Conflicting Views ???

[lorsand]

Hi everyone. I was diagnosed T2 three weeks ago after having a HbA1c of 9.5 then 9.1. Have been on the low carb diet since then. Lost 4kgs. When I saw Diabetic Nurse she was happy to let me try and control with diet and exercise, in fact she seemed quite positive about it. The last week I have joined the gym and been to do 30 minutes cardio three times, an hours aquacise once and weights once. Whether it was coincidence or not my fasting blood sugars have been 9.9 / 8.2 / 7.0 / 6.8 and forgot to take it today but pre lunch after the gym it was 5.4 and 7.1 after a wholemeal cob with ham, cheese and lettuce and tomatoes. Been to see GP today for a different reason and ended up in tears as she said I "should be taking a high dose of metformin because my HbA1c's were very high" (all her words). She told me not to worry about my low carb diet just eat smaller portions - she never asked me what my portion size is (actually it is now a healthy size not piled up!) and exercise because the main thing is to lose weight. She never said anything about my current weight loss (not that I am a child wanting a silver star but a little bit of positive reinforcement would have been nice). I have to see the Diabetic Nurse again next Tuesday to go on Metformin. GP said that once I am on it, I may as well resign myself to taking it for life because very few people are able to come off it when I asked if my HbA1c came down if I could stop taking it??? She said I would need to go onto Metformin at some point anyway. I feel like she just looked at me and thought - fat / lazy / uninformed and ripe for a lecture on 'lifestyle changes'. Told her I had also stopped drinking alcohol 4 months ago and was trying to follow all the advice given. Has any one else had this experience. I feel like a total failure at controlling it with diet and I have been trying so hard only to be patronised ... I am now moving from the upset stage of the appointment to raging whilst writing this.

 

[Brunneria]

I have been overweight all my adult life, despite sometimes herculean efforts to change that fact.
Sorry to say that thistreatment is not something just aimed at T2s, although once you get an official diagnosis, the 'Lifestyle Lecture' can get even more regular and monotonous.

Ironically, once i was (after 20+ yrs) diagnosed with a legitimate hormone Thing to justify my shape, the lectures stopped dead.

Yet all those years have left their mark, and i now have to mentally brace myself and prepare a few choice come-backs before every appt. otherwise i still get blindsided sometimes. This is particularly ironic when you see the number of docs and nurses who drink, smoke and snack on rubbish.

I suggest that you do your research, attend the necessary checkups, take total responsibility for your diabetes management, and consider most health care professionals as sadly ignorant on the subject.

If i had followed doc/nurse advice about diet over the years i would be 30+ stone and a housebound recluse by now. No exaggeration!

 

[Lamont D]

Go on, let rip, we also have a thread for that as well.
Almost everyone that joins has conflicting ideas, diets, thoughts, and of course treatment.
What you have to do is found out what is best for you.
Having said that, congrats on getting yourself together and doing something about your condition, your weight and your future health.
If you gain the knowledge that empowers you to do the things to get you there, then the conflicting information will not matter. The main issue is you and your health.

You have started well, and have hit a little bump in the road and the road is long, it took me over a decade of seeing health care providers to get the right advice.
I found it on this forum.
I now weigh five stone plus less and I'm healthier than two decades ago. All because I followed a low carb diet, kept a food diary and tested and experimented with all food.

If you read the threads, you will see many posters talk about this topic.

I would never say ignore your GP or dsn but maybe they have been ill informed on what is good for you. Prove them wrong and be well.

 

[zand]

Unfortunately when some HCP's see a fat person they think they see a stupid, lazy person. That's when I see a stupid, lazy HCP. Yes I have been reduced to tears a few times. To say you will need to stay on Metformin forever is just plain ignorant. I'm not allowed to have it anymore because my HbA1c is down to below 48.

I go to my check ups and listen to them. Then I tell them that I follow LCHF that's why my blood results are so good and they don't listen to me. It's kind of a routine now.

I've lost over 3 stones and I'm getting a bit more respect from them now because of this. They have less respect from me because I had to find out for myself that low carbing was what my body needed.

Stick with us and then you can stick it to them with your next set of results.

Oh and well done for all your effort. Keep us informed of your progress because we are genuinely interested here.

 

[Bluetit1802]

There will always be conflicting information on every subject so we have to do the research and make our minds up which way to go. We are brainwashed into believing what doctors and nurses tell us is best for us, but we don't have to believe them, nor follow their advice. The comment that you will be on Metformin at some point in the future is just plain wrong. Your nurse probably doesn't see any proactive diabetics who lower their levels because most Type 2s don't. They blindly do as they are told, eat carbs with every meal, don't test, take meds, then need more meds, then more meds as their disease progresses. This is what your nurse sees every day. On this forum we know better. There are many, many T2s on here who have not only reduced their levels to non-diabetic standards, but have also come off all meds. There are also many of us who have never had meds yet manage to get our levels right down (and I include myself in that group).

The decision whether to take Metformin is entirely down to you. You have until Tuesday to think about this, read what others have done, read up about Metformin, and make your own judgement. All I can tell you is that Metformin is no miracle drug. It does help to a limited extent with reducing the amount of glucose our livers produce in times of fasting, exercise, stress etc. but it doesn't help with reducing post meal spikes, and makes only a small difference to future HbA1c results. However, it is known as a safe drug,

I wish you luck, and say congratulations on the results you have achieved so far.

 

[Hiitsme]

Hi everyone. I was diagnosed T2 three weeks ago after having a HbA1c of 9.5 then 9.1. Have been on the low carb diet since then. Lost 4kgs. When I saw Diabetic Nurse she was happy to let me try and control with diet and exercise, in fact she seemed quite positive about it. The last week I have joined the gym and been to do 30 minutes cardio three times, an hours aquacise once and weights once. Whether it was coincidence or not my fasting blood sugars have been 9.9 / 8.2 / 7.0 / 6.8 and forgot to take it today but pre lunch after the gym it was 5.4 and 7.1 after a wholemeal cob with ham, cheese and lettuce and tomatoes. Been to see GP today for a different reason and ended up in tears as she said I "should be taking a high dose of metformin because my HbA1c's were very high" (all her words). She told me not to worry about my low carb diet just eat smaller portions - she never asked me what my portion size is (actually it is now a healthy size not piled up!) and exercise because the main thing is to lose weight. She never said anything about my current weight loss (not that I am a child wanting a silver star but a little bit of positive reinforcement would have been nice). I have to see the Diabetic Nurse again next Tuesday to go on Metformin. GP said that once I am on it, I may as well resign myself to taking it for life because very few people are able to come off it when I asked if my HbA1c came down if I could stop taking it??? She said I would need to go onto Metformin at some point anyway. I feel like she just looked at me and thought - fat / lazy / uninformed and ripe for a lecture on 'lifestyle changes'. Told her I had also stopped drinking alcohol 4 months ago and was trying to follow all the advice given. Has any one else had this experience. I feel like a total failure at controlling it with diet and I have been trying so hard only to be patronised ... I am now moving from the upset stage of the appointment to raging whilst writing this.

Hi @lorsand
My suggestion is when you see the nurse next week ask if you can have 3 months to try to control by diet and agree if your HbA1c hadn't come down in that time you would reconsider medication. Have a good think about your situation and write down a plan to show the nurse. Really what you have already started to do. Your blood sugar readings already showing great improvement. Your weight loss already starting to happen. Your exercise that you have already started doing.

 

[Enclave]

I feel you pain, and fully understand how you are feeling.. been their and got the T-shirt ... Look around these forums and be brave, its your body and some times the DSN's and Drs seem to forget this. Your advice on being on metfomin for life is total rubbish .. I had mine stopped when my blood sugars were in the normal level .. If you follow the Drs diabetic eating advice its up to you .. it almost killed me .. I now LCHF and lost 5st .. blood sugars in the normal range and getting my heart meds reduced now.

 

[lorsand]

I have been overweight all my adult life, despite sometimes herculean efforts to change that fact.
Sorry to say that thistreatment is not something just aimed at T2s, although once you get an official diagnosis, the 'Lifestyle Lecture' can get even more regular and monotonous.

Ironically, once i was (after 20+ yrs) diagnosed with a legitimate hormone Thing to justify my shape, the lectures stopped dead.

