Type 2 Carbs And The Doctor/dn

kokhongw

Well-Known Member
Messages
2,394
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
There would have been no need for this site or forum if the existing treatment and guidelines had any success for the past few decades...

And just reading up on Dr Bernstein would tell you what we are up against.. low carb is not the latest fad at all. It has been too successfully suppressed over the last 40 years. Countless lives and limbs have been lost unnecessarily if that means anything to anyone who care.
 

MikeyJ

Well-Known Member
Messages
72
Type of diabetes
Type 2
Treatment type
Tablets (oral)
When up against a brick wall you tend to have to shout a little to get your point a across.
haha good point, ok how about you and @bulkbiker attack the wall and I'll infiltrate beyond the wall with a 'hearts and minds' strategy - a pincer movement for a glorious victory

........this has all gone a little Game of Thronesy
 

satindoll

Well-Known Member
Messages
2,083
Type of diabetes
Type 2
Treatment type
Insulin
Had I blindly followed the HPC's advice last week to "Pop a couple of painkillers, jump in the car and come on up to see me".......I would have been breaking the law and a danger to every other person on the road.........:banghead:
 

zand

Master
Messages
10,784
Type of diabetes
Type 2
Treatment type
Diet only
Had I blindly followed the HPC's advice last week to "Pop a couple of painkillers, jump in the car and come on up to see me".......I would have been breaking the law and a danger to every other person on the road.........:banghead:
Oh I hope you are feeling better now?
 
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Jay-Marc

Well-Known Member
Messages
218
Type of diabetes
Type 2
Treatment type
Tablets (oral)

At the end of my interview with my DN I felt so belittled that I told her that I was not lying to her, there would be no point. It was the last time I wasted my time and hers with an appointment. I saw a doctor afterwards and was reprimanded for not starting metformin, 'you will regret not taking one little pill when you are going blind'
...
I had a DN once who advised me not to test blood glucose regularly 'because you will need sensitive finger tips when (not if) you go blind' (addition in brackets mine). I was quite taken aback anyone would say something so blunt, and I don't know what kind of affect that might have had on some other people if it was a regular line she used. Made sure I never saw her again. The other one in the same practice has a much more sympathetic and open attitude though, quite accepting of my restricted carb diet and eating-to-meter.
 

Debandez

Well-Known Member
Messages
4,019
Type of diabetes
Type 2 (in remission!)
Treatment type
Diet only
This is what I got from my diabetic nurse at my first appointment in December sadly.
 

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Honeyend

Well-Known Member
Messages
151
'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.'

Hopefully they are people who want to manage effectively their condition.
I have been a HCP for over 40 years, and I am amazed at the arrogance of a lot of other HCP. When you walk away from the bed or the patient walks out of the consulting room door, they are left to manage their life and their condition. Often there is not space to ask questions or they ask closed questions, so effectively no real response is required.
This is not only in diabetes care, they do not want to hear what does not fit in with what their mental check list a ticked and has jumped to the end bypassing any input from the patient. Of course when the planned care does not achieve the results its because the patient is not compliant not that the plan was based on incorrect assumptions
I attended a course last year and it was stressed throughout was the importance of listening, and taking a history. Some of my favourite questions after I have suggested a plan, but does make sense to you and is there anything you think we should change?
If someone does not follow my plan but the objective is achieved but they are too intimidated to tell me how does that help? The patient is unsupported and I am patting my self on the back for something I had no hand in, or the worse case scenario something catastrophic happens I do not know why.
My pet hate is the tinkering with insulin which appears to have no basis in the patients real life and diet, so the patient is left with hypo's or hypers because they either can not eat enough, or the is just a complete lack of understanding of how much carb they are eating. I seem to spend most of my time telling people to check the total carb content on the back of the packet. No seems to have suggested they do this, but they did get told to cut out sugar.

