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Yorksman
Well-Known Member
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- Type of diabetes
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The NHS is not a single hierarchical structure where specific outcomes can be determined by individual decisions or group policies. There is nobody to talk to who has the ability to act. It is an almalgamation of disparate and, often, self governing special interest groups, professional bodies, professional associations and councils, often quite separate from the employer, different tiers of local accountibility, different legal statuses, different constitutions, separate business associations and interests and trade unions. Positions are jealously defended, usually because budgets are at stake. There is no single view on any topic and no one person for researchers to talk to about their findings. There are dozens of views and thousands of knowledgeable people keeping their heads down, not wanting to rock the boat and serving out their time until they get their pensions.
Prof Roy Taylor summarised a widely held view amongst patients he consulted:
"It must be recorded that many individuals expressed frustration at the routine manner in which their doctor, nurse or dietitian regarded the diagnosis of type 2 diabetes. This conflicted with the cataclysmic blow which they personally felt. They were told that the diagnosis was clear and therefore the guidelines will be rolled out. Lose some weight and take this metformin. Get used to it"
Prof Roy Taylor summarised a widely held view amongst patients he consulted:
"It must be recorded that many individuals expressed frustration at the routine manner in which their doctor, nurse or dietitian regarded the diagnosis of type 2 diabetes. This conflicted with the cataclysmic blow which they personally felt. They were told that the diagnosis was clear and therefore the guidelines will be rolled out. Lose some weight and take this metformin. Get used to it"
Yorksman
Well-Known Member
- Messages
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- Type of diabetes
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- Diet only
The NHS has just over 1,650,000 employees and is the 4th largest employer in the world.
The NHS has about 550,000 doctors, nurses, haematologists, biochemists, microboliologists, physiotherapists, oncologists, histologists, bacteriologists, podiatrists, radiologists and many others working providing clinical analysis and care. The other 1,100,000 are employed monitoring the work of the 550,000, recording statistics for targets and inventing novel methods of ensuring that they are met and making sure that they don't go over budget.
Beachbag
Well-Known Member
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- Nr Swansea, S Wales
- Type of diabetes
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- Insulin
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- Filling in forms! ;)
Chiefs, Indians ...ppfft!
C
catherinecherub
Guest
And creating a "them and us" helps people how?
You will find that many people who call themselves low carbers are eating many more carbs than you personally would equate with a low carb diet.
However people manage their diabetes is really not a concern of mine, I am just glad that they are trying their best to reduce risks of complications.
Aren't you pleased for non low carbers too?
Andy12345
Expert
paul-1976
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250 grams a day I was told at the time.
Mongoose39uk
Well-Known Member
douglas99
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That would have put a serious crimp in my eating, After the 4 slices of thick white toast at breakfast, the packet of 4, or maybe 6 jam donuts throughout the day, I'd have used all my carbs up.
No more chips, crisps, chocolate, biscuits, cola.
Actually, no white bread or donuts either, as they were on the banned list they gave me too.
And I will have to put my hand up here as well, lunch just was a lean steak, cabbage (boiled, not buttered), French beans, mushrooms, onion, lettuce, tomato. But fried without oil, so either it was low carb, but not high fat, or healthy, depending on viewpoint. Or even low calories, (well maybe if the steak wasn't quite so big, but it's a week off the portion control diet, and it was andy's fault for posting about steak yesterday!)
Ok, I went a bit overboard, the nhs would have suggested a smaller steak, and maybe a small jacket potato. I know I have good kidneys, so I'm good with the amount of protein. Not everyone is.
- Messages
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Quite right, and both can be summed up in one sentence............'There's no one diet that will suit all.'
As human beings we are diverse in our tastes for certain things, be it The Arts, Music, Politics, Religion and of course when it comes to Food & Drink, there never will be a diet that will suit everyone with diabetes and the sooner everyone realises that the better, then we won't have to go round and round in circles time and time again
Andy12345
Expert
A
AnnieC
Guest
Thanks Kat
A
AnnieC
Guest
So it seems now that GP's and DN's are more enlightened and no longer tell diabetics to eat plenty of starchy carbs..the DN I saw certainly didn't tell me to do that so I just went by her advice of having a low fat low sugar diet with fruit and veg...she did say bananas and grapes were not very good for diabetics and if I wanted to eat starch carb like rice pasta and bread then to have wholemeal and small portions
douglas99
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It's worth getting a meter and test strips.
Eat to your meter is something we all agree on.
I hope you find the diet that suits you, but it sounds like you're well on the way already yourself.
Montana
Well-Known Member
Went on a diabetes course last year and was told that it has been discovered that eating too many carbs was no different to eating sugar. Therefore I would have to reduce carb intake to gain control of my diabetes. This meant two very small potatoes for instance instead of my usual half plate of them. I think we all need to look at our plate portions and drastically reduce the size. Therefore I think this is why gps and dns have recently changed their advice.
Sent from the Diabetes Forum App
Sent from the Diabetes Forum App
As many of you know, I manage my BG very well through a low-carb approach and believe it is the most effective method for most people. I have limited confidence in the medical profession as they misdiagnosed me and left me managing progressive LADA on diet and exercise for nearly a year with the advice that I should eat 4 portions of carb a day and I should not test my blood. They nearly killed me!
