Few questions from a newbie

[sooliz]

Hi all, help needed please.

Was diagnosed with Type 2 a fortnight ago, saw the diabetic nurse/GP for the first time last Thurs and feeling completely confused now. Can you kind experienced people help with the following?:-

a) Nurse said no special diet, just 'normal' healthy diet including plenty of starchy carbs (well I know now from reading on here that starchy carbs are not a good thing). Well, why aren't the NHS saying otherwise? No real guidelines given as to exactly what/what not to eat so I'm really none the wiser.

b) Nurse stated quite categorically that they DO NOT provide meters/test strips (when I asked her, she admitted it's on cost grounds), except for Type 1s on insulin. She also said there is no need to test BG regularly and said in fact they do not recommend it! I found this absolutely astounding - how on earth can we monitor our BG level if no equipment is provided, no real info given as to what foods may spike our BG, and it appears our surgery only test our levels every 3 or 6 months!?

c) She's booking me in for a DESMOND course......is there any point in going on it if they advocate a dietary regime that is at odds with what you good people (who should know!) advise, and if the NHS line is that self testing is not necessary?

d) I WANT to be proactive, so I want to test my levels. Do you know where is the best (and cheapest) place to buy meters/strips? And I understand there are several different ones on the market - any recommendations as to which is the best?

I think they're my most pressing concerns at the moment, if anyone can help I'd be hugely grateful.

Thanks in advance

Sue

 

[chocoholicnomore]

Hi Sue and welcome to the forum.

You have been given the standard advice given to all newbies on diagnosis. I was told the exact same things.

After reading this forum I bought my own meter-bayer contour- and tested before and 2 hours after eating. I now know the foods that I can and cannot eat. (E-bay is good for buying testing equipment)

I also cut down my carbs but not as drastically as some do. I eat approx 130 g carbs per day. I prefer to alter my diet more slowly as it has to be sustainable. It is, after all, for the rest of my life.

Nurse is right in that there is no special diet. Years ago all sugary food was banned. My dietician advised the only banned foods are full fat sugary drinks e.g. coca cola and sugar in hot drinks. Also advised that diabetic foods are a waste of money and are not necessary. (If you like chocolate then stick to high cocoa content. Aldi's do a nice one-moser roth. Comes in 5 small bars in each packet with only 5.3 g carbs per bar. One per night and it's only 99p)

I am currently attending x-pert course which is similar to DESMOND. Although I disagree with the diet advice, I do feel it has been worthwhile going as you get to talk about all sort of diabetes related things and I have learned from it.

This forum has been absolutely brilliant and I couldn't have got to where I am without it.

You are welocome to ask as many questions as you need and you will always get loads of good advice. It is really good being able to share with others and they are all so friendly.

Take care
x

 

[Daibell]

Hi

You are not alone in wondering why many in the NHS are stuck in a time-warp ref carbs. One problem is the definition of 'starchy' carbs; well there isn't really a good definition hence the confusion. What is OK is starchy carbs that have not been refined and hence low-GI e.g. beans, lentils etc. Once the starchy carbs have been processed into white flour and so on then they become high-GI and bad. The fibre content in some carbs is important but vegetables can also provide much of that. Fats have been declared bad by the diet experts but for diabetics fats are OK apart from watching the saturated ones to avoid high cholesterol and obviously calorie intake. The meter problem is due to a mix of costs to the NHS and that the profession 'knows best' and you don't need to be involved as such. We all know that a meter is essential. You can often get one free from the manufacturers. I buy my strips on the web. You don't need to test every day but just find out what affects you and by how much. Good luck and welcome to the community.

 

[AMBrennan]

Well, why aren't the NHS saying otherwise?

Somewhat more charitably, one could assume that the NHS is simply trying to choose the best intervention based on the available evidence.
If there isn't any evidence that a low-carb diet is better (and not just for HbA1c) the NHS is quite right to not tell patients to eat a low-carb diet.
[If you believe that the current obesity and diabetes epidemic was caused by the general recommendation to eat a low-fat (and thus necessarily) high-carb diet then please remember that this recommendation was not supported by any evidence when it was made. Shouldn't we make doubly sure that we don't repeat that mistake?]

Another possible explanation might be that the NHS failed to account for patients' resistance to taking medication (farsightedness is a medical condition that prevents you from reading, so people get glasses; diabetes is a medical condition that prevents you from eating carbohydrates, so people stop eating carbohydrates...)