If you are HCP you are supposed to read around a subject, things change and the chances are dietary advice is about to change.
https://www.ncbi.nlm.nih.gov/pubmed/29269890
'CONCLUSIONS:
Reducing dietary carbohydrate may produce clinical improvements in the management of type 2 diabetes. Further research is needed to understand the true effect of dietary carbohydrate restriction on HbA1c independent of medication reduction and to address known issues with adherence to this dietary intervention. Clarity is needed regarding appropriate classification of a low-carbohydrate diet.'

Evidence based practice is good but if something works but there is not the will or the money to do the random trials how to you get the evidence?
The news today about the predicted increase in Type2 perhaps the money will follow because what ever we are doing now its not working.

As to disrespect. I got a f*****g c**t last night by a patient. My first though was not that they were disrespectful, but what caused that?
 

bulkbiker

BANNED
Messages
19,576
Type of diabetes
Type 2
Treatment type
Diet only
'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.'

Hopefully they are people who want to manage effectively their condition.
I have been a HCP for over 40 years, and I am amazed at the arrogance of a lot of other HCP. When you walk away from the bed or the patient walks out of the consulting room door, they are left to manage their life and their condition. Often there is not space to ask questions or they ask closed questions, so effectively no real response is required.
This is not only in diabetes care, they do not want to hear what does not fit in with what their mental check list a ticked and has jumped to the end bypassing any input from the patient. Of course when the planned care does not achieve the results its because the patient is not compliant not that the plan was based on incorrect assumptions
I attended a course last year and it was stressed throughout was the importance of listening, and taking a history. Some of my favourite questions after I have suggested a plan, but does make sense to you and is there anything you think we should change?
If someone does not follow my plan but the objective is achieved but they are too intimidated to tell me how does that help? The patient is unsupported and I am patting my self on the back for something I had no hand in, or the worse case scenario something catastrophic happens I do not know why.
My pet hate is the tinkering with insulin which appears to have no basis in the patients real life and diet, so the patient is left with hypo's or hypers because they either can not eat enough, or the is just a complete lack of understanding of how much carb they are eating. I seem to spend most of my time telling people to check the total carb content on the back of the packet. No seems to have suggested they do this, but they did get told to cut out sugar.

If you are HCP you are supposed to read around a subject, things change and the chances are dietary advice is about to change.
https://www.ncbi.nlm.nih.gov/pubmed/29269890
'CONCLUSIONS:
Reducing dietary carbohydrate may produce clinical improvements in the management of type 2 diabetes. Further research is needed to understand the true effect of dietary carbohydrate restriction on HbA1c independent of medication reduction and to address known issues with adherence to this dietary intervention. Clarity is needed regarding appropriate classification of a low-carbohydrate diet.'

Evidence based practice is good but if something works but there is not the will or the money to do the random trials how to you get the evidence?
The news today about the predicted increase in Type2 perhaps the money will follow because what ever we are doing now its not working.

As to disrespect. I got a f*****g c**t last night by a patient. My first though was not that they were disrespectful, but what caused that?
So pleased that you can appreciate where a lot of our frustration comes from. If I haven't said it before I hope you always feel welcome here.
 

zand

Master
Messages
10,784
Type of diabetes
Type 2
Treatment type
Diet only
'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.'

Hopefully they are people who want to manage effectively their condition.
I have been a HCP for over 40 years, and I am amazed at the arrogance of a lot of other HCP. When you walk away from the bed or the patient walks out of the consulting room door, they are left to manage their life and their condition. Often there is not space to ask questions or they ask closed questions, so effectively no real response is required.
This is not only in diabetes care, they do not want to hear what does not fit in with what their mental check list a ticked and has jumped to the end bypassing any input from the patient. Of course when the planned care does not achieve the results its because the patient is not compliant not that the plan was based on incorrect assumptions
I attended a course last year and it was stressed throughout was the importance of listening, and taking a history. Some of my favourite questions after I have suggested a plan, but does make sense to you and is there anything you think we should change?
If someone does not follow my plan but the objective is achieved but they are too intimidated to tell me how does that help? The patient is unsupported and I am patting my self on the back for something I had no hand in, or the worse case scenario something catastrophic happens I do not know why.
My pet hate is the tinkering with insulin which appears to have no basis in the patients real life and diet, so the patient is left with hypo's or hypers because they either can not eat enough, or the is just a complete lack of understanding of how much carb they are eating. I seem to spend most of my time telling people to check the total carb content on the back of the packet. No seems to have suggested they do this, but they did get told to cut out sugar.

