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

[seadragon]

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.

Sorry it meant to signify fat and/or lazy not that fat people are lazy. I had a dance teacher once who appeared very overweight but was so light on his feet and certainly not lazy so the two don't go together in my mind. I'l see if I can edit it.

Also as Brunerria points out - having insulin resistance and/or diabetes can make you feel very lethargic so to outsiders you appear lazy. The energy definitely comes back once you change diet to low carb. I would never have dreamed of running a 10k nor been able to before I went LCHF. No more after lunch naps, no more tired all the time.

If people are interested in helping change ideas the Tim Noakes foundation is asking diabetics to fill in a questionnaire to help them further research in to benefits of LCHF. I'll try and find the link.

 

[DavidGrahamJones]

Sorry it meant to signify fat and/or lazy not that fat people are lazy. I had a dance teacher once who appeared very overweight but was so light on his feet and certainly not lazy so the two don't go together in my mind. I'l see if I can edit it.

Also as Brunerria points out - having insulin resistance and/or diabetes can make you feel very lethargic so to outsiders you appear lazy. The energy definitely comes back once you change diet to low carb. I would never have dreamed of running a 10k nor been able to before I went LCHF. No more after lunch naps, no more tired all the time.

If people are interested in helping change ideas the Tim Noakes foundation is asking diabetics to fill in a questionnaire to help them further research in to benefits of LCHF. I'll try and find the link.

No worries, I'm having a "sensitive" day or is it a week. I was thinking I might like to attend the event but at £300, maybe not. A good way of keeping the riff raff out. LOL

 

[zand]

To me the most important point is in this quote from @seadragon
1. Many of us get fat because we are diabetic - we are not diabetic because we are fat.
That's why there's a correlation between obesity and diabetes. Insulin resistance (T2) causes obesity. So of course you have more chance of being diagnosed T2 if you are overweight, chances are you have already been insulin resistant for many years. Advising overweight people to eat low fat is crazy, they just get hungry and fill up with carbs....now if they were advised to reduce carbs dramatically and increase fats until they are satiated they might have a chance of actually losing some of their excess baggage. Such a simple message and it could change the lives of thousands.... and also lose food manufacturers and drugs companies millions. I wonder if the doctors and officials at the conference will be brave enough to spread the word?

 

[chalup]

Meters. Not just giving people meters but teaching them how to use the information. If you just have a high number but no idea what to do about it then that is just a source of stress but eating to your meter teaches you how to use those numbers and take control of their diet and that is empowering. People that get a meter and then just throw it in a drawer are people that don't know what to do with the information and telling someone not to test because they will get sore fingers is insanity. All diabetes patients should also get a card with the address for this forum as well.

 

[MikeTurin]

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!

Not to mention that most of these healthy foods are starch and carbohydrate overloaded. Lactose free foods and gluten free foods are still high on carbs.
Same thing for vegan lookalikes.

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!

The only problem I foresee is that for the effective use of a meter the patient must be instructed and then motivated.
I've known a diabetic that made a strong diet the month before hba1c tests and visit just to pass them and then going back to eat cakes and muffins.
And dpn' t let me start how what I've seen on a diabetics meeting. Suffice to say I wondered if all of them were T1....

 

[AndBreathe]

@LivingLoud , unless the delegates are very young, I would be astonished if you were the only T2 attending he event. T2s may not necessarily attend your session (I am assuming there are a group of workshops and folks decide which to go to) for a number of reasons.

 

[paganlass]

I agree mike turin but if given the choice I think the majority would take on board the fact that if done right T2, s could manage their diabetes without the need for medication. Of course there will always be exception to the rule. It's human nature.

 

[kokhongw]

I also think there is an important role for sugar substitutes.

I would be cautious about advocating sugar substitutes...some factors observed to cause hyperinsulinemia...
“Hyperinsulinemia: Cause or Consequence?”
http://diabetes.diabetesjournals.org/content/61/1/4

"Several additional nonlipid stimuli were also identified in our screening, including artificial sweeteners and iron.Artificial sweeteners that are also frequently present in modern foods were found to impact insulin secretion.Shown here is insulin secretion at basal and two stimulatory concentrations of glucose in response to saccharin,aspartame, and sucralose. All stimulated basal secretion acutely, but saccharin was most potent and also inhibited glucose-stimulated secretion. Interestingly,only saccharin stimulated basal secretion at concentrations that might be achieved by high levels of consumption,for example,in diet beverages."

