Type 2 Carbs And The Doctor/dn

[Guzzler]

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.

There is a whole world of difference between the absence of insulin and hyperinsulinaemia. Your regime has worked for you so you needn't feel pressured into the low carb approach but this approach works for the majority of people with T2 and for some with T1. The number of carbs is immaterial in itself, what is important is the number of carbs that gets the best results for the individual.

 

[Daibell]

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.

Hi. I don't think we are being told that 20gm/day is the 'right' amount but OK if you tolerate that low level. Like you I have around 150gm/day with my insulin but for T2s on just tablets (like I was before finally being offered insulin) going way below 100/gm may be the only way to keep BS down. In many ways being T1 on insulin makes life so much easier than being a struggling T2.

 

[There is no Spoon]

turn a civil (if heated) discussion into a War Zone.

IF were going to WAR I need to change to my Bugs Bunny Avatar.

 

[bulkbiker]

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!

It is certainly possible and achievable.. check out typeonegtrit on facebook. Whether you wish to do it is your choice. Of course when you are eating that way digestive biscuits are off the menu but eggs and bacon steak mushrooms and spinach with butter and cream are on it. As for hypo treatments you likely would need far fewer as insulin requirements would be reduced. Agreed its not for all but it should still be considered as an option. For Type 2's it has huge benefits not only lower bloods but for the most part easy weightloss without hunger too. Not a lot to say against it really.

 

[Flora123]

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.

Thank you. I will remember that!

 

[Indy51]

Maybe things with Type 2 treatment are different here in WA, Oz or maybe it's just my GP. After diagnosis I got sent off to do a group course given by a diabetes educator - I went for the first day and decided it wasn't for me and that self-research would suit me better. My doc has only ever congratulated me on my control and expressed zero interest in how I did it. If he expressed interest, I'd tell him.

I think the short appointment time turnaround culture doesn't do much for communication these days. Never any diagreements or clashes of any kind. Every 6 months he writes me lab requests for the Type 2 test battery, a larger range at 12 months and gives me a referral to the podiatrist. I make my own arrangements with optometrist for eye testing. All very routine and boring really.

Different story with my hospital respiratory specialists who I'm pretty sure have written me off as non compliant because I won't take their advice on new medications that I can't see any benefit in, except possibly for them. But that's a whole other story and issue

 

[Moggely]

Where is the disagree button when you need it!

What a shame @Debandez , you mange to find everything else. However you did find it, it is in your comment. Have a good day/night.

 

[Moggely]

My own comments are against the outdated NHS guidelines which are harming people. I don't know how anyone can stick up for those guidelines when the statistics speak for themselves. I was quite hurt by the one person you speak of who told me 'I can't imagine your doctor accused you of lying'. Then the back lash about my attitude. My attitude re the NHS comes from years of not being listened to, going right back to things that should have been noticed by my GP when I was a baby. The NHS wasn't cash strapped back then.

@zand i have heard your story about your son and my sympathies go out to you, however it is you that kept him alive and yes the GP let you down. One form of healing for that painful memory and one only is Forgiveness. Yes it is hard but you can be the victor, not the victim. I really hope that helps.

 

[kitedoc]

'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?

Hi @Honeyend, As a retired GP I second your sentiments. I used to photocopy (and enlarge) food ingredients on some food packets to show to patients and to help emphasise the information on there and provide education. The printing is too small on many food packets also. One image I found helpful was of a word written in a Chinese graphic symbol - the word 'to listen' had 4 elements: Ears, Eyes, Heart and Undivided Attention - so elegantly simple yet so often not used. Whilst disrespectful language seems more and more to be viewed by some patients as their right, it sadly hurts them more than the health provider - not that I agree that such behaviour is acceptable.

 

[Guzzler]

Hi @Honeyend, As a retired GP I second your sentiments. I used to photocopy (and enlarge) food ingredients on some food packets to show to patients and to help emphasise the information on there and provide education. The printing is too small on many food packets also. One image I found helpful was of a word written in a Chinese graphic symbol - the word 'to listen' had 4 elements: Ears, Eyes, Heart and Undivided Attention - so elegantly simple yet so often not used. Whilst disrespectful language seems more and more to be viewed by some patients as their right, it sadly hurts them more than the health provider - not that I agree that such behaviour is acceptable.

The use of this guttersnipe type of language is something I struggle to understand. Don't misunderstand, if I stub my toe I can swear like a scouse stevedore but there's a time and a place.

 

[Brunneria]

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.

Yes.
5 or 6 years ago I was told (photocopied A4 diet sheet) that I should be on 9 portions of ‘brown carbs’ a day.

What a lovely thought! The idea of ploughing through all that brown bread, brown rice and brown pasta... horrible.

Needless to say I binned the bit of paper before leaving the building.

 

[Safi]

Yes.
5 or 6 years ago I was told (photocopied A4 diet sheet) that I should be on 9 portions of ‘brown carbs’ a day.

What a lovely thought! The idea of ploughing through all that brown bread, brown rice and brown pasta... horrible.

Needless to say I binned the bit of paper before leaving the building.

My colon hurts just thinking about it

 

[zand]

@zand i have heard your story about your son and my sympathies go out to you, however it is you that kept him alive and yes the GP let you down. One form of healing for that painful memory and one only is Forgiveness. Yes it is hard but you can be the victor, not the victim. I really hope that helps.

