Appalling ignorance about diabetes in NHS

[Rosie9876]

First of all, I have deep affection for the NHS and the dedicated staff who work in it. But my experience as a Type 2 diabetic has been poor. My bad for blindly following advice for years, to eat lots of carbs, just less refined and not sugar - and low fat. But I finally got my act together and think I understand it. Though recognise still much to learn.

I am in my 4th hospital stay for surgery. At first, I was shocked by the poor nutrition and total failure to cater for diabetics. But I muddled through.

Today, as I was recovering from the anaesthetic, my (obviously fasting) blood sugar dropped from 8 to 4.8. The recovery room nurse insisted I drink a glass of orange juice because I was in danger of passing out. I tried to explain that I am T2, on Metformin, not on insulin, that 4.8 was a good reading, and my Libre CGM more than likely underestimated my BS. But she got very angry with me, said I MUST drink the juice, my life was in danger. She called the doctor, who smoothed things over.

But the point is, she has clearly been mistaught. There is no longer any excuse for ignorance in the NHS. I was made to feel "difficult" for what is in fact acting in my interests, and watched her making copious notes afterwards. When will the NHS get its act together?

 

[KennyA]

You know, it's not that long ago that Type two diabetes didn't exist. I have diabetes textbooks published in 1999 which talk only about "insulin-dependent diabetes mellitus" and " non-insulin dependent diabetes mellitus". The assumption was that these were two stages of the same disease and that one inevitably progressed to the other. Those textbooks will have been used to train people who are still in practice today. In addition, those textbooks and the thinking in them were used to set the initial requirements of the Quality and Outcomes Framework, which rewards GPs for doing certain things, and in setting the NICE guidelines which set the standard for treatment. The T2 guidelines were and are are obsessed with avoiding hypos, which is why they recommend aiming for maintaining diabetic levels of blood glucose.

So its entirely possible that your nurse was taught according to the prevailing opinion and actually learnt and applied her training. It's just that the orthodox medical opinion was and still is, er, sub-optimal. While many doctors - see David Cavan, for example, are fully on-board with low carb (which was, after all, the orthodoxy up to the 1980s) others will not be.

You might be interested in reading Gary Taubes' book "Rethinking Diabetes" which covers the history of medical attitudes to the condition, and the consequently different treatment approaches that have been in the ascendancy at various times.

 

[lovinglife]

First of all, I have deep affection for the NHS and the dedicated staff who work in it. But my experience as a Type 2 diabetic has been poor. My bad for blindly following advice for years, to eat lots of carbs, just less refined and not sugar - and low fat. But I finally got my act together and think I understand it. Though recognise still much to learn.

I am in my 4th hospital stay for surgery. At first, I was shocked by the poor nutrition and total failure to cater for diabetics. But I muddled through.

Today, as I was recovering from the anaesthetic, my (obviously fasting) blood sugar dropped from 8 to 4.8. The recovery room nurse insisted I drink a glass of orange juice because I was in danger of passing out. I tried to explain that I am T2, on Metformin, not on insulin, that 4.8 was a good reading, and my Libre CGM more than likely underestimated my BS. But she got very angry with me, said I MUST drink the juice, my life was in danger. She called the doctor, who smoothed things over.

But the point is, she has clearly been mistaught. There is no longer any excuse for ignorance in the NHS. I was made to feel "difficult" for what is in fact acting in my interests, and watched her making copious notes afterwards. When will the NHS get its act together?