 

[LivingLoud]

I would be cautious about advocating sugar substitutes...some factors observed to cause hyperinsulinemia...
“Hyperinsulinemia: Cause or Consequence?”
http://diabetes.diabetesjournals.org/content/61/1/4

"Several additional nonlipid stimuli were also identified in our screening, including artificial sweeteners and iron.Artificial sweeteners that are also frequently present in modern foods were found to impact insulin secretion.Shown here is insulin secretion at basal and two stimulatory concentrations of glucose in response to saccharin,aspartame, and sucralose. All stimulated basal secretion acutely, but saccharin was most potent and also inhibited glucose-stimulated secretion. Interestingly,only saccharin stimulated basal secretion at concentrations that might be achieved by high levels of consumption,for example,in diet beverages."

very interesting subject artificial sweeteners.
the research work did a few years ago quoted in this article has been broadly dismissed as it was based on very flimsy methodologies. That doesn't mean it is not true, there just has not been enough good quality research done, My instinct and personal experience tells me that it is likely that some of these may have negative effect on leptin and dopamine but i think there is some way to go to prove that. What worries me is sugar lobby have tried for years to discredit sweeteners, a reasonably parallel might be climate change deniers. So we seen repeated attempts to ban stevia and link aspartame to cancer which has been so thoroughly tested and proved to be otherwise, we need to be very skeptical, as Tim Noakes points out most research is funded by big pharma and big food - the only thing i trust is my meter.

Personally i favour stevia as it is natural and humans have been eating it for thousands of years, but it doesn't cook/bake well. So I prefer xylitol for cooking. But these need to be in moderation. Its Sunday night, I have just watched a movie, my wife has some nice chocs, so I have just enjoy 60g of Ohso chocolate with only 2g of sugar, sweetened with stevia and xylitol. This gives me strength, makes me happy and has no impact on my BG.

 

[CherryAA]

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 Do think when people hear low carb fat diet they visualise something they conceptualisee as 'unhealthy ' . In practise practically any plate based on a bed of greens, with a normal say (100 g) of protein looks just like a normal dieters plate. If you add to that plate a dressing of balsamic oil and mayonnaise, some avocado and some nuts or seeds you transform it to an Lchf meal that can easily be 60-70 percent fat, full if nutrients and very low carb.

Maybe using a few minutes to show some pictures of thar kind of transformation might help correct that kind of impression, Ie whilst lchf can mean fried egg and bacon, it could just as easily mean poached egg on a bed of spinach with a little dressing.

You state you are managing on diet and exercise. What diet and how much extra exercise?
I would imagine that your own experience would be a good place to start. Did you try the usual advice and fail and then find something better? Need to know more about your own journey.
Obviously I would push an ultra low carb diet with fasting because that's what i do. Exercise.. not so much.
You could take a look at the success stories section here and report back from there.
I think you need to be a little more specific about the track you intend to take before we can assist.
Hope that helps.
Mark

yup fair point
my view is that 90% of T2 diabetes starts and ends with food.
in most cases people get T2 because they make "poor lifestyle choices", I know I did
but why, (I am (was) an ad man by trade)
The answer lies in a combination of lack of good choices, poor knowledge, poor direction and the wrong desires.
what we tend to see in response is a focus solely on knowledge, but realistically most people have a reasonable general sense that junk+sweet+sofa=bad whereas veg+fruit+exercise = good. Knowledge is helpful in the hands of the willing - the low carb mantra at the heart of this site are an excellent example. But with no will there is no way.
But there are 4m diabetics in the UK, a reasonable small number are active here. The reality is that 60% of diabetics are failing to managed their glucose, fat and pressure levels. The system is failing them - a skinny healthy looking nutritionists grinning away suggesting we swap chips for lentils rarely works. Any plan that requires will power will ultimately fail, which is why 99% of diet fail (fact). The only thing that works is a change in desire.
We need:
- at home we need recipes that are easy, delicious, affordable and don't spike our glucose - we need to encourage the chefs, grocers and food makers to give us these choices. As diabetics we mostly see recipes and products that are either soulless or often irresponsible high in sugar but labelled as low/no sugar.
- in restaurants we need delicious choices on the menu that are clearly flagged as being low sugar, ideally with a recognized and trusted kitemark
- and we need snacks that are tasty, delicious, occasionally naughty but always low in sugar - so we can be human, stress eat, comfort eat, have treats and rewards but do so safely.
Above all we need to use the power of advertising in its many forms from TV through to packaging to make no sugary choices exciting and attractive.
I could go on, but that is the heart of it.
What do you guys think?