Oh I have moved on from that years ago, I just mention it here on the forum when it is relevant to a discussion.

The thing that upsets me the most is that the same GP did tests and found that I had fatty liver...and didn't tell me! A few years later another doctor told me about it but said that nothing could be done. I researched and improved it myself by low carbing. Firstly why would a GP withhold such information from a patient? Secondly to say nothing could be done about it is ridiculous, the info is out there. I bought a book about Syndrome X as soon as I was informed, but I did need that crucial bit of info before I could help myself. They were my blood tests results. I had a right to know them.

Another upsetting thing for me is that when an overweight person goes to a GP they do tests for blood glucose levels, but not for insulin levels. Since insulin is a fat building hormone I would have thought that that would be a good place to start if someone is piling on the pounds. I was insulin resistant for many years (20, 25?) before I became T2. I didn't know about IR then, but my doctors should have. All those years with too much insulin have damaged my body. I am pretty upset about that. I am trying to repair it now by low carbing so I really don't see why a lot of the medical profession can't see that carbs are a problem if someone is overweight. I have been left to my own devices and have struggled with simply living and being morbidly obese, that's why I take exception to someone saying we shouldn't criticize the professionals and defending them. Why are they there if not to help us?

The fact that so many of us have taken exception to a particular member's words defending HCPs means that we have all been in the same boat so it's not just one rotten apple. I think we all have a right to post about how HCPs being against LCHF has affected our health, the thread is about carbs and a doctor and DN

 

[Debandez]

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.

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.

The 1936 diabetes guidelines are in fact LCHF.

 

[Safi]

Oh I have moved on from that years ago, I just mention it here on the forum when it is relevant to a discussion.

The thing that upsets me the most is that the same GP did tests and found that I had fatty liver...and didn't tell me! A few years later another doctor told me about it but said that nothing could be done. I researched and improved it myself by low carbing. Firstly why would a GP withhold such information from a patient? Secondly to say nothing could be done about it is ridiculous, the info is out there. I bought a book about Syndrome X as soon as I was informed, but I did need that crucial bit of info before I could help myself. They were my blood tests results. I had a right to know them.

Another upsetting thing for me is that when an overweight person goes to a GP they do tests for blood glucose levels, but not for insulin levels. Since insulin is a fat building hormone I would have thought that that would be a good place to start if someone is piling on the pounds. I was insulin resistant for many years (20, 25?) before I became T2. I didn't know about IR then, but my doctors should have. All those years with too much insulin have damaged my body. I am pretty upset about that. I am trying to repair it now by low carbing so I really don't see why a lot of the medical profession can't see that carbs are a problem if someone is overweight. I have been left to my own devices and have struggled with simply living and being morbidly obese, that's why I take exception to someone saying we shouldn't criticize the professionals and defending them. Why are they there if not to help us?

The fact that so many of us have taken exception to a particular member's words defending HCPs means that we have all been in the same boat so it's not just one rotten apple. I think we all have a right to post about how HCPs being against LCHF has affected our health, the thread is about carbs and a doctor and DN

I think the advice many are given by their HCPs not to test their blood sugar is probably the most stupefying to me. I simply can't get my head around it.

 

[Debandez]

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

Handbags at dawn in my case, not much of a physical fighter! But show me something that isn't just and I'm in there. I worked on the last census. Put £3000 worth of extra hours in as did many others across the country. Went to court to get that little monkey sorted only 8 of us in the end but i dont give up. Even got matching holiday pay. Shouldn't have to fight but sometimes when things aren't right you just have it to do. Anyway, my hand bag is massive with everything plus the kitchen sink in. Lethal weapon! Let's go!!!

 

[Debandez]

What a shame @Debandez , you mange to find everything else. However you did find it, it is in your comment. Have a good day/night.

Ive just never come across it.

 

[Debandez]

I think the advice many are given by their HCPs not to test their blood sugar is probably the most stupefying to me. I simply can't get my head around it.

My meter is the answer to all my problems. Best investment ever.

 

[Jay-Marc]

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.

I have in front of me now the Diabetes UK 'Your Guide to Type 2 Diabetes' published in 2014. It takes 36 pages before it reaches food at all. On that page there is a recommendation to eat between 5 and 14 portions of starchy foods (ie bread, rice, potatoes or pasta) per day, one third of your diet. This is the eat well plate.

Tucked away on page 39 is: "the amount of carbohydrate you eat has the biggest influence on your blood glucose levels after meals" (my bolding). On the same page though is the suggestion to add baked beans to a jacket potato and salad for lunch.

 

[Guzzler]

I have in front of me now the Diabetes UK 'Your Guide to Type 2 Diabetes' published in 2014. It takes 36 pages before it reaches food at all. On that page there is a recommendation to eat between 5 and 14 portions of starchy foods (ie bread, rice, potatoes or pasta) per day, one third of your diet. This is the eat well plate.

Tucked away on page 39 is: "the amount of carbohydrate you eat has the biggest influence on your blood glucose levels after meals" (my bolding). On the same page though is the suggestion to add baked beans to a jacket potato and salad for lunch.

'Thud' That was sound of my jaw hitting the floor.