Twitter threads on why most GP's won't suggest low carb

[bulkbiker]

A teeny bit sweary but a great read

https://twitter.com/vincentninja68/status/1061372441920864256

 

[Geordie_P]

It's bizarre, isn't it?
I didn't know much about diabetes when I was diagnosed, but I did know it was to do with sugar levels being too high in your blood, so my immediate instinct was to stop eating sugar and things which turn into glucose after you eat them. How these clowns have the audacity to suggest this is a bad idea is beyond me.
I suppose if I hit my thumb with a hammer, their cure would be to keep hitting it with a hammer every day, but take escalating amounts of painkillers to deal with the worsening situation.

 

[kokhongw]

How these clowns have the audacity to suggest this is a bad idea is beyond me.
I suppose if I hit my thumb with a hammer, their cure would be to keep hitting it with a hammer every day, but take escalating amounts of painkillers to deal with the worsening situation.

It takes years of marketing dollars from the painkiller company to make it the preferred treatment protocol...protected by law. Deviate from it and you are on your own.

 

[ickihun]

Another ignorant tweeter who just doesn't understand just how dangerous hypos are though.

 

[ickihun]

It's bizarre, isn't it?
I didn't know much about diabetes when I was diagnosed, but I did know it was to do with sugar levels being to high in your blood, so my immediate instinct was to stop eating sugar and things which turn into glucose after you eat them. How these clowns have the audacity to suggest this is a bad idea is beyond me.
I suppose if I hit my thumb with a hammer, their cure would be to keep hitting it with a hammer every day, but take escalating amounts of painkillers to deal with the worsening situation.

No they are suggesting next time use a rubber mallet. Because you cannot stop accidents with hammers.

 

[bulkbiker]

Another ignorant tweeter who just doesn't understand just how dangerous hypos are though.

Not in the slightest.. by telling T2's to eat carbs then giving meds and, more dangerously insulin, hypos become more not less likely.. doctors fear them but don't make any attempt to mitigate them which is kind of crazy.

 

[zand]

I thought I read somewhere on this forum that there were NICE guidelines going back to Dec 2015 saying that low carb should be offered as an option for T2s? Can't find the thread now. Perhaps I was dreaming it.

 

[rosco 2]

I tread delicately here. Of course hypos are life threatening. It is also true that vast numbers of people diagnosed with whatever variant of diabetes are woefully ignorant, unwilling to address their issues and possibly see education as an opportunity to stick fingers in ears whilst singing lalalala, I can’t hear you. Then there are those who choose to do their utmost to educate self and take responsibility.
So...the outcome is we - the “patients” are a very mixed bag (no insult intended!). I could wish that we are regarded as discrete individuals and our care titrated to that but...GPs are busy, their work is a business and thus we are often seen as a homogenous whole. Therefore the reality is that the collective experience within sites such as this become increasingly important, certainly for those who choose to take their health seriously. I used to tell those for whom I cared, ‘you are the guardian of your health, don’t allow any of us to scr3w you over’.

 

[HSSS]

No but you can use the hammer less often, learn to use it more carefully, find alternatives (a screw instead of a nail), wear protective gloves etc. It doesn’t stop the accidents but sure does help.

And whilst hypos are definitely serious and I’m not diminishing the need to avoid this, I’d venture as the majority of diabetics are type 2 and at least start out at low risk of hypos getting bgl down is the largest single addressable treatment for the largest number of people.

 

[Bluetit1802]

The fear of killer hypos is only relevant to those on insulin and insulin stimulating drugs. These people are in the minority. Most of us are never likely to hypo, so the argument just doesn not apply to us.

 

[bulkbiker]

I thought I read somewhere on this forum that there were NICE guidelines going back to Dec 2015 saying that low carb should be offered as an option for T2s? Can't find the thread now. Perhaps I was dreaming it.

It's weird.. even iif NICE say they should getting GP's to actually do it is amazingly hard. I was having a phone consult with my GP which after me saying no to statins once again turned to Low Carb (as conversations between me and HCP's tend to these days!) he admitted to intermittently fasting himself but was adamant that patients would do low carb I explained to him that if their HCP's didn;t give them the option to the they wouldn't even know about it! Its just an uphill battle.
Also was having another discussion on twitter with a dietician yesterday and she pointed out that the BDA and DUK had low carb advice but she had to struggle to find it whereas I put "Type 2" into the BDA website and got... yep the Eatwell Guide.
The problem is that they have been so anti low carb for so long that they can't support it without anyone with a memory seeing how stupid they have been.

