Help...i have their attention what should I say

[Mbaker]

30 minutes is an astonishing amount of time in the context you have found yourself in. I believe prevention and management is important. In the prevention camp I would encourage Doctors to perform FBG tests where possible for patients who attend clinic on other matters and for those in at risk groups. In terms of management they could provide a powerful collective voice for Type 1 CGM's. Doctors can help change the "normal". So called normal mainstream food tends to processed carb laden rubbish (which unfortunately tastes nice due to familiarity eating over a lifetime), why should this even be considered normal. Doctors deal with first line consequences of carb addiction. I would politely challenge them compare the general outcomes of LCHF against the Eatwell plate outcomes. I think if you were able to project on screen the powerful self explanatory pictures on Diet Doctor such as meat, fish, broccoli, berries etc and ask if any of these are objectionable, maybe contrasting these with prevalent fast food or even what is considered a balanced plate. I see it as vitally important to ensure that LCHF is not seen as dangerous, a fad, unbalanced and a health risk, to do this facts will need to demonstrated, these might be available from those @Brunneria referenced. I would provide a cheat sheet with thought provoking references to Diet Doctor, successes stories on this site, Dr. Jason Fung, Dr. Sarah Hallberg, asking the Doctors to review the material. Last I would implore Doctors to offer LCHF and exercise as a first step (with support).

 

[kokhongw]

Perhaps all that T2D needs is to learn how to get into and maintain a healthy state of ketosis.

A fats fueled rather than carbs/glucose fueled life may be how we were meant to be...glucose is more toxic than fats, hence it is a priority to remove it from our blood stream...

In addition, it is about giving T2D a choice to have normal glucose/insulin levels and be medication free for as long as possible.

 

[LivingLoud]

Hmm well you keep mentioning sugars where you should really be thinking carbs IMHO. I try to have as few as possible.
But each to their own.. I think we would have different things to say to the group that you are addressing. I know what has worked for me so far.

sugar and carbs are to all intense and purpose the same thing.
carbohydrates are made of sugar (typically glucose), starch (primarily glucose) and fiber.
It is the glucose in the carb that is bad for us.
The fiber is generally a good thing, the denser the fiber the more slowly we absorb the glucose in the carb.
So fluffy white brad which is low in fiber and high in glucose is very bad, whereas a heavy dark rye bread that is heavy in fiber and low in glucose is good as it will be absorbed more slowly.
So when we say low carb, we are actually say low in glucose, i.e. sugar. The tricky bit is that people don't see bread/rice/pasta/etc as a sugar product. So yes, absolutely low in carbs is essentially, we are saying the same thing.

 

[LivingLoud]

30 minutes is an astonishing amount of time in the context you have found yourself in. I believe prevention and management is important. In the prevention camp I would encourage Doctors to perform FBG tests where possible for patients who attend clinic on other matters and for those in at risk groups. In terms of management they could provide a powerful collective voice for Type 1 CGM's. Doctors can help change the "normal". So called normal mainstream food tends to processed carb laden rubbish (which unfortunately tastes nice due to familiarity eating over a lifetime), why should this even be considered normal. Doctors deal with first line consequences of carb addiction. I would politely challenge them compare the general outcomes of LCHF against the Eatwell plate outcomes. I think if you were able to project on screen the powerful self explanatory pictures on Diet Doctor such as meat, fish, broccoli, berries etc and ask if any of these are objectionable, maybe contrasting these with prevalent fast food or even what is considered a balanced plate. I see it as vitally important to ensure that LCHF is not seen as dangerous, a fad, unbalanced and a health risk, to do this facts will need to demonstrated, these might be available from those @Brunneria referenced. I would provide a cheat sheet with thought provoking references to Diet Doctor, successes stories on this site, Dr. Jason Fung, Dr. Sarah Hallberg, asking the Doctors to review the material. Last I would implore Doctors to offer LCHF and exercise as a first step (with support).