Sorry for your bad experience, but nurses on wards aren’t specialists in everything. Anything they are being taught will be within NHS guidelines. I have a few nurses in my family with different specialisms, oncology, cardiology, paediatric and none of them have any deep knowledge of diabetes. At family gatherings we have discussed this & they all say, you know what your doing it’s your condition- I know nowt. Don’t expect me to save you if you hypo, I don’t know what I’m doing. (I wouldn’t hypo)

What she did do wrong was make you feel bad & not listen to you when you explained that you had a very good understanding of what you are doing to control your diabetes

 

[grantg]

Swift recovery. Last stay in hospital I asked for other menus to find something more appropriate. Family member who spends massive amount of time admitted to hospital also able to see and order from choice of menus. Maybe something from one of other menus perhaps more suitable. Little arguing to get other choices but can be done eg allergy. Check renal menu lunches and dinner usually omelette is available alongside various salads. Breakfast will be trickier scrambled egg maybe avail take with toast leave it aside butter portion can melt over it if wish little extra fat

Other menu can ask vegetarian/halal etc if need further info on above let me know will try assist further.

Oh ps if allowed out of ward could use delivery service to hospital entrance if use one which texts when on way all the better

 

[Lamont D]

Due to my experience with many healthcare professionals (ha!) Over the last quarter of a century, many times spending quite some time in my local hospital and of course my surgery.
It is always a chance to talk to staff and discover how my better half (T2) and how is the treatment is going to affect her other issues. I'm surprised sometimes of how it is seen by those on the wards and clinics. The few specialist that have been on the wards, have not without consulting the doctors or is in her dietary and meds, because we are doing ok with her T2.
In my own case with RH, it's a landmine of explanation and disbelief by many in the healthcare system. Not many can get their heads around what causes my hypoglycaemia. The science alludes them. And that surprises me quite a bit, because the underlying cause is dietary. As could be for many T2s.
For instance, the amount of circulating insulin after carbs, the first phase response and how high the spikes. Many and most T2s will not go hypo unless the meds they take do this. Metformin alone will not cause a hypo.
Most general practitioner doctors and doctors in hospital, (not specialist endocrinologist) do not have the training or very few specialise in endocrinological conditions.
My surgery has a diabetic GP and a very experienced dsn.
The NHS is getting better besides all its current issues, which are many.
My wife has been in hospital three times in the last few weeks. But you can see how much better it is.

 

[Lamont D]

Swift recovery. Last stay in hospital I asked for other menus to find something more appropriate. Family member who spends massive amount of time admitted to hospital also able to see and order from choice of menus. Maybe something from one of other menus perhaps more suitable. Little arguing to get other choices but can be done eg allergy. Check renal menu lunches and dinner usually omelette is available alongside various salads. Breakfast will be trickier scrambled egg maybe avail take with toast leave it aside butter portion can melt over it if wish little extra fat

Other menu can ask vegetarian/halal etc if need further info on above let me know will try assist further.

Oh ps if allowed out of ward could use delivery service to hospital entrance if use one which texts when on way all the better

I did the same, ordering a salad and putting it in the bay fridge.
diabetic choice for T2s is insane and does not make sense.

 

[grantg]

I did the same, ordering a salad and putting it in the bay fridge.
diabetic choice for T2s is insane and does not make sense.

Lucky if can get to use fridge sis takes small usb one in with her. Depending ward some more strict than others. Some fine if sealed unopened. Not all allow to use theirs

 

[Rosie9876]

Swift recovery. Last stay in hospital I asked for other menus to find something more appropriate. Family member who spends massive amount of time admitted to hospital also able to see and order from choice of menus. Maybe something from one of other menus perhaps more suitable. Little arguing to get other choices but can be done eg allergy. Check renal menu lunches and dinner usually omelette is available alongside various salads. Breakfast will be trickier scrambled egg maybe avail take with toast leave it aside butter portion can melt over it if wish little extra fat

Other menu can ask vegetarian/halal etc if need further info on above let me know will try assist further.

Oh ps if allowed out of ward could use delivery service to hospital entrance if use one which texts when on way all the better

Your points all eminently sensible, and I tried them - not Halal. No other menu. Not allowed out of ward. In my 8 day stay, my BS shot up. Next stay, I brought individual wrapped portions cheese, etc. Hard worked, soft didn't. Once a nurse agreed to microwave no added sugar baked beans. This time, I brought Keto granola and will ask for milk or plain yoghurt. But I'm hoping my stay will be short. I'll get the knack eventually. Like Groundhog Day.
P.s. Just had a severe pain attack - kidney stones? Hooked up to drip. Suddenly food not important.