 

[zand]

It's weird.. even iif NICE say they should getting GP's to actually do it is amazingly hard. I was having a phone consult with my GP which after me saying no to statins once again turned to Low Carb (as conversations between me and HCP's tend to these days!) he admitted to intermittently fasting himself but was adamant that patients would do low carb I explained to him that if their HCP's didn;t give them the option to the they wouldn't even know about it! Its just an uphill battle.
Also was having another discussion on twitter with a dietician yesterday and she pointed out that the BDA and DUK had low carb advice but she had to struggle to find it whereas I put "Type 2" into the BDA website and got... yep the Eatwell Guide.
The problem is that they have been so anti low carb for so long that they can't support it without anyone with a memory seeing how stupid they have been.

But they are happy to use NICE guidelines when it suits them....

 

[bulkbiker]

But they are happy to use NICE guidelines when it suits them....

Mainly when saving money....

 

[HSSS]

I thought I read somewhere on this forum that there were NICE guidelines going back to Dec 2015 saying that low carb should be offered as an option for T2s? Can't find the thread now. Perhaps I was dreaming it.

All I can find is this https://www.nice.org.uk/guidance/ng28/ifp/chapter/diet-and-lifestyle which seems to advocate eatwell. Low fat, fruit, whole grains etc

 

[HSSS]

It's weird.. even iif NICE say they should getting GP's to actually do it is amazingly hard. I was having a phone consult with my GP which after me saying no to statins once again turned to Low Carb (as conversations between me and HCP's tend to these days!) he admitted to intermittently fasting himself but was adamant that patients would do low carb I explained to him that if their HCP's didn;t give them the option to the they wouldn't even know about it! Its just an uphill battle.
Also was having another discussion on twitter with a dietician yesterday and she pointed out that the BDA and DUK had low carb advice but she had to struggle to find it whereas I put "Type 2" into the BDA website and got... yep the Eatwell Guide.
The problem is that they have been so anti low carb for so long that they can't support it without anyone with a memory seeing how stupid they have been.

https://www.diabetes.org.uk/resources-s3/2017-09/low-carb-diets-position-statement-May-2017.pdf
https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/meal-plans-/low-carb Lots of wholemeal toast, chickpeas and porridge so not terribly low carb
https://www.bda.uk.com/improvinghea...s/policy_statements/policy_statement_diabetes Page two recommendations has one sentence about low carb and generally seems to say ‘we don’t know so we’ll keep it as it is with regards to fats’

 

[ickihun]

Not in the slightest.. by telling T2's to eat carbs then giving meds and, more dangerously insulin, hypos become more not less likely.. doctors fear them but don't make any attempt to mitigate them which is kind of crazy.

Fear borne from deaths though so very understandable. Surely?
Mind u no Dr has even given me any dietary advice. Only dieticians.
Dr's don't get any dietary training I saw somewhere.

 

[HSSS]

But the crazy @bulkbiker is referring to is despite a justifiable fear (no one is arguing that point) drs actually make a hypo more likely by their advice or lack of.

 

[ickihun]

But the crazy @bulkbiker is referring to is despite a justifiable fear (no one is arguing that point) drs actually make a hypo more likely by their advice or lack of.

Yep. More likely a lack of..... to avoid being sued, maybe. Hypo death family members do see the medical profession hugely responsible if insulin bad advice is involved somehow.
A hugely preventable death. Deaths which are common for diabetics. More than off and on spikes which do resolve in T2's without meds as long as no additional food intake and/or stressful exercise. (Or addition health problems or/and their meds).
GPs are trained to prevent deaths, first and foremost. More than nurse-maiding bad habits or the bad upbringing affects which I suppose involves them because of the risk of slowly killing ourselves without meds they CAN prescribe until re-educated. Maybe.
That Dr only see us (patient) briefly so their concern is preventing death... first.

 

[HSSS]

@ickihun can I clarify your post please . Not sure I’m reading it right

Family members blaming drs for hypo deaths where bad insulin advice given. “Somehow” what does this mean? That you’re shocked they would blame in this situation? Really?

So whilst I agree preventing death is a first goal it’s ok to let’s us die slowly through complications because time is short?

So the nursemaiding of bad habits/upbringing is nothing to do with people following nhs advice they usually advocate themselves?

And just feeding us meds is better than re-education or accurate diet information again because time is poor so that’s ok.


Apologies if I’ve been got your meaning wrong.....

 

[KK123]

I think the tweeter has it spot on, Dr's/Consultants ARE scared of hypo's. So scared in fact, that they would rather we all ended up with complications caused by hyper's. There is one easy way to minimise the risk of hypo's though, give us all a Libre. There you go, problem solved, now they can give out advice that works, ie eat fewer carbs.

 

[Boo1979]

I think this is the kind of stuff that scares them, not hypos per se
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5669378/