Dietician Advice

[whatdoesthisbuttondo]

I had my first appointyment with the practice visiting dietician yesterday and it was just as disapointing as I expected it to be.

She gave me the booklet about 'eating with type 2 diabetes' and explained the 'healthy plate' and portion size advice, but just seemed to be mentally ticking boxes as she went along.
She was aware this site (and others) and of the 600/800 cal diets but certainly did not advocate them and rather surprisingly did not know of the majority of type 2's leaning towards a low carb diet....the polar opposite of what she had just instructed me to do (eats a fair ammount of carbs, always ensure that you plate coantains a good portion as carbs give you the energy you need)

And as my daily diet was 'good enough' and I had come down from 103 to 98Kg in 6 months I was on the right track, she would discharge me back to my doctor.

It wasnt a COMPLETELY wasted afternoon off work as I got to play with my daughter for a lot longer than normal....

I have been following the various Newcastle diet threads pro's and con's and think I will do it for 8 weeks with the aim of lower BG and a 10% weight drop and after it, maintain where I end up with a low carb diet.

The NHS advice will not assist me in getting towards more 'normal' Bg readings and enable me to reduce or eliminate oral medication for T2 in the longer term.
I dont want miracles.....I just want an old age!

 

[Unbeliever]

Its sad really isn't it? Where money is spent on Diabetes Care it is often not spent effectively .Unil the whole approch changes and patients are treated as individuals money will continue to be .poured down the drain.

For T2s much of the advice appears o be based solely on the reamen of obesity . I suppose in the pas as it was mainly the overweight who were diagnosed and weight loss seemed to be effective , that this is not surprising.

Now that it is more evident that excess weight gain may be a symptom not a cause and that T2" is an umbrella term for many metabolic disordersperhaps it is time to reject the old ideas.

I am sure that there are many HCPs who are aware of alll this but they are forced to oe he party line.

I am very graeful for a few obscure hints I received which unfortunately ook a while for me to understand but I go there in the end.

As always the thing o do is to demonstrate that you want o take control of your own health and
to be able o prove that you can do so and that the advice normally given does not work for you.

I suppose if there was a chance of all diabetics being able to sue for damages caused by inapppropriate advice and treatment hen the NHS would get its act together.
I have some sympathy with box-ticking dietitians in their dealindgs with diabetics. I am sure many of them mus be aware that they are being old to give ou advice which is inappropriate.

I just hope that the same isn't true of other aspecs of health care in which they work.

 

[Daibell]

It's very sad that so many in the NHS and those associated with diabetes treatment push out this nonsense about having plenty of carbs. It has no scientific foundation, other than the bad effects of zero carbs. Fortunately there are enough of us on this forum and elsewhere who through measurement and experience know that refined carbs are a big problem for many diabetics.

 

[Angeleyes]

I too have had terrible advice from NHS dietitians over the years, however as I have never been one to take things as 'gospel' I went my own way and reduced all the carbs to sane levels for me and then became a well controlled diabetic. Since that time I have spoken to other dietitians who have given much better advice, especially about carbohydrate consumption. Many are now quite happy to see people avoid too many carbs and positively encourage that method of diabetic control.

I wouldn't go so far as to say all advice is bad, there is much nowadays that is good and forward looking. Plenty are willing to listen to their patients and are subtly changing the advice given out. Some good, some bad.

 

[Unbeliever]

Pity that there is no real choice for most people as regards their HCPs. Same with GPs.

I know there is a websie which allows you o "rate the practice" but few do and ,of course, they are probably unrepresentative of the majority of patients.

Maybe a secret register of diabetic-friendly people and places. An underground movement..... :lol:

We could have passwords and codes.....{sorry long-term effects of metformin kicking in}

 

[whatdoesthisbuttondo]

If its the metformin, perhaps we should have passwinds and not passwords?!?

 

[Grazer]

I had my first appointyment with the practice visiting dietician yesterday and it was just as disapointing as I expected it to be.

She gave me the booklet about 'eating with type 2 diabetes' and explained the 'healthy plate' and portion size advice, but just seemed to be mentally ticking boxes as she went along.
She was aware this site (and others) and of the 600/800 cal diets but certainly did not advocate them and rather surprisingly did not know of the majority of type 2's leaning towards a low carb diet....the polar opposite of what she had just instructed me to do (eats a fair ammount of carbs, always ensure that you plate coantains a good portion as carbs give you the energy you need)

Sounds like you had the same dietician as me! Fortunately for a lot of us, we read posts on forums like this and know to ignore the HCPs advice. Mine told me I wasn't eating ENOUGH potatos in my pre-diagnosis diet!

 

[carbman]

I too have had terrible advice from NHS dietitians over the years, however as I have never been one to take things as 'gospel' I went my own way and reduced all the carbs to sane levels for me and then became a well controlled diabetic. Since that time I have spoken to other dietitians who have given much better advice, especially about carbohydrate consumption. Many are now quite happy to see people avoid too many carbs and positively encourage that method of diabetic control.

All things must pass. Control carbs and you can control diabetes.

 

[Sid Bonkers]

She gave me the booklet about 'eating with type 2 diabetes' and explained the 'healthy plate' and portion size advice,

What did she say about portion size? Because I was told a portion was what would fit in your hand, and I eat carbs with every meal but only a portion. ie a portion of cornflakes for breakfast for me is 16g as thats all I can fit in my cupped hand and a portion of rice (basmati of course) ie between one and two tablespoons full, so what is wrong with that advice? Seems OK to me :?

I have followed this advice and lost 4 stones and have never had an HbA1c outside of the 5%'s. I think its all about perception, you see a dietician and hear all the wrong things I see a dietician and hear all the right things.