If you are HCP you are supposed to read around a subject, things change and the chances are dietary advice is about to change.
https://www.ncbi.nlm.nih.gov/pubmed/29269890
'CONCLUSIONS:
Reducing dietary carbohydrate may produce clinical improvements in the management of type 2 diabetes. Further research is needed to understand the true effect of dietary carbohydrate restriction on HbA1c independent of medication reduction and to address known issues with adherence to this dietary intervention. Clarity is needed regarding appropriate classification of a low-carbohydrate diet.'

Evidence based practice is good but if something works but there is not the will or the money to do the random trials how to you get the evidence?
The news today about the predicted increase in Type2 perhaps the money will follow because what ever we are doing now its not working.

As to disrespect. I got a f*****g c**t last night by a patient. My first though was not that they were disrespectful, but what caused that?
Wow! You really are a breath of fresh air! :)

I read the last paragraph and gasped, thinking there's no excuse for anyone to talk to you like that...but I guess you are right, something must have caused it. I will think twice before I get offended next time someone swears at me now.

I wish all HCPs were like you :)
 

fatismyfriend

Member
Verified HCP
Messages
17
Type of diabetes
HCP
So I have an appointment coming up and I will be quizzed about my diet (low carb and working very well). What do you say when you are lectured about eating carbs and how important they are. I’m fed up smiling sweetly and agreeing. I keep getting told I need carbs yet doing just fine on 20g a day. Thanks x
Hello Flora123

I’m a GP. Try this...

‘I eat real unprocessed food, and a low enough carb level to keep my blood glucose normal. I’m told that my body makes glucose so I don’t need to eat it.’

The process by which the body makes sugar is called gluconeogenesis.
Many people forget this in their zeal to follow outdated guidelines. Technology proves to us that they are wrong.
Nice guidance states we should give individualised carbohydrate advice, and low GI, so if you need to go as low as 20g to keep your blood glucose normal, that is the right amount for you. Not a lot of people know that yet. It is in NICE type 2 Diabetes December 2015 1.1.1 and 1.3.3.
Hope that makes sense.
There are great courses about this now from the Public Health Collaboration and Inspired Medics that they could sign up with, but they are relatively new.
 

Glucobabu

Well-Known Member
Messages
248
Type of diabetes
Type 1
Treatment type
Insulin
Sorry to stick out guys, but I just cannot accept that extreme low carb diet is possible or preferable for longstanding Type 1s like me. People are talking about 20gm carbs a day! That’s about 2 digestive biscuits in a whole day! An average hypo would need about 40gm carb to treat. I have been Type 1 on insulin for about 45 years, a veggie, of below average weight and with no obvious complications yet. I try to have a balanced law starch diet and carb count and inject (DAPHNE trained). I feel I have done quite well on an average 150gm carbs a day. Maybe I have just been lucky but I find this constant talk of extreme low carb diet rather tiring.
 

Daibell

Master
Messages
12,642
Type of diabetes
LADA
Treatment type
Insulin
This is what I got from my diabetic nurse at my first appointment in December sadly.
If I remember correctly it was Diabetes UK that recommended the up to 14 portions of carbs a day. I don't think they would dare do that now.
 

xfieldok

Well-Known Member
Messages
4,182
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Sorry you feel like that @Glucobabu, as a T2 on 20 carbs a day, I now have my BG under control and I find it exhilarating.
 
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Indy51

Expert
Messages
5,540
Type of diabetes
Type 2
Treatment type
Diet only
To be honest, because of your attitude "So now you are accusing me of lying too!" I couldn't care less about you!
Good luck
To be honest, because of your attitude, "Who the hell do you think you are", I couldn't care less about you either.
What a stuck up, snooty, entitled - and ******* - attitude. So much for the "professional" in HCP.

Edited by mod to remove unacceptable language
 
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