Prof Taylor on BBC4 soon this lunchtime

[AdamJames]

Agreed! I am all for 'disruption' in health care to increase capacity and improve actual outcomes for individuals! So, for me, that begs the question, why does support have to be located in primary care/GP's offices?

I would say that this forum (as a great example) does more in terms of providing great support, with very positive results for many, than a rushed 5-10 minute consultation in primary care no matter how well it is done - and, even if more funds were to be allocated to primary care/GP practices to provide this support, the nursing literature shows that this type of 'invisible' support is always vulnerable to being omitted downstream due to competing demands on a busy nurse's time. The risk of 'missed nursing care' becomes even more acute if the prevailing wisdom in an individual GP surgery is that T2DM is a progressive disease, and is compounded by a reward system where early introduction and escalation of medications is incentivised, such as through the QOF framework.

We need a lot of disruption all around! Perhaps this is the perfect project for the upcoming 75th Anniversary of the NHS!

Haha! I've suggested something like this elsewhere, but I really think that if we could all persuade our GPs to allow us to put a 'Diabetes.co.uk' flyer somewhere prominent in their premises, the country would get much healthier!

 

[AdamJames]

Thanks Adam. I don't have a thread where I documented my progress. I just did my thing.

At diagnosis HbA1c of 73, reducing to 37 at 4 months, then reducing further until my present toggling 31/33 state. There's actually a fair bit of diabetes in my family of both major types, but my asymptomatic diagnosis was still a bit of a shocker.

I chose to tackle my condition by eating to my meter, with a sole focus on achieving improved blood scores. I concluded I'd rather have love handle with good blood scores than be skinny with rampant diabetes. I chose to eat to my meter, which then guided me to reduce my carbs.

I trimmed up, but have no idea by how much as I didn't weigh myself on diagnosis (and wasn't weighed by the medics) or for the initial 4 months, but by 4 months I was pretty trim. I'm a very slight 47/48kg (at 160cm), six 6 clothing, with size 3 tootsies, so my current maintenance regime is as much about ensuring I don't lose, rather than gain. My current visceral fat score is 3 and body fat percentage is 16%, as measured by my Karada Scanner scales. I wouldn't complain if I saw 50kg on the scales, but wouldn't care to go much beyond that.

I've never really counted carbs, but stuck with eating to my meter. These days I can get away with plenty carbs, but prefer not to go OTT. Most carbs are pretty tasteless, so I stick with the tasty stuff, plus loads of veg, which I have always enjoyed. I won't count today's carb intake as we're having a curry this evening, and I'll likely have some rice, although by "normal" standards a modest portion. I'm also gluten-free.

In terms of calories, I may not be a very big person, but I pack away my food. I'm rarely below 2000 calories a day and quite often can be nearer 2500, so for me it is clear not all calories are equal, as I'm pretty certain I didn't consume that much pre-diagnosis.

We're all different and I feel I was fortunate to be diagnosed when I was fit and otherwise healthy and had the energy and time to invest in my health.

As I have said, ad nauseum, people should try what they want to, but in this life, unfortunately there are to guarantees. I aim to keep my health in a good place for as long as I can, but should I ever find myself having to have meds, or adopt a different way of living, I guess I'll just have to get on with it. The only certainty in life is change.

Just for full disclosure, before I adopted the DCUKMod role, my user ID was AndBreathe which still exists, so I have posts all over the place from my time of joining in late 2013.

Thank you so much for taking the time to write that.

Interesting, that's how I started out (once I started taking it seriously) - eating to my meter, at one point realising I had to keep carbs for certain meals down to 6 grams! I also knew nothing about LCHF so wasn't adding fat or counting calories or working out macro nutrient ratios or anything.

It sounds like you took the approach that someone like Jenny Ruhl would recommend - the overarching thing to focus on eating to your meter and little else matters, I think she suggests at a minimum never be over 7.8 two hours later.

I hope you enjoy your curry

I'll be searching for AndBreathe, thank you!

 

[lindisfel]

Haha! I've suggested something like this elsewhere, but I really think that if we could all persuade our GPs to allow us to put a 'Diabetes.co.uk' flyer somewhere prominent in their premises, the country would get much healthier!

I think most GPs have to pay so much of their salary in litigation insurance they are not willing to stand outside national guidelines. There are always pathfinders like David Unwin, but you cannot believe the arguments I have had with my own daughter, who is a GP!
D.

 

[lindisfel]

I think most GPs have to pay so much of their salary in litigation insurance they are not willing to stand outside national guidelines. There are always pathfinders like David Unwin, but you cannot believe the arguments I have had with my own daughter, who is a GP!
D.

I know you think it funny Adam but it gets both of us hot under collar at times!

 

[AdamJames]

I know you think it funny Adam but it gets both of us hot under collar at times!

Haha! No doubt. I assumed that you meant you thought it was funny (not sure why I inferred that from an exclamation mark the end!?), but perhaps it gets SO heated that you could do without it.

The important thing is that you win the arguments with your daughter, anyway!

 

[Tannith]

I won't use my own words here as it's serious enough to not want to spread misinformation by using my rubbish memory!

From the 'information for doctors' pdf at

http://www.ncl.ac.uk/magres/research/diabetes/reversal/#publicinformation

"It is most important to consider the individual’s microvascular complications before embarking upon major dietary change. If there is no retinopathy, or only early changes (scattered micro aneurysms with few blot haemorrhages) then no additional precaution is required other than an annual screening. However, if moderate or more severe retinopathy is present then arrangements should be made to re-screen the eyes within six months of achieving a substantial improvement in blood glucose control. The reason for this is that the sudden normalisation (reduction) in retinal blood flow associated with the return of normal blood glucose control can disadvantage areas of the retina in areas of marginal circulation with resulting deterioration in retinopathy."

Thank you very much Adam

 

[Fuggs]

Eat less move more just about sums it up...how original..!
http://www.bbc.co.uk/programmes/b09k0nch#play
He starts about minute 28.00

My idea of eat less is Dr Jason rings protocol....

 

[bulkbiker]

My idea of eat less is Dr Jason rings protocol....

Me too presuming you mean Jason Fung that is..

 

[DavidGrahamJones]

Have you seen Jenny Ruhl's book "Diet 101 - the Truth about Low Carb Diets" ? (Diet here means weight loss diet as well as blood glucose diet.) She has struggled for years with her weight AND has been coping with and researching diabetes for years, being now over 70. She talks a lot about stalling and what to do about it. I haven't read those chapters as my problem is being under rather than over-weight, but I think she knows what she is talking about, from her own experience and also from that of the many people who have been in contact with her on the net. You may also be able to find much of what she has to say on her website:

http://www.phlaunt.com/diabetes/sp3index.php

Thanks for that, I will have a look. Today is day 7 of the VLCD although I've had to cheat by eating meat because I'm still fighting off whatever this dreaded lurgy is. At least the Christmas day 104 F temperature and passing molten lead every 30 minutes has gone, but the aches, pains, coughing and general feeling knackered seems to be more of an issue. BG isn't great either, hopefully it'll straighten out when symptoms return to normal.

 

[DavidGrahamJones]

I've had to cheat by eating meat because I'm still fighting off whatever this dreaded lurgy is.

At least I'm 4kgs lighter and as I'm drinking loads, I'm hoping it's not all fluid loss. Can't tell until I see my Nutritional Therapist who has a "posh" set of scales that differentiate between muscle/fat/water.

 

[Alexandra100]

Thanks for that, I will have a look. Today is day 7 of the VLCD although I've had to cheat by eating meat because I'm still fighting off whatever this dreaded lurgy is. At least the Christmas day 104 F temperature and passing molten lead every 30 minutes has gone, but the aches, pains, coughing and general feeling knackered seems to be more of an issue. BG isn't great either, hopefully it'll straighten out when symptoms return to normal.

Oh dear!!! Lots of sympathy. I am going through a lot of health problems lately and it feels SO unjust that as a result I also have to see worse bg results despite all my endeavours. I imagine you must have invested a lot of effort already to have managed 7 days of VLCD, but my instinct would be to put that on hold and concentrate on building your strength and some digestive normality back before going on with it. "Passing molten lead" went straight to my heart, as I recently experienced something like that over 2 days and nights, albeit thankfully without your other symptoms. Well described!

 

[Alexandra100]

At least I'm 4kgs lighter and as I'm drinking loads, I'm hoping it's not all fluid loss. Can't tell until I see my Nutritional Therapist who has a "posh" set of scales that differentiate between muscle/fat/water.

If you have any spare cash left after Christmas it might be worth investing it in your own set of scales that monitor body fat as well as weight. eg
https://www.amazon.co.uk/Tanita-BC7...8872&sr=8-14&keywords=body+composition+scales
I have had a simple Tanita set which has worked for me for many years. It was hardly any dearer than the basic scales and I have found it extremely useful in sickness and health. I don't recommend the more complicated ones that claim to take all sorts of interesting measurements as I don't believe they can really do it.

 

[DavidGrahamJones]

Oh dear!!! Lots of sympathy.

Cheers, the lurgy's persistence has surprised me but although I didn't see my GP she did test my sample on Friday showing nothing untoward left but a note to make an appointment on Monday if no improvement by then. Temperature still in the 38s, nothing serious compared to the 40 C on Xmas day.

The last time I tried ND it did wonders to my BG levels which weren't great even on low carb. That has been the most frustrating thing and makes me question Metformin's claim to prevent the liver putting glucose into the blood.

Always learning in this game.

 

[lindisfel]

No good for me, I have large Hobbit like feet! D.

If you have any spare cash left after Christmas it might be worth investing it in your own set of scales that monitor body fat as well as weight. eg
https://www.amazon.co.uk/Tanita-BC7...8872&sr=8-14&keywords=body+composition+scales
I have had a simple Tanita set which has worked for me for many years. It was hardly any dearer than the basic scales and I have found it extremely useful in sickness and health. I don't recommend the more complicated ones that claim to take all sorts of interesting measurements as I don't believe they can really do it.