We all know that a meter is essential

I was going to address the meter issue in a bit more detail, your quote nicely sums up why the NHS is right to not pay for meters for all diabetics.
Edit to clarify: That is, the NHS should make decisions based on evidence and not on what "everybody knows"

 

[LittleGreyCat]

Meters - often free from the manufacturer. They make their money on the consumables. Try and find one which links to your computer because that makes tracking your readings much simpler.

Testing - obviously you need to test to know if you are doing the right thing for your body. However once you have established how your body reacts, you don't need to test every day - just run a set of checks now and then to confirm you are managing O.K. In my humble opinion.

If your GP is not supportive of diabetic testing, check round the other surgeries in your area - this is a major factor in your life. If you didn't get on with a plumber or gardener you would look for someone else. The same applies to GPs and diabetic nurses just like any professional who provides you with services.
Ask yourself - which is more important to them - your health or their profit margin?

Cheers

LGC

 

[AMBrennan]

In my experience the manufacturers only provide free meters to patients who have been told by their GP to test at least per day. Further, as you have pointed out they make their money on consumables so whilst getting a free meter will save you a fee pounds you would still have to spend a lot on test strips.

If you are looking to save money you should instead pick a meter with the cheapest test strips.

 

[Grazer]

Hi Sue and welcome to the forum. Your questions show that you understand the issues. Of course you need to test to understand what you can and can't eat, and in what quantities. Of course, if you're on diet only, you need to moderate your carb intake - there's no other way that a person on diet only can reduce their blood sugar levels. You've been given lots of good advice already [personal comment removed] so keep on asking questions. I've not been on the Desmond course, but I've heard it's quite good. Worth going, then balancing it with what you hear on this forum. Good luck!

 

[Grazer]

your quote nicely sums up why the NHS is right to not pay for meters for all diabetics.

In your opinion, NOT an opinion shared by the vast majority of all other members on this site, which is of course WHY this site has an e-petition asking for testing facilities to be provided to ALL type 2's, something you obviously dismiss.

 

[AMBrennan]

If there is evidence that making testing facilities available to all diabetics improves outcomes then this should, of course, be done.* I do have to insist on this evidence since, unfortunately, humans don't "get" numbers and statistics (just look at the number of people playing the lottery).

As for the vast majority supporting this petition, how come you go to hairdresser to have your hair cut but insist that you can do a better job than NHS policy makers?

* Also, you wouldn't need a petition.

 

[sooliz]

Oh dear, I seem to be caught in the middle of an argument :?

Thank you all for the advice and warm welcome. I have applied for a Freestyle Lite test meter free from Abbotts, and will look on ebay for test strips, good idea. I have signed the petition. I think I will go on the DESMOND course, it should be interesting at least, even if I don't agree with their dietary advice. I do want to go down the low carb route, it seems pretty sensible to me, especially since I need to lose more weight (have already lost a stone since cutting out bread, pasta, potatoes, cakes and sugar in the last month, due to food intolerance issues since being diagnosed with a candida infection).

Thanks again.

 

[borofergie]

Oh dear, I seem to be caught in the middle of an argument :?

Sooliz ignore it, it isn't your fault, and frankly it's a little disappointing to see your thread hijacked.

I agree that you should choose your meter based on the cheapest strips. Sustainability is the key here, you're going to be a diabetic a long time, so cutting the annual cost of testing is sensible.

It's true that there is no conclusive evidence that either low-carbing or self-testing will help control your diabetes, however that's mainly because no-one wants to fork out the money for the kind of long-term, well designed trial required to answer the question once and for all.

There is however lots of anecdoctal evidence on this forum, and in other places, that both self testing and reducing your carbohydrate intake will deliver spectactular results. Indeed, apart from AMBrennan (who is a T1 diabetic), testing for T2 diabetics is one thing that we all agree on:
viewtopic.php?f=2&t=24424&hilit=+testing#p222486

Now, I realise that the plural of anecdoctal evidence is not data, however, you should consider the people that post here to be on the cutting edge of self diabetes management. We experiment on ourselves, armed with our BG monitors, and see the influence of cutting carbs on our blood sugar levels.

Anyway, like me, you don't have the luxury of waiting for the "smoking gun" long term research that will prove AMBrennan and the NHS wrong.

