Nurse & Low Carb Diet

[mike944]

Hi All,
Spoke to the nurse today and told her that I had started to low carb. I got a very negative reaction and she is going to have the dietician speak to me.

Also the last few days I have had my glucose between around 9 & 12 mmol and a reading this evening of 8.0 mmol (lowest yet). This is down from over 20 in one week with consistent drops. Despite this I have been told to double my morning dose of Gliclazide. Is this good advice? My levels are dropping, why should I up the medication?


Cheers,
Mike

 

[Hobs]

Good for you and well done Mike. Its your body and ultimately its your informed decision how you go about treating your diabetes.
With figures going down like that, at the end of the day they really cannot argue with good reason why you should give up low-carbing.
I say stand your ground and be assertive. Friendly and polite, but assertive!

Good luck and keep us up to date with your progress.

 

[anniep]

Hi Mike

funnily enough I have just said all of this on another thread. I recieved exactly the same reaction from the practice nurse, who told me soundly not to and sent me to the dietician who told me not to.

I followed their advice and got worse and worse, eventually I decided to ditch their advice and follow my own instinct and things are so much better I have reduced my BG my weight and am so much healthier. I don't count carbs as such I have just ditched the starchy carbs, and it is working for me.

We are all individuals and so are our bodies if you have tried one way and it is not working, keep trying until you find a way that does, you are the one who will be the expert in your body. Test every food and the effect that it has on you and eat to your meter.

 

[the_anticarb]

Hiya
Two ways to skin the cat = a) reduce carbs or b) increase medication - or of course a combination of the two.

Some unenlightened medical professionals seem to only think that option b applies.

You just have to accept that you are more educated than they are, but then, they don't have to live with being diabetic do they?

 

[daisy1]

I eat reduced carbs and got the usual advice from the dietician about meals consisting of loads of carbs. I decided to keep my low carb diet a secret from the doctor so I don't get lectured as I know they all have a different (wrong in my opinion) idea from mine of what I should eat. I won't go and see a dietician again and don't think I will be sent to one anyway. I saw my specialist yesterday who was very complimentary about my levels and my new HbA1c of 5.2 so I am obviously doing the right things. I like to avoid confrontation and arguments. Life is easier that way.

 

[jaykay]

Daisy, I think you are very wise Sometimes, people just aren't enlightened enough to look outside the box. It is something that I have gradually learnt and now accept as unequivocal truth that just because somebody says something, it doesn't make it so.And, yes, that includes professionals, well meaning family and friends. The message on this forum is test for yourself, test and test again as everybody is different and what works for one may not work for others. It is a message that our overburdened and sometimes uncaring NHS seems unable or unwilling to process. I will continue to listen to all advice, do as much research as I can bear, then engage brain and make the best decision I can! 8)

 

[hanadr]

Stick to what WORKS! Don't believe "Experts" who have all their knowledge from textbooks and who believe that if their advice isn't working, it's down to a non-compliant patient. After all they won't have to live with drug side effects and diabetic complications. Believe your meter,[even if you pay for strips yourself]
Hana

 

[Sid Bonkers]

OK I'm going to go against all the previous advise and say accept the double dose of Gliclazide but to carry on low carbing and testing regularly, when your bg levels get down to NICE recommendations reduce the Glic

Better to get those levels down than to refuse medication that will help you, why cut your nose off to spite your face.

I can never understand why people argue with their doctors, if you are not happy with your doctors advice, get another, or if thats not an option then listen to their advice, smile and say "Oh, OK" and then go away and do your own thing. But personally I would not stop with a doctor I argued with.

 

[Patch]

Ridiculous advice, Sid.

Gliclazide forces the Pancreas to produce more insulin. If you are lo-carbing, you don't NEED extra insulin - lets not forget that T2's produce some insulin, and that it is the resistance to insulin that is a problem. Insulin is required to take glucose from the blood, so if you're eating less carbs, you don't need more insulin! Taking Glic can cause weight gain. And no T2 wants weight gain. Weight gain inreases your resistance to insulin.

And if your resistance to insulin increases, so does your dependancy on drugs.

People are getting more shrewd these days - where as people used to blindly follow doctors advice, more and more are now researching the drugs that their doctors prescribe. This is is how it should be. You wouldn't blindly follow the advice pf any other professional, why should Doctors be any different?

 

[Sid Bonkers]

Ridiculous advice, Sid.

No need to mince your words Patch, say what you mean :lol:

I still think it is "Ridiculous" to antagonise your doctor
And is it not best to reduce those numbers as quickly as possible? Wrong maybe, but ridiculous?

 

[Bigglesworth]

Well said Sid!

 

[ally5555]

The internet is a great media but there is also alot of rubbish on it - as a wicked HCP I do find it difficult that people will take advice from total strangers - just an observation!