 

[Bluetit1802]

If you have any spare cash left after Christmas it might be worth investing it in your own set of scales that monitor body fat as well as weight. eg
https://www.amazon.co.uk/Tanita-BC7...8872&sr=8-14&keywords=body+composition+scales
I have had a simple Tanita set which has worked for me for many years. It was hardly any dearer than the basic scales and I have found it extremely useful in sickness and health. I don't recommend the more complicated ones that claim to take all sorts of interesting measurements as I don't believe they can really do it.

I've just received some Tanita Body Composition Scales and am struggling with them at the moment, although from what I can gather I seem to have a healthy composition. It is the visceral fat percentage I am interested in. I know they are likely to be vague and inaccurate, but I am happy to accept my visceral fat percentage, which is 6%. (Healthy range 1 to 12) and will be watching out for trends.

 

[Alexandra100]

It sounds like you took the approach that someone like Jenny Ruhl would recommend - the overarching thing to focus on eating to your meter and little else matters, I think she suggests at a minimum never be over 7.8 two hours later.

I try to work to JR's guidelines, and my understanding is that she says 6.66 mmols (120mg/dl) before and 2 hours after a meal, although higher than "normal", is probably still OK for avoiding damage to the heart. However one of the aspects of JR's writing that I appreciate the most is that she is compassionate and realistic. For her the over-arching thing is to keep the bg low enough to avoid complications while following a regime that is bearable for YOU over the many years you will have to continue it. And if that means compromise and / or taking some of the safer drugs (eg Metformin) so be it. For her, anything is better than a few years of a perfect keto diet followed by total burnout. She seems to know what she is talking about, as she says she experienced several years of a keto regime followed by serious burnout herself.

By contrast, I see Dr Bernstein as a kind of saint. He claims that diabetics can and should have perfect bg if they follow his keto diet of 30g carbs daily (perhaps less if you are small / old / female!) plus whatever drugs and / or insulin are necessary. Unfortunately no-one in the UK is likely to have a GP who shares this view and will prescribe them insulin to this end, so we are left with only the keto diet, which is not always enough. And we are not all capable of living on 30g carbs daily. I have heard Dr B in one of his videos commenting (approximately) "The thing about type 2s is, they like to eat!", said with a kind of benevolent wonderment. It is as if he were reporting on the tastes of Martians or penguins. He knows it is so, he is not criticising, but he is not empathising either.

 

[Alexandra100]

I've just received some Tanita Body Composition Scales and am struggling with them at the moment, although from what I can gather I seem to have a healthy composition. It is the visceral fat percentage I am interested in. I know they are likely to be vague and inaccurate, but I am happy to accept my visceral fat percentage, which is 6%. (Healthy range 1 to 12) and will be watching out for trends.

Please continue to give us updates on these scales. From time to time I am tempted to update from my simple scales, but each time I back off. My old ones are so simple to use, and I value the fact that I can compare my readings with them back over decades.

 

[lindisfel]

I've just received some Tanita Body Composition Scales and am struggling with them at the moment, although from what I can gather I seem to have a healthy composition. It is the visceral fat percentage I am interested in. I know they are likely to be vague and inaccurate, but I am happy to accept my visceral fat percentage, which is 6%. (Healthy range 1 to 12) and will be watching out for trends.

Hi Blue Tit, do they differentiate between visceral and subcutaneous fat?
thanks
Derek

 

[Bluetit1802]

Hi Blue Tit, do they differentiate between visceral and subcutaneous fat?
thanks
Derek

Mine do. I get normal body weight, percentage of body fat (subcutaneous), total body water, muscle mass, bone mass, BMR, metabolic age, and visceral fat. There are different types of scales, and if considering buying some it is essential you read all the reviews first. None of them is 100% accurate, but some are better than others. The metabolic age on mine is laughable! It says mine is 22. The description in the manual says "If your metabolic age is higher than your actual age, it's an indication that you need to improve your metabolic rate.". It doesn't say anything about if it is 48 less than your age. Lol. Either I am reading the scales wrong or I'm super woman, or it thinks I am 18, and I am certainly not the latter two. For now I am ignoring everything apart from the visceral fat, and I#m happy with that being 6.

 

[lindisfel]

Thanks Blue Tit,
You must be very young for your age.

It unusual for scales to flatter us.
I remember my mother jumping off a speak your weight machine and she had arthritis.

Derek

Mine do. I get normal body weight, percentage of body fat (subcutaneous), total body water, muscle mass, bone mass, BMR, metabolic age, and visceral fat. There are different types of scales, and if considering buying some it is essential you read all the reviews first. None of them is 100% accurate, but some are better than others. The metabolic age on mine is laughable! It says mine is 22. The description in the manual says "If your metabolic age is higher than your actual age, it's an indication that you need to improve your metabolic rate.". It doesn't say anything about if it is 48 less than your age. Lol. Either I am reading the scales wrong or I'm super woman, or it thinks I am 18, and I am certainly not the latter two. For now I am ignoring everything apart from the visceral fat, and I#m happy with that being 6.