I agree with you 100%.
In terms of diet I think low carb is the absolutely single most important issue in diabetic management.
I am also a massive advocate in the role of sugar substitutes when used well and in moderation, as they lift the spirits, and more than anything good diet is about emotion

 

[LivingLoud]

In addition, it is about giving T2D a choice to have normal glucose/insulin levels and be medication free for as long as possible.

totally agree.
I very much like you mountain and molehills and your blog site
this is exactly right, though i would add sugar substitutes to the molehill path
my view is anything that requires ongoing will power will ultimately fail

 

[bruciebonus]

The only role a doctor can play with a T2 diabetic is to tell you, you have it and direct you to this website and make sure you read everything. Then it's up to YOU to manage YOUR condition, if you don't eat it, it can't get in your blood . In my experience doctors know very little about type 2 often confusing it with type 1.

Sent from my RAINBOW using DCUK Forum mobile app

 

[paganlass]

I think in addition to what most people have already said I would mention the fact that if T2 where given a bg monitoring meter most diabetics would avoid taking any medication as they would be able to work out for themselves what and does not affect their bg. Therefore avoiding that food and learning more about how their decision on certain food groups affects them. People who don't know about this site are wandering blindly through life miss managing their diabetes and getting complications due to just not knowing! If doctors gave them a bg meter I think the nhs would save thousands of pounds. Knowledge is key!

 

[ExChocoholic]

Aeconding catherinecherub's comment - we are not all lazy couch - we do not all make ourselves ill! Secondly - the big 'sugar' issue - still too much sugar in many foods and too many foods 'advertised and presented as healthy' are still full of sugar - that cannot be healthy!

 

[ExChocoholic]

And we are not all overweight and I am sure that those who are really don't want to be. I know overweight people and they struggle to lower weight.

 

[AndBreathe]

@LivingLoud - Unfortunately, the timings of this conference are not good for me. Do you know if all the presentation/workshops are to uploaded either to the event's own site, YouTube or another web hosted service? I would be interested to view some of the content.

Many thanks.

 

[DavidGrahamJones]

Tell me what you want me to say?

Even looking at the replies given so far, it's obvious that we have different experiences. Trying to think of something that says it all I'd have to say that one message to get across is that the current thinking by NICE/NHS on carbs being 1/3 of calories is WRONG, for type II diabetics, in general.

Thinking that in most cases type II diabetics are diabetic because of poor lifestyle choices is also WRONG. I'm not saying that poor lifestyle choices are not behind the cause of some type II, I just think that using the word "most" is not accurate. We will all have had different experiences. So I suppose I'm saying that we're not all the same, something a lot of doctors should realise.

I note that you are a volunteer consultant to "Sugar Smart", please tell Jamie that it should really be "Carb Smart", same difference really, but he might have us all believe that porridge is good for all of us because it's not Sugar Puffs, WRONG.

I'm thinking aloud, hence the rambling nature, but as I've already mentioned, we've all had different experiences so it would be very difficult to present a type diabetics perspective on managing diabetes so I'm pleased you've asked for some input. The answer has to be that carbs are the issue, to varying degrees.

Looking at the programme, there seems to be a lot of emphasis on low fat, obesity, healthy eating on not much on carbs.

http://www.preventingillness.co.uk/programme/

I'm not sure that people going to that conference will get the message.

 

[bulkbiker]

sugar and carbs are to all intense and purpose the same thing.
carbohydrates are made of sugar (typically glucose), starch (primarily glucose) and fiber.
It is the glucose in the carb that is bad for us.
The fiber is generally a good thing, the denser the fiber the more slowly we absorb the glucose in the carb.
So fluffy white brad which is low in fiber and high in glucose is very bad, whereas a heavy dark rye bread that is heavy in fiber and low in glucose is good as it will be absorbed more slowly.
So when we say low carb, we are actually say low in glucose, i.e. sugar. The tricky bit is that people don't see bread/rice/pasta/etc as a sugar product. So yes, absolutely low in carbs is essentially, we are saying the same thing.