Yet all those years have left their mark, and i now have to mentally brace myself and prepare a few choice come-backs before every appt. otherwise i still get blindsided sometimes. This is particularly ironic when you see the number of docs and nurses who drink, smoke and snack on rubbish.

I suggest that you do your research, attend the necessary checkups, take total responsibility for your diabetes management, and consider most health care professionals as sadly ignorant on the subject.

If i had followed doc/nurse advice about diet over the years i would be 30+ stone and a housebound recluse by now. No exaggeration!

Thank you x

 

[lorsand]

Go on, let rip, we also have a thread for that as well.
Almost everyone that joins has conflicting ideas, diets, thoughts, and of course treatment.
What you have to do is found out what is best for you.
Having said that, congrats on getting yourself together and doing something about your condition, your weight and your future health.
If you gain the knowledge that empowers you to do the things to get you there, then the conflicting information will not matter. The main issue is you and your health.

You have started well, and have hit a little bump in the road and the road is long, it took me over a decade of seeing health care providers to get the right advice.
I found it on this forum.
I now weigh five stone plus less and I'm healthier than two decades ago. All because I followed a low carb diet, kept a food diary and tested and experimented with all food.

If you read the threads, you will see many posters talk about this topic.

I would never say ignore your GP or dsn but maybe they have been ill informed on what is good for you. Prove them wrong and be well.

Thank you, that is really motivating. I do want control over this.

 

[lorsand]

There will always be conflicting information on every subject so we have to do the research and make our minds up which way to go. We are brainwashed into believing what doctors and nurses tell us is best for us, but we don't have to believe them, nor follow their advice. The comment that you will be on Metformin at some point in the future is just plain wrong. Your nurse probably doesn't see any proactive diabetics who lower their levels because most Type 2s don't. They blindly do as they are told, eat carbs with every meal, don't test, take meds, then need more meds, then more meds as their disease progresses. This is what your nurse sees every day. On this forum we know better. There are many, many T2s on here who have not only reduced their levels to non-diabetic standards, but have also come off all meds. There are also many of us who have never had meds yet manage to get our levels right down (and I include myself in that group).

The decision whether to take Metformin is entirely down to you. You have until Tuesday to think about this, read what others have done, read up about Metformin, and make your own judgement. All I can tell you is that Metformin is no miracle drug. It does help to a limited extent with reducing the amount of glucose our livers produce in times of fasting, exercise, stress etc. but it doesn't help with reducing post meal spikes, and makes only a small difference to future HbA1c results. However, it is known as a safe drug,

I wish you luck, and say congratulations on the results you have achieved so far.

Thank you so much. I have read lots on this forum which is brilliant and motivating. The low carbs seem to be a constant theme yet she said 'forget about them' ... I know from this short time that I should not forget about them at all. Your idea about her only seeing patients who are passive in their treatment makes a lot of sense. After reading the replies to my post, and managing to stop my son from going to the surgery to complain (protective instinct for Mom I guess) I have decided that this is MY condition, I WILL have an attempt at giving it 100% diet and exercise only, and IF I need Metformin after my next HbA1c I will consider it, but as can be seen my fasting levels seem to be reducing slowly this week so I will continue doing what I am doing. Thank you again.

 

[seadragon]

It is really sad that people continue to be treated this way. I was lectured on 'healthy eating' by a significantly overweight nurse when first diagnosed as pre-diabetic. She was much fatter than me and I was left wondering if the advice was so good why was she so fat? To be a fair the advice was rubbish - eat more starchy carbs with every meal - I'd have had to vastly increase my carb intake and that just didn't make sense to me. I basically ignored it anyway for a year but then had a 2nd GTT. got a message to see my doctor urgently which scared me to death. Doc turned out to be the diabetes specialist of the practice. She just said "you are at high end of pre-diabetes here's a script for metformin and I'll put you on a statin". I asked what it was for when my cholesterol levels weren't that high - 'oh all diabetics need statins" she said, "you'll need to take them for the rest of your life", she said.

I said No thanks I'll try alternative ways. " oh nobody succeeds with diet and exercise" she said " and anyway you haven't got a lot to lose". This because my BMI was 25 so not really overweight. "T2 is progressive so you'll end up on insulin eventually".