 

[CherryAA]

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.

Another thought for you.

For very many of us, our blood sugars went down within a two weeks of starting to low carb. lt is that aspect of the journey that makes it so exciting because it is something that one can see is starting to work almost immediately so you know that even though there is a long haul ahead you can see how you can make it happen.

Currently people are not even given tje chance to see before the prescription comes out.

Maybe some kind of plea that doctors consider the idea of giving their patients a diet sheet that simply says no potatoes, flour. Wheat packaged foods, rise pasta and sugar and a meter for one month as the very first stage so that all the patients who have enough self control to see for themsrlveshow they can control it together with a link yo this website. , in the end diabetics will end up with a lifetime of medical intervention so at least trying to give control to all those capable of taking control and thus reducing the pressure on the health service.

It's hard to see how a simple instruction to cut out sugars and fattening foods like your grandma would have told you to, for a short period and see what happens can rw as let bring tje entire medical profession into disrepute.

That could be backed up with things like the recent study that just three consecutive low carb meals makes a difference which was also reported on this website.

The tragedy of it all is that for very many people the whole thing can be nothing like as traumatic as it currently is.

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

 

[DavidGrahamJones]

Currently people are not even given the chance to see before the prescription comes out.

I have a feeling that most GPs find that telling a patient to cut their carbs is a recipe for disaster because the vast majority of people don't have the will power or the discipline to make such a change to their diets.

I know several people, 3 of whom are relatives (including my father), who find it impossible to cut their carbs. Two in particular are insulin dependent and having poor BG control.

 

[MikeTurin]

I Do think when people hear low carb fat diet they visualise something they conceptualisee as 'unhealthy ' .

If you say high fat one visualizes a cornucopia of lards and sausages, not absolutely some olive oil and goat cheese. The problem is that the advertising as good food some cereal based wholegrain or not things tends to skew what one sees as good food.

 

[MikeTurin]

I have a feeling that most GPs find that telling a patient to cut their carbs is a recipe for disaster because the vast majority of people don't have the will power or the discipline to make such a change to their diets.

Cutting the carbs totally as in ketogenic diet is a thing. Cutting to 35-45% is reasonable and easy if the diet is tailored on what one eats. I think the problem with willpower and discipline is on control the food intake in general before looking at the food plate composition.
Frankly, having to choose between 100 grams of bread and 100 grams of meat, I prefer to eat the latter.

 

[CherryAA]

I have a feeling that most GPs find that telling a patient to cut their carbs is a recipe for disaster because the vast majority of people don't have the will power or the discipline to make such a change to their diets.

I know several people, 3 of whom are relatives (including my father), who find it impossible to cut their carbs. Two in particular are insulin dependent and having poor BG control.

Whilst you might be right,if I take me as an example, Ii pretty much ignored it when a doctor told me to lose weight by eating low fat, because I knew I needed to be "in the "zone" and prepared to undergo massive hunger to lose any weight . When I found i had diabetes, the first thing I found was this website where I realised if I wanted get my blood sugar down I needed to reduce carbs, the weight loss per se was a byproduct not a prime goal .. Once I got released from the hunger by being in ketosis it became much easier to turn things down. whilst " most people" might find it hard to cut carbs, - there will be a good few that do actually read this stuff and realise the implications. That there is even one such person out there on an array of medications because he has just not found the right website, then that is too much. it is one thing for someone to deliberate fly in the face of advice he's been given and quite another to not even get the advice! If they do ignore the advice, the only thing that has been lost is a few weeks delay in medications that work marginally at best for most, in what will be a future lifetime of drugs

 

[zand]

Over 100,000 people have been helped to reduce carbs in our own DCUK low carb program

https://www.diabetes.co.uk/lowcarb/
This is for beginners and therefore covers any problems they may encounter along the way. If anyone doesn't have the discipline to 'go it alone' I would recommend they use this resource. It would be great if you could mention it this week, it is a very simple way to start reducing the carbs gradually and has proven results. A big plus here is that it isn't extreme and is therefore a more acceptable way of introducing the idea to both patients and doctors.