Swift recovery. Last stay in hospital I asked for other menus to find something more appropriate. Family member who spends massive amount of time admitted to hospital also able to see and order from choice of menus. Maybe something from one of other menus perhaps more suitable. Little arguing to get other choices but can be done eg allergy. Check renal menu lunches and dinner usually omelette is available alongside various salads. Breakfast will be trickier scrambled egg maybe avail take with toast leave it aside butter portion can melt over it if wish little extra fat

Other menu can ask vegetarian/halal etc if need further info on above let me know will try assist further.

Oh ps if allowed out of ward could use delivery service to hospital entrance if use one which texts when on way all the better

 

[grantg]

hugs. you've had kidney stones in the past i think. very painful

Is it perhaps possible during your stay in hospital to speak to a dietician(preferably one which specialises in relevant fields?

website that you may find helpful. https://www.kidney.org/kidney-topics/kidney-stone-diet-plan-and-prevention can be hard to balance worth a wee read if its repeated kidney stone issue. If is repeated wondering if they can perhaps analyze?

Kidney stones - Prevention

The best way of preventing kidney stones is to make sure you drink plenty of water each day to avoid becoming dehydrated.

www.nhs.uk

 

[Rosie9876]

hugs. you've had kidney stones in the past i think. very painful

Is it perhaps possible during your stay in hospital to speak to a dietician(preferably one which specialises in relevant fields?

website that you may find helpful. https://www.kidney.org/kidney-topics/kidney-stone-diet-plan-and-prevention can be hard to balance worth a wee read if its repeated kidney stone issue. If is repeated wondering if they can perhaps analyze?

Kidney stones - Prevention

The best way of preventing kidney stones is to make sure you drink plenty of water each day to avoid becoming dehydrated.

www.nhs.uk

Thanks. I should have explained - I had a wee kidney stone 11 years ago. More painful than labour. Now, my series in hospital is for bilateral giant kidney stones, discovered over 2 years ago. I'd never even heard of Staghorn stones! Mine are mostly uric acid. I was told from eating too much meat, when I was mostly vegetarian , a little fish. They couldn't operate because my blood sugar levels were too high. THAT is what made me learn about Type 2 diabetes and go on a low carb diet, bringing my A1c down from 88.

But it's a dilemma. There are loads of supposedly healthy high oxalate foods I shouldn't eat, spinach for example. For my kidneys, I shouldn't have a high protein diet, but for my diabetes, I should. It's been a balancing act, and hugs to anyone who has to walk this tightrope.

As to a dietician, I did go to one. She said her expertise was diabetes, she knew nothing about kidney stones. She told me to limit my carbs to a fistful at meals. I thanked her and continued on my own, and YouTube and this forum.

 

[Outlier]

I've had some dangerously wrong "advice" about my T2 while in hospital. Really, it should come into training as it's such a common condition. I won't stand for being bullied either - medical professionals should realise I know more about my condition than they do. As for the available food choices..... bordering on criminal. I always skipped breakfast - all sugar and carbs, and lovely husband brought in keto salad and Greek yoghurt for the other 2 meals, which the catering staff were kind enough to allow him to put in their 'fridge.

 

[saucequery]

I've been in a&e a few times in the past with ketones/super high BG and put on a drip. Standard fayre available was a cuppa with biscuits and a selection of sandwiches, all of which i was told would be absolutely fine (and I didn't really know any better)... cue a couple more hours before my BG was low enough again to get me released back into the wild..

 

[Lainie71]

I was informed by the experienced DN that I would go into hypo mode if I didn't eat wholemeal bread, potatoes every 2 hours! I was also told by the GP a tablet would solve all my problems. No real advice, just lectures. I went away feeling deflated, unsupported, confused and feeling I was ready for the cemetery. I came here and the rest is history, few bumps along the way but not doing bad.