I said i wasn't going to take statins and didn't want to take metformin if there was another way. She said, "Go away and think about it for two weeks then come back and I'll give you the prescription".

Then I learnt that the practice gets extra money for every diabetic on it's books and money for prescribing statins.

I spent the two weeks on research. Decided there's no way i'd ever take a statin and metformin should not be necessary if I followed low carb high fat lifestyle - though it's acknowledged as a safe drug so can be helpful for some people.

When i went back I really wanted to have a bit of a discussion and some advice on testing and meters etc. She was very dismissive. "There's no point in testing for Type 2s" she said, reiterated that no one succeeds with diet and exercise and was plainly not interested in discussing anything. If i wasn't going to take meds she really didn't want to know. And this is the diabetic specialist who runs the diabetic clinics.

Luckily by then I'd found this forum, bought myself a meter and test strips and found the www.dietdoctor.com website with fantastic free info on low carb high fat and it's efficacy for weight loss and diabetes management. highly recommend you take a look at it.

Almost a year on I had an HbA1c test and a lipid panel ( just asked my local practice to organise these which they did)

I really would have loved to go back to that doctor to show her how I'd achieved an Haba1c of 35 (firmly non-diabetic range) and improved lipid profile (better than any statin could have done for me). Sadly i didn't get the opportunity as the message just came back from the doc "No action needed". Progressive my foot! It doesn't have to be if you are prepared to ignore NHS advice.

So congratulations on the progress you have made - keep up the low carb high fat diet and the exercise. Get a meter if you haven't already and test what foods spike your blood sugar and keep coming to the forum for the best advice and answers to any questions you may have.

 

[lorsand]

It is really sad that people continue to be treated this way. I was lectured on 'healthy eating' by a significantly overweight nurse when first diagnosed as pre-diabetic. She was much fatter than me and I was left wondering if the advice was so good why was she so fat? To be a fair the advice was rubbish - eat more starchy carbs with every meal - I'd have had to vastly increase my carb intake and that just didn't make sense to me. I basically ignored it anyway for a year but then had a 2nd GTT. got a message to see my doctor urgently which scared me to death. Doc turned out to be the diabetes specialist of the practice. She just said "you are at high end of pre-diabetes here's a script for metformin and I'll put you on a statin". I asked what it was for when my cholesterol levels weren't that high - 'oh all diabetics need statins" she said, "you'll need to take them for the rest of your life", she said.

I said No thanks I'll try alternative ways. " oh nobody succeeds with diet and exercise" she said " and anyway you haven't got a lot to lose". This because my BMI was 25 so not really overweight. "T2 is progressive so you'll end up on insulin eventually".

I said i wasn't going to take statins and didn't want to take metformin if there was another way. She said, "Go away and think about it for two weeks then come back and I'll give you the prescription".

Then I learnt that the practice gets extra money for every diabetic on it's books and money for prescribing statins.

I spent the two weeks on research. Decided there's no way i'd ever take a statin and metformin should not be necessary if I followed low carb high fat lifestyle - though it's acknowledged as a safe drug so can be helpful for some people.

When i went back I really wanted to have a bit of a discussion and some advice on testing and meters etc. She was very dismissive. "There's no point in testing for Type 2s" she said, reiterated that no one succeeds with diet and exercise and was plainly not interested in discussing anything. If i wasn't going to take meds she really didn't want to know. And this is the diabetic specialist who runs the diabetic clinics.

Luckily by then I'd found this forum, bought myself a meter and test strips and found the www.dietdoctor.com website with fantastic free info on low carb high fat and it's efficacy for weight loss and diabetes management. highly recommend you take a look at it.

Almost a year on I had an HbA1c test and a lipid panel ( just asked my local practice to organise these which they did)

I really would have loved to go back to that doctor to show her how I'd achieved an Haba1c of 35 (firmly non-diabetic range) and improved lipid profile (better than any statin could have done for me). Sadly i didn't get the opportunity as the message just came back from the doc "No action needed". Progressive my foot! It doesn't have to be if you are prepared to ignore NHS advice.