However, the advice they gave verbally about carb is open to interpretation. It was accompanied by the leaflet on the eat well plate that we all know and love LOL. If you actually read the leaflet, it explains that a portion of carb is one medium cut slice of bread or two small new potatoes or two tablespoons of cooked rice etc. This only works out to about 60g carb a day - which in my opinion is almost perfect low-carb advice!
There are two problems though, as far as I'm concerned:
1. Most people's idea of a portion is much bigger than the portions being advocated and most people won't read the leaflet, so all they hear is 4 portions of starchy carb, and do not get as far as the small portion sizes.
2. While this is reasonable advice for the majority of Type 2s who need to lose weight, the eat well plate would not work for an underweight LADA (or Type 2) because on the portion size of carbs and the percentage of the total plate they take up (about 50%), there isn't sufficient calories to maintain, let alone increase, body weight. We would starve. We have to increase something to get sufficient calories. So what should we increase - carbs, protein, or fat? Answers on a postcard please LOL
Ultimately, while you need to lose weight, you do not need to increase fat on a low carb diet because you need the reduced calories to lose the weight but eventually, when you need to maintain your weight and maintain you BG, you have to increase something to get enough calories.
Smidge
However, the advice they gave verbally about carb is open to interpretation. It was accompanied by the leaflet on the eat well plate that we all know and love LOL. If you actually read the leaflet, it explains that a portion of carb is one medium cut slice of bread or two small new potatoes or two tablespoons of cooked rice etc. This only works out to about 60g carb a day - which in my opinion is almost perfect low-carb advice!
There are two problems though, as far as I'm concerned:
1. Most people's idea of a portion is much bigger than the portions being advocated and most people won't read the leaflet, so all they hear is 4 portions of starchy carb, and do not get as far as the small portion sizes.
2. While this is reasonable advice for the majority of Type 2s who need to lose weight, the eat well plate would not work for an underweight LADA (or Type 2) because on the portion size of carbs and the percentage of the total plate they take up (about 50%), there isn't sufficient calories to maintain, let alone increase, body weight. We would starve. We have to increase something to get sufficient calories. So what should we increase - carbs, protein, or fat? Answers on a postcard please LOL
Ultimately, while you need to lose weight, you do not need to increase fat on a low carb diet because you need the reduced calories to lose the weight but eventually, when you need to maintain your weight and maintain you BG, you have to increase something to get enough calories.
Smidge
carty
Well-Known Member
The smaller portion may work for some but what about the skinnies who need to put on weight but keep our BGs down?
CAROL
CAROL
douglas99
Well-Known Member
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I'm just about to switch from a weight loss diet to a maintenance diet.
So I intend to increase portion size, a lot of veg, stick to fish, prawns, chicken, some lean meat.
Still avoid saturated fats, but may have the odd bit of cream again.
Cook with unsaturated fats, rather than dry fry.
I won't eat anything that spikes me, so some beans, livlife bread, a bit of porridge, maybe a couple more snacks in the day, and go low GL with little and often.
I intend to cut down on the beer and wine and spirits, after the new scientist article that suggests alcohol may give a long term rise in Hb1ac, so I have a few calories to replace there as well, and see where my bloods are in 3 months.
Daibell
Master
Hi Smidge. Yes, I came across similar problems with my two diabetes GPs following my diagnosis as a 'T2' with a urine stick; pretty technical! The first GP after weighing me said 'good, carry on losing weight' when I was 9.5 stone and stick thin. My wife had to tell him to look at me. My second db GP, who I subsequently found had only just come off her db course, told me to stop starving myself and have a normal, healthy diet. Again my wife had to point out to her that my blood sugar would sky-rocket if I did that as I was already on three meds; so much for the training. I was told insulin was a 'last resort'. Fortunately 1 year later and with a lot more experience she offered me insulin. I think the GP db training is not broad enough and probably a bit dated. A good GP as my 2nd one actually is soon learns the reality of diabetes and reacts to the patient rather than practising the textbooks. So, I've learned to be very wary of diabetes HCPs but there are good ones including my excellent DN.
Ref the Eat Well Plate, the 'amusing' thing is the DUK website which says T2s should have between 5 and 14 portions of carbs per day, where a portion is a slice of bread. I can't imagine 14 slices of bread per day or equivalent being good for any diabetic. I might question the number of calories a person needs per day; I think the oft-quoted amount is probably too high. Increasing fats and proteins as needed is obviously the way to go, but I suspect many people wouldn't need that much to even put on some weight?
Ref the Eat Well Plate, the 'amusing' thing is the DUK website which says T2s should have between 5 and 14 portions of carbs per day, where a portion is a slice of bread. I can't imagine 14 slices of bread per day or equivalent being good for any diabetic. I might question the number of calories a person needs per day; I think the oft-quoted amount is probably too high. Increasing fats and proteins as needed is obviously the way to go, but I suspect many people wouldn't need that much to even put on some weight?
douglas99
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5 to 14 slices.
12g per slice in a decent wholemeal.
Even only 18 in white, which they don't recommend.
Can't understand why 60g of carbs is a bad thing.
even 168 is ok for most.
So it seems DUK have the correct numbers there.
If you choose to eat the total as bread, and no other carbs, that's a personal choice.
Me, it would be a better choice than potatoes to be honest, particularly if it was burgen bread for example.