Allyx

 

[hanadr]

Ally
this probably doesn't apply to you,however taking the advice of some HCPs is potentially lethal. Fellow diabetics are much safer!
Like my T1 husband's recent hospital stay with an acute and quite severe infection, where allowing the medics to control his blood glucose, managed to get it up from 18 on admission to 22 in 2 days .
Not to mention the nurse who told me that the saline drip would lower the bg!!
and YES we have made a formal complaint.
Hana
PS the infection was caused by the hospital issue shoes, which he reported as too tight, when he collected them, and was advised to try for 2 weeks and then come back. He has severe neuropathy and Charcot feet from years back
He was an emergency admission within the week.

 

[Patch]

I still think it is "Ridiculous" to antagonise your doctor

Me too. There's no need to antagonise your doctor. If the doctor feels antagonised if you disagree with them, then that's something they should deal with. It boils down to what we KNOW is true, versus what they BELIEVE is true. (We've learned from (sometimes bad) experience, they've learned from books).

Just saying - the days are gone when people respected doctors above all other professions. We now know that doctors (not all doctors, of course) don't know as much as we'd hope they do. It's in our benefit to question them if we think they are providing bad advice.

 

[anniep]

My Problem is not with my doctor as such - except for the way they run the diabetes care in the practice, which is another argument.

The practice has all the diabetes care done by the practice nurse who is not a diabetes expert, she does everything. And she is the one dishing out the 'no low carbing' edict

I snuck in a mini review with the doctor when she took bloods for other things and doctor now knows I reduce carb and is happy with that as I have regained control of my BG.

I am due to move house in the next year or I would change my practise to one who I think cares better for their diabetic patients than to put their care in the hands of someone who has done a short course and treats everybody according to the same 'crib sheet'

 

[donnellysdogs]

There are lots of people for low carb and the opposite as far as I can tell. I go by this: I believe the minimum recommendations are 100 g of carbs each day to have, otherwise there could be a risk of ketosis. However, everybody is made up differently, some have faster metabolism, some slower, some fit and vice versa. I actually think about my weight and my BG's in relation to the carbs...if my weight is remaining level I stay around 130g a day, if I want to lose then I lower my carb intake slightly to about 110 (I never want to put weight on, but if I did I would increase my carbs), and my insulin is worked out accordingly. I'm 5'6" and size 10 and this has allowed me to be this for almost 25 years. My Consultant hasn't mentioned the qty of carbs that I take, just that I need to keep my bolus/basals about 50/50.

Had friends around a few weekends ago who talked about diets and some of the community diet clubs they go to counting in what used to be points. They were staggered as to just how easy it is to stay healthy by counting carbs and not having excess carbs and excess weight....instead of counting their points now, they are looking at their carbs....and they are non diabetics.

My DSN couldn't lecture me, as she is at least double my side, so I feel quite lucky!!!! If she did, I think I would ask her if she counts her carbs!!!

 

[anniep]

My practice nurse looks like one of these people who have never eaten a meal in their life, and she thinbks being overweight is simply a matter of not looking after yourself!

 

[jopar]

Hana

Why didn't you or your husband actually check that shoes weren't rubbing, we should all be checking our feet on a daily bases...

Sorry it's you can't blame your husbands poor control or any injury substained form not carrying out daily feet checks on his HCP..

As to saline lowering the BG of cause it can if the patient is dehydrated and the blood has thickened, this will give a condenced blood glucose level, rehydrating the patient and thining the blood will weaken the density of glucose in the blood..


@OP

If you perfer to go the low carb route you are entitled to, how ever do keep in mind that it's not always the total solution and you may still need medication to maintain blood glucose levels, One of the main reasons that HCP's don't like extreme low carbing is that it is an difficult regime to stick too, and many low carber regularly fall of the wagon as they struggle keeping to it..

Along side the on going debate whether long term it's a healthy diet to follow, as yet it hasn't really been proved either way...

 

[noblehead]

Just saying - the days are gone when people respected doctors above all other professions.

Speak for yourself Patch! :roll:

Where did you come to this conclusion? I like many others have the utmost respect for our gp's and other health care providers, just remember a bad apple doesn't spoil the bunch, so do refrain from trying to speak for us all when drawing your own conclusion!

As for the OP dilemma, I would go along with what Sid suggested and take the extra Gliclazide to bring your levels down from 9-12mmol to within the recommended guidelines, only then can you reduce your dose and see if your low-carb diet will keep you within your own personal bg range. Good luck and hope your bg comes down soon!

Nigel

 

[ally5555]

It is an interesting chat but it also works both ways - nhs staff have to put withalot of abuse - even as a dietitian I have been pushed against a wall by a pt who was annoyed I took to long with another pt.
Some pts are very rude and there is just no need for it!

Non compliance is an interesting one too - there is no doubt that there are many - I have caught quite a few in the act as I live near the surgery!