But you can't see the glucose content of foods on the package whereas carbs are shown . So while we may be agreeing I am trying to show that people need to see something they can monitor. I advise newcomers to this site to try to limit foodstuffs to less than 5g of carb per 100g. This is easy to monitor as it's on almost all food packaging. Also I have found that "slow release" carbs are still carbs and still have the same effect as regular carbs. Still back to your presentation.. please plead that a very low carb approach can work wonders and they should try it on some patients as Dr Unwin et al are doing with great success.

 

[MikePea]

Great that you are able to make your point to such a group. All that advice from here (Though not all in agreement), no doubt you will sort out what's best. As you can see you have enormous backing from us. More power to your elbow, and T2's. I wish you success.

 

[seadragon]

I would like you to point out that for some the lifestyle choice that has made them ill is the very one the NHS is pushing on us as being 'healthy'. I took care to eat the supposedly health whole grains, low fat foods and when I started to put on weight despite not changing my diet I then found I was pre diabetic. Had I continued with the 'Eatwell Plate' I would definitely now be a fat type 2 diabetic and have some NHS person telling me I was diabetic because I was fat. Not the case - I was becoming fat because I had insulin resistance and that was indeed due in part to diet - the NHS advocated type of diet. I was diagnosed with pre-diabetes although I had a 'healthy' BMI and only checked because it was in the family(using my mother's BG meter) not because I had any syptoms.

So several things:
1. Many of us get fat because we are diabetic - we are not diabetic because we are fat.
2. We are basically carb intolerant (since carbs turn to sugar in the body - plus excess carbs turns to fat) so do not tell us to eat starchy carbs with every meal.
3. A low carb high fat diet has stopped type 2 diabetes in it's tracks for many thousands of people. I have yet to see anyone tell me they have stopped or reversed diabetes by following a high carb low fat diet. NHS needs to wake up to the fact it's advice has been plain wrong.
4. If NHS encouraged type 2's to eat to their meter they would save many people from a lifetime of distress and save vast sums of money for the NHS.

Edited to add: looking at the other presentations at the conference you are up against the low fat low calorie brigade and the orthodox NHS advice. It is wrong advice but how can that be got through to them. Please add references to dietdoctor.com and Sarah Hallberg and Tim Noakes and the host of other low carb experts. It is vital that the orthodoxy is challenged or more and more people will be consigned to the diabetic scrapheap which benefits only food manufacturers and pharmaceuticals industry. Good Luck!

 

[DavidGrahamJones]

carbohydrates are made of sugar (typically glucose), starch (primarily glucose) and fiber.
It is the glucose in the carb that is bad for us.

Surely carbohydrates convert to sugar? Nothing to do with containing sugar?

 

[LivingLoud]

Thanks all for your feedback. I won't reply to all as i'm sure you don't want 10 posts from me.
We need to shoot for where we can win.
I very much like @kokhongw picture, high road low road.
We all know low carb is the most important message, but there is also a real concern about fiber and the complexity of explaining glycemic load, but we MUST find a way to navigate this so we get people off high glucose/low fiber carbs.
I also think there is an important role for sugar substitutes.
Realistically we could not, and should not, move the focus from obesity and lifestyle. 90% of newly diagnosed diabetics are overweigh (fact) and the link between high glucose diet, sedentary lifestyle and T2 is absolutely clear. There are a few exceptions, but they are rare.
If we want to be listened to as a patient group, as a consumer group and a social group, if we want to get a better world for ourselves we need to be open, honest and realistic - denying these links would be futile, and would lose us any credibility. Diabetics currently have little voice in this debate at public health level (I bet I;ll be the on T2 in the room), if we want to change that we need to face the hard truths.
What we need to do is change the language and tone to be less "blame and shame" to encourage better quality education, particularly on carbs, and for the system to provide more emotional support.

 

[DavidGrahamJones]

Realistically we could not, and should not, move the focus from obesity and lifestyle. 90% of newly diagnosed diabetics are overweight (fact) and the link between high glucose diet, sedentary lifestyle and T2 is absolutely clear. There are a few exceptions, but they are rare.

I don't mean to disagree with anything you say, but it's not always 100% accurate. The 90% figure I saw in the Government paper "Obesity and Type II Diabetes" refers to the number of type II diabetics who are overweight. Clearly not the same as newly diagnosed diabetics. It also overlooks the fact that not all overweight people become diabetic, I have no idea where that figure would come from, but in my own circle of friends and acquaintances, I can think of several overweight and not diabetic. There would seem to be something else going on, maybe epigenetics. As somebody who gained weight not only because of taking a diabetic drug called Rosiglitazone but again when my GP said I didn't eat enough, I'm unhappy that anyone thinks obesity and a sedentary lifestyle are synonymous, that just isn't true for everybody.

I have thought of something else and apologies if somebody has already mentioned it. Some GPs are recommending that type II diabetics don't measure their BG. I believe this is actually based on some research. If I was a cynic I'd say it was because they didn't want to be asked for supplies on prescription, because they can't afford to. I'm sure most would agree that using a meter is essential, waiting for an HbA1c which some (me) might only have once a year, is far too late if there are changes.

 

[seadragon]

Realistically we could not, and should not, move the focus from obesity and lifestyle. 90% of newly diagnosed diabetics are overweigh (fact) and the link between high glucose diet, sedentary lifestyle and T2 is absolutely clear. There are a few exceptions, but they are rare..

If diabetes were caused by people being fat/ lazy then all fat/ lazy people would be diabetic. They are not.

Diabetes can make you fat and diabetes can make you tired. Conversely you can be fat and not diabetic and lazy and not diabetic. Even fat and lazy and not diabetic.

Most people are fat when diagnosed because they have been insulin resistant/pre-diabetic for a long time before they hit the point at which it is diagnosed as diabetic (it'a sliding scale and an arbitrary point chosen based on the physiology of Pima Indians or some such and designed to keep people from being diagnosed as diabetic). It's not a magic change from being pre-diabetic to diabetic -it's simply reaching a point on the sliding scale of BG levels. I wasn't fat when diagnosed pre-d as I caught it early.

I agree we should not move the focus from obesity and lifestyle but we should be clear that it's the NHS idea of 'healthy eating" i.e a carbohydrate rich diet, that is helping to push more and more of those pre-disposed to being diabetic into reaching that point of diagnosis. And the NHS insistence of 'one size fits all 'healthy eating' that ensures that once diagnosed, those people remain on the slippery slope and progress to needing more and more medication.

At the very least NHS must stop telling newly diagnosed that it's a progressive disease with an inevitable ending up on insulin and instead let people know that there are options if people are willing to change their eating habits to reduce carbs in all forms and start giving support for that. Not everyone will be willing or able to change but NHS needs to stop dismissing and hindering those of us that are and can.

Give us the options and the tools (BG meters, support for low carb lifestyles) and we can save the NHS all that money spent on drugs and amputations.

Please watch and share this video from Dr Rangan Chatterjee who shares this view

 

[DavidGrahamJones]

If diabetes were caused by people being fat/lazy then all fat/lazy people would be diabetic. They are not.

Great message, I'd like to suggest that fat/lazy makes it look like fat people are lazy and nothing could be further from the truth. It might be a personal thing and an idiot endocrinologist's comments to me some years ago. I worry about terminology too much and freely admit that I want things to be accurate.

 

[Brunneria]

A lot of the misunderstanding arises from the fact that insulin resistant people, and people with high blood glucose (who may or may not be fat) are usually tired, lethargic, sleepy after meals, and hardly the picture of bouncing vital health.

And that LOOKS lazy.

But if you subtract the insulin resistance, and lower the blood glucose, those same people (who may or may not still be fat) are suddenly revitalised, with stamina they haven't seen in years.