 

[sooliz]

Borofergie, what a plain and balanced post, thank you for that.

Sue

 

[sugar2]

Hi Sue,

Sound advice above. If I were you, I agree, go on the DESMOND course, you will learn something...although as you already know, not everythingis black and white. I would encourage you to ask questions, especially, should something be suggested that you think is wrong? It may be, you still think it is wrong after the discussion, but in my humble opinion anyway, it is always good to know both sides of the argument, then you can decide what is right for you with more knowledge.

Assume you know about free prescriptions and eye tests etc?

Welcome to the forum,
S

 

[AMBrennan]

I'm sorry, I was under the impression that you had asked why the NHS offered the advice it did.

 

[Sueper]

Hi Soolz, I'm in the same place as you just now a bit confused & overwhelmed :crazy: My visit to the nurse was awful she basically said much the same as yours but all i could hear was "you cant have chocolate":shock: So was delighted to see chocoholicnomore's post re: chocolate in Aldi's that you can have :clap: can i ask is it plain choc or milk? Anyway back to the nurse :***: she had taken blood then called me next day to say my diabetes would not be treated with diet alone the doc wanted to see me & i would prob be prescribed metformin as my hb1ac was too high (8%) I know i am going to struggle with my weight as i have other health problems. I exercise twice a day & have a fairly healthy diet (except i like a bit of choc) Regarding testing in the U.S all diabetics are encouraged to self test in fact they face a rollicking from their doc if they dont? It makes sense to me to test after all you are the one dealing with your diabetes on a daily basis?

 

[borofergie]

I can understand, but don't agree with, the NHS decision not to provide free test strips for all T2 diabetics: diabetes is an epidemic and they can't afford to treat it.

What drives me mad is when newly diagnosed T2s are actively discouraged from testing, even when it's done on their own buck. I pay for all of my own kit, yet GPs, practice nurses, DSNs have all told me to stop testing or not to test so frequently.

 

[viviennem]

If there is evidence that making testing facilities available to all diabetics improves outcomes then this should, of course, be done.* I do have to insist on this evidence since, unfortunately, humans don't "get" numbers and statistics (just look at the number of people playing the lottery).

As for the vast majority supporting this petition, how come you go to hairdresser to have your hair cut but insist that you can do a better job than NHS policy makers?

* Also, you wouldn't need a petition.

Catch-22 again! The only way we can get you your evidence is by running a testing group against a non-testing control group - but they won't give us meters, so how do we do that?

I'm lucky, I get a meter and strips on prescription, and I know how much testing has helped me. Anecdotal evidence, of course :lol:

Viv 8)

 

[chocoholicnomore]

So was delighted to see chocoholicnomore's post re: chocolate in Aldi's that you can have can i ask is it plain choc or milk?

Plain chocolate is best- the higher the cocoa content then the lower the carbs and the better for BG levels. I try to buy the 85% cocoa bars which have 5g carbs per bar but I have also bought the 70% which has 8g carbs. As a wee treat I once bought the mint chocolate at 12g per bar-delicious

You can also buy high cocoa chocolate from most supermarkets but tends to be a bit more expensive and is usually one big bar which is no good for me-an open bar of chocolate is a finished bar of chocolate :lol:

 

[borofergie]

As for the vast majority supporting this petition, how come you go to hairdresser to have your hair cut but insist that you can do a better job than NHS policy makers?

Because we have the best possible empirical evidence, by testing ourselves and seeing the influence of carbohydrates on our BG readings and our HbA1cs. Yes it's an N=1 trial, but across the internet we are N=many, and when your toes and eyeballs are at stake all that matters is N=me.

When I go to the "hairdresser" (barber) I talk to him, tell him what I want, and we decide together what is practical. I don't just let him cut my hair in the single style that the "National Hairdressers Service" prescribes for everyone.

Can I do a better job than the NHS policy makers? When it relates to my own health, absolutely yes. I don't blindly follow generic "one-size-fits-all" advice.

 

[chocoholicnomore]

When I go to the "hairdresser" (barber) I talk to him, tell him what I want, and we decide together what is practical. I don't just let him cut my hair in the single style that the "National Hairdressers Service" prescribes for everyone.

Can I do a better job than the NHS policy makers? When it relates to my own health, absolutely yes. I don't blindly follow generic "one-size-fits-all" advice.

Well said Borofergie :clap: :clap: :clap: