about this. She used the analogy of a gas tank for insulin. Some people people are born with a large one; they can eat anything they want (including high carbs) all their lives. Others are born with a small one and as they age, it runs low (their pancreas become less efficient and less able to cope with carbohydrates) and they develop Type 2 diabetes. (I realize some young people also get Type 2 but its incidence rises sharply with age.)

 

[Chronicle_Cat]

Reading your comments in this thread and some others I get really angry. The number of disparaging remarks about your doctors and nurses is astonishing. Talking about educating them?!?!? Who the hell do you think you are? If you are so sure of your ways, why are you going to your doctor, nurse, etc. Go and treat yourselves and don't waste the professionals time which could be spent on other patients.

I'm an informed patient who tries to take good care of myself that's who I think I am.

A very wise former family doctor of mine (only former because she died too young of breast cancer) told me once "it's your body and your life and you know it best" and I was the most invested in seeing that I stayed healthy. She always took the time to listen to me and together we made choices and decisions. I've been lucky that my current family doctor also listens to me and works with me. I've also been lucky that this has been true of the various specialists I've seen (urologist, ophthalmologist, gastroenterologist and 2 surgeons for major surgeries). I value(d) their judgement. My late son was severely disabled and I dealt with many, many professionals over the course of his life. Whenever possible I chose medical professionals for him who were good at listening rather than the dismissive and patronizing ones. Unfortunately the dismissive and patronizing professionals do exist and I believe the stories about bad experiences people have had.

Medical professionals are human beings who can't know everything. It isn't just diabetes, virtually all of the medical professionals (except for neurologists) I talk to here (Canada) have never heard of the cause of my son's death - SUDEP - sudden death in epilepsy (awareness here is lower than the UK). (I'm trying to raise awareness for SUDEP and break the conspiracy of silence that surrounds it here.)

I don't expect medical professionals to know everything. However, I expect them to be open to discussion, willing to consider various points of view and willing to learn something new.

 

[Sani Thomas]

I'm an informed patient who tries to take good care of myself that's who I think I am.

A very wise former family doctor of mine (only former because she died too young of breast cancer) told me once "it's your body and your life and you know it best" and I was the most invested in seeing that I stayed healthy. She always took the time to listen to me and together we made choices and decisions. I've been lucky that my current family doctor also listens to me and works with me. I've also been lucky that this has been true of the various specialists I've seen (urologist, ophthalmologist, gastroenterologist and 2 surgeons for major surgeries). I value(d) their judgement. My late son was severely disabled and I dealt with many, many professionals over the course of his life. Whenever possible I chose medical professionals for him who were good at listening rather than the dismissive and patronizing ones. Unfortunately the dismissive and patronizing professionals do exist and I believe the stories about bad experiences people have had.

Medical professionals are human beings who can't know everything. It isn't just diabetes, virtually all of the medical professionals (except for neurologists) I talk to here (Canada) have never heard of the cause of my son's death - SUDEP - sudden death in epilepsy (awareness here is lower than the UK). (I'm trying to raise awareness for SUDEP and break the conspiracy of silence that surrounds it here.)

I don't expect medical professionals to know everything. However, I expect them to be open to discussion, willing to consider various points of view and willing to learn something new.

You don't seem to understand what angers me. I agree there are good and bad doctors. More good than bad. And yes, this is called informed consent for treatment. But Im not talking about that.
I'm talking about constantly disparaging the Med.professionals, disregarding their advice and insisting patients know better. The forceful promotion of things that the professionals know better. And believe me, they know.
I am so disappointed that I'm thinking about leaving this forum. I'm also worried that new diabetics get wrong or conflicting advice. Your attitude is the right attitude but most others on the thread I commented on were not. If you are not going to follow the advice of your doctor, or even to discuss it with them, why are going there?
Anyway, right now I have decided that I'm going with my support team. Being a nurse, I know the responsibility they shoulder, the constant studying, the research, etc. I'm not going to go with some half-assed ideas of various gurus. And I'll continue to be the other side and tell people my opinion, so they know they have options and discuss them with the correct people - The medical team.
Apropos, I know about the epileptic condition. Any epilepsy specialist knows it too.
Bye

Sent from my SGP611 using Diabetes Forum mobile app

 

[Mr_Pot]

And I'll continue to be the other side and tell people my opinion, so they know they have options and discuss them with the correct people - The medical team.

Good idea, the wider range of opinions on the forum the better.