Portion control naturally reduces carbohydrates and all other food groups, try it if your lifestyle isn't working for you, just remember that a portion is what will fit in your cupped hand, thats hand not hands, reduce the amount of food you eat and you will loose weight despite what some 'ultra low carbers' may say, and you don't need to increase fats either

 

[Grazer]

Understand Sid, and that's great, but most of us probably don't get the "cupped hands" bit and end up on 16g of cornflakes. I was shown photos of plates with about 6 boiled potatoes on. I was also shown bowls of cereal that would put daddy bear to shame! You did well with your advice maybe, lots don't.

 

[smidge]

Hiya all!

I had similar advice to Sid's on diagnosis - two egg-sized potatoes, 2 Tbs rice, half slice of bread all equal a portion of carbs - only eat 4 portions of carb per day. However, I had no advice about adjusting this downwards or upwards depending on your size (the cupped hand thing might have helped there), and was told I definitely did not need to test :roll: Ultimately, I think I probably got reasonable dietary advice for a Type 2 - sadly I was a misdiagnosed Type 1 eating small portions of carb at each meal and trying to control it with diet and exercise - luckily i wasn't testing so i didn't know i was killing myself :lolno: The medical and dietician advice on diabetes is very variable and borders on negligence at times. I've taken the view to listen to all advice, learn as much as I can and make up my own mind on how to manage my diabetes. I think that's all you can do.

Smidge

 

[whatdoesthisbuttondo]

I can see where you are coming from Sid, and I'm glad the advice has helped you to gain control.
I guess it literaly is a glass half full/empty scenario ( Im an engineer. The glass is twice as big as it needs to be...... :lol: )

I understand that portion control will eventually bring results (eat less, do more). We live in an age where everyone wants results NOW, and dont have the patience to plod away and wait for 6 months to see a noticeable difference.
(going back to photography, thats the big advantage of digital over film, but we all know film gives much more beautifull results!)

I agree with Smidge's last line. I will listen to all advice and then decide which course is best for me personally.

Cheers
Gav

 

[noblehead]

I've taken the view to listen to all advice, learn as much as I can and make up my own mind on how to manage my diabetes. I think that's all you can do.

Smidge, that's the most sensible sentence I've read on the forum for a long time! :clap: .......it should be made a 'Sticky' at the top of the forum :thumbup:

 

[Helenababe]

I wasn't even offered the chance to see a dietician. I just got a short diet sheet handed to me by my DN saying to eat porridge, milk puddings, bread, potatoes, and cereals.

And I'm tired of hearing the 'Obesity causes diabetes' too. I personally know 3 people with T2, and they're all slim, infact one of them is as thin as a stick.
Helena

 

[Unbeliever]

I was never given the chance o see a dietitian either. Hardly - I am a slim T2. Just had a chance word wih one while in the hospital who hinted that "carbs" was the magic word.

When my sister had a long spell in hospital with a mystry condiion she as always being moved from ward to ward wherever there was a vacant bed. On three seprerate occasions she had abed on diabeic wards. Many T2s . Not one obese.
if obesity causes diabetes then there is a cure for most people. If diabetes causes obesity then that is a differnt mater entirely isn't it?

Obviously there is a connection but it is a chicken and egg situation.
certainly some diabees medication can cause massive and rapid weight gain.

 

[Sid Bonkers]

Its worth bearing in mind that while 80% of T2's are overweight that only 20% of obese people are diabetics, now if obesity caused diabetes I think that last percentage would be a lot higher.

Yes the is a definite connection but it is absolutely wrong to say that obesity causes diabetes.

 

[Etty]

An easier system than portion control is just to eat the "yes" list and avoid/minimise the "no" list, as shown on http://www.dietdoctor.com/lchf

How big is your hand, Sid, mines very little. I'm sure I'd starve.

 

[Unbeliever]

An easier system than portion control is just to eat the "yes" list and avoid/minimise the "no" list, as shown on http://www.dietdoctor.com/lch.[/quo...ard is i? Who is going to tell the NHS? :lol:

 

[Sid Bonkers]

An easier system than portion control is just to eat the "yes" list and avoid/minimise the "no" list, as shown on http://www.dietdoctor.com/lchf

How big is your hand, Sid, mines very little. I'm sure I'd starve.

How can eating to a list be easier than eating a normal diet the same as everyone else in your family/street/town/county/Country?

And I can assure you that you will not starve to death if you eat portions as big as your cupped hand, dont forget that is a cupped handful of carbs and a cupped handful of protein/meat and a cupped handful of veg, maybe two cupped handfuls of veg one of broccoli and one of garden peas for example, I can assure you that amply fills a 10" dinner plate. The problem was I used to eat my dinner off a 14" dinner plate and that was also full. Using a smaller dinner plate will trick your mind into thinking you have more on your plate than you have.

I can only actually only fit about 10g to 12 grams of cornflakes into my cupped hand but my meter tells me I can eat 16g to 18g It is surprising how light corn flakes are :lol:

 

[Etty]

I don't want to eat cr*p like cornflakes, Sid, but I agree with you about the plate size. I'm using smaller ones too. So there we are, I'm portion controlling too.
As for eating the same as everyone else, I don't find this a problem. My meals are much the same as they used to be minus the heaps of starch and sugar. I didn't grow up with pasta and rice, so don't miss them. Everyone else eats a piece of meat, some veg. and a potato, and I eat the same minus the potato.
My mother-in-law told me that when she was young (in the 40's to 60's), this was how people dieted- ate normal meals, but left out the cereal (breakfast), bread (lunch), potatoes and puddings (dinner). Not so odd, is it?