So congratulations on the progress you have made - keep up the low carb high fat diet and the exercise. Get a meter if you haven't already and test what foods spike your blood sugar and keep coming to the forum for the best advice and answers to any questions you may have.

Hey my GP must have gone to the same school as yours! After a sleep and a good old talking to myself, I have woke up with my positive take control attitude returned. I have been testing and my fasting blood glucose has reduced every day this week (I started exercising this week - hmm think there may be a link there! .... drat). As you say it is my body and I will give myself the chance to be in control and see if diet and exercise work for a few months.

 

[seadragon]

Hey my GP must have gone to the same school as yours! After a sleep and a good old talking to myself, I have woke up with my positive take control attitude returned. I have been testing and my fasting blood glucose has reduced every day this week (I started exercising this week - hmm think there may be a link there! .... drat). As you say it is my body and I will give myself the chance to be in control and see if diet and exercise work for a few months.

That's good news that you have a positive attitude back - be kind to yourself and realise that you will sometimes find it overwhelming (I did and had several crying 'poor me' episodes before realising I am actually now probably healthier than I've ever been thanks to the diagnosis and the changes I've made because of it)
Doctors unfortunately get taught about medicine but not about diet and nutrition (very little if any med school time is spent on nutrition topics) and have themselves been following the bad advice that comes from the Top (government advisory panels etc which are often made up of those with vested interests)
Good advice i was given was to try and walk for 20 minutes twice a day, preferably after meals, as this uses up any carbs in the body straight away and then they don't have a chance to be stored as fat. It really helped and if I ever see a spike (tested on my meter) I will walk or jog on the spot indoors if necessary for 15 minutes (you can do this while watching TV!) and it reduces BG levels fairly quickly.

 

[muzza3]

Hi @lorsand
It is fantastic that you are going to take control. As you can see from all the responses it is not uncommon for many to get that rubbish from some medical professionals(not all).

So keep us updated on your progress and ask any questions as you go forward.
Cheers

 

[Grungysquash]

Well done - starting weight loss is an important step, but a low carb diet will assist in lowering your BG levels.

Everyone's body is different everyone tolerates carbs differently so monitor your results before and after a meal to see how you react.

So again congratulations on the weight loss - you must keep it up and in my view reduce your carbs, and measure what impact each one has on your BG.

 

[Mep]

@lorsand - welcome you're doing well considering you were only diagnosed 3 weeks back. As everyone has already said there will always be conflicting information. You just need to figure out what works best for you as everyone is different. What works best for someone else may not work well for you. You get to figure that out by using your meter and testing how everything including the food affects you. There is so much that affects our sugar levels, not just our diet. I wish you the best.

 

[Devonbear]

I've yet to read a single testimonial on this site that says "I reduced my carb intake and it didn't reduce my blood glucose". So far as I can tell the success rate for low carb lifestyles in improving, and often sending into remission, T2 diabetes is virtually 100%.

My GP has a similar attitude. Yesterday he actually said the words "Every food molecule has some carbohydrate in it, if you didn't have some carbohydrate in your diet you'd just keel over" which is simply factually incorrect.

Remember two things.

1) Medical treatment can only be given by consent. A doctor can no more force you to adopt a medication regime than they can perform an operation without asking you first. You're perfectly within your rights to tell them what you will or wont agree to, and they just have to adapt their treatment offer to fit your preference. To respond with a "take it or leave it" attitude would, I think, be medical malpractice.

2) I have come to realise, in my own profession and others, that "experienced" is not the same as "good". Most practitioners just do the same thing, week in, week out, without giving it a moment's thought. Changing is counter-intuitive, because it would invalidate everything you've said and done before. Your nurse probably just has lots of experience of telling people the wrong thing. Any evidence that suggests that they are wrong will be airily dismissed.

Good luck, and really do stick with the low carb thing. It is truly the Holy Grail for T2 diabetics.

 

[Sirmione]

Terrible way to be treated ---- much sympathy.
A part from the dickensian treatment one thing that struck me in your post is that eating bread even if it is labeled wholemeal is not a good idea for most diabetics, Breads even apparently very similar whole grain products vary greatly in their effect on blood glucose level.