 

[bulkbiker]

I have a feeling that most GPs find that telling a patient to cut their carbs is a recipe for disaster because the vast majority of people don't have the will power or the discipline to make such a change to their diets.

I know several people, 3 of whom are relatives (including my father), who find it impossible to cut their carbs. Two in particular are insulin dependent and having poor BG control.

But most GP's mine included haven't a clue that cutting carbs will be of huge benefit.

 

[CherryAA]

Mine thought it would be a great idea then promptly recommended eating 2 bananas each evening to help my potassium levels. The level of ignorance out there is breathtaking. Thats why I'm so keen on trying to illustrate via easy to see pictures what a good " low car high fat diet" actually looks like . i.e. a good low carb, low fat diet but with the addition of some good quality fats, not a protein fest, or a license to gorge on anything.

 

[LivingLoud]

Another thought for you.

For very many of us, our blood sugars went down within a two weeks of starting to low carb. lt is that aspect of the journey that makes it so exciting because it is something that one can see is starting to work almost immediately so you know that even though there is a long haul ahead you can see how you can make it happen.

Currently people are not even given tje chance to see before the prescription comes out.

Maybe some kind of plea that doctors consider the idea of giving their patients a diet sheet that simply says no potatoes, flour. Wheat packaged foods, rise pasta and sugar and a meter for one month as the very first stage so that all the patients who have enough self control to see for themsrlveshow they can control it together with a link yo this website. , in the end diabetics will end up with a lifetime of medical intervention so at least trying to give control to all those capable of taking control and thus reducing the pressure on the health service.

It's hard to see how a simple instruction to cut out sugars and fattening foods like your grandma would have told you to, for a short period and see what happens can rw as let bring tje entire medical profession into disrepute.

That could be backed up with things like the recent study that just three consecutive low carb meals makes a difference which was also reported on this website.

The tr agedy of it all is that for very many people the whole thing can be nothing like as traumatic as it currently is.

good points, thank you
I will try and find out more why the NHS diabetic diet policy has not embraced low carb. I believe it is mostly to with concerns about fiber, but i'll try and pick some brains whilst i am there

 

[Deleted Account]

yup fair point
my view is that 90% of T2 diabetes starts and ends with food.
in most cases people get T2 because they make "poor lifestyle choices", I know I did
but why, (I am (was) an ad man by trade)
The answer lies in a combination of lack of good choices, poor knowledge, poor direction and the wrong desires.
what we tend to see in response is a focus solely on knowledge, but realistically most people have a reasonable general sense that junk+sweet+sofa=bad whereas veg+fruit+exercise = good. Knowledge is helpful in the hands of the willing - the low carb mantra at the heart of this site are an excellent example. But with no will there is no way.
But there are 4m diabetics in the UK, a reasonable small number are active here. The reality is that 60% of diabetics are failing to managed their glucose, fat and pressure levels. The system is failing them - a skinny healthy looking nutritionists grinning away suggesting we swap chips for lentils rarely works. Any plan that requires will power will ultimately fail, which is why 99% of diet fail (fact). The only thing that works is a change in desire.
We need:
- at home we need recipes that are easy, delicious, affordable and don't spike our glucose - we need to encourage the chefs, grocers and food makers to give us these choices. As diabetics we mostly see recipes and products that are either soulless or often irresponsible high in sugar but labelled as low/no sugar.
- in restaurants we need delicious choices on the menu that are clearly flagged as being low sugar, ideally with a recognized and trusted kitemark
- and we need snacks that are tasty, delicious, occasionally naughty but always low in sugar - so we can be human, stress eat, comfort eat, have treats and rewards but do so safely.
Above all we need to use the power of advertising in its many forms from TV through to packaging to make no sugary choices exciting and attractive.
I could go on, but that is the heart of it.
What do you guys think?

@LivingLoud. Sounds as if you have some great thoughts. i would like to add one (perhaps an aside): can you distinguish between the different types of diabetes. I have been amazed by how many HCP don't know.
I believe the 4m figure is total number of people with diabetes in the UK of which about 90% have type 2. It seems as if most of your thoughts are around type 2 and there is more understanding about what makes someone more likely to have type 2. However, when it comes to managing diabetes (managing glucose, fat, pressure levels), this is true for type 1 too (sorry, I do not have enough knowledge to comment on this for other types such as LADA, gestational, etc.)
Good luck and enjoy the opportunity