A Conversation with the Nurse

[Listlad]

Owing to a comedy of errors a member of the nursing team at my local surgery phoned me this morning about something we had discussed in December which was a visit to a dietician.

I reminded her that she had already called me to tell me that I didn’t qulaify as I wasn’t “fat enough”. She then remembered the conversation. It turns out that as my BMI is around 30 that I do not qualify. This then gave me the opportunity to discuss with her Dr David Unwin and his disciples, the LCHF method and also test meters.

First and foremost I “grabbed her by the scruff of the kneck, put the spotlight on and demanded to know” why the hell they hadn’t recommended or given me a test meter. Her explanation was that they only gave them out to those who might be at risk of a hypo.

She then went on to explain that she personally follows a Palaeo diet hence her advice to me on “fishing hunting and farming”, back in February of last year. I do recall that at the time she also advised brown rice instead of white and brown bread instead of white. I did detect a slight shift in her own thinking though.

I think she realised and agreed with my gains using LCHF diet and that the gospel according to David Unwin was indeed being banded about at the surgery in general. My impression is that it hasn’t fully caught on and that disparity was one that I had detected from previous visits.

It was a productive conversation and I think we both benefited from the exchange.

I do feel a lot better now that I realise that my GP and the practice nurse are on the same kind of wavelength as the forum ethos on diet and diabetes, that is test metering strategy apart maybe.

 

[Guzzler]

One point I think is pertinent here is my feeling on cost. It would be prohibitive to give all T2s a meter and free strips as this would bankrupt our already overstretched NHS. There is also the immediate question of who would benefit more, a T2 on no meds or insulin or T1 who would benefit from the use of a CGM?

At this time I think that the CGM trumps a meter (in my circumstances) all day long.

 

[Bluetit1802]

It would be a waste of money giving all T2s a meter. Just how many of them would learn from it, or even use it? Very few. We are a very small percentage of T2s on this forum.
I did nag my nurse for a meter some time after diagnosis, and explained why. She knew I was proactive and would gain some advantage from it, so she gave in and gave me a meter that had one cartridge of 50 strips, but no repeat prescriptions. She said I was on my own after that, as far as funding was concerned. Had I not been so proactive, been like most of the T2s she saw who continued eating cakes and taking the pills, I doubt very much I would have got one.

 

[Listlad]

I should also add that the whole conversation led me to believe that there is slow but steady evolution in theses matters at surgery level even if change hasn’t been revolutionary. She will have learned from my feedback as we discussed my results and method.

 

[Flora123]

It would be a waste of money giving all T2s a meter. Just how many of them would learn from it, or even use it? Very few. We are a very small percentage of T2s on this forum.
.

That’s why my doc will prescribe some for me occasionally as he can see my progress as well as the shock diagnosis

 

[JohnEGreen]

It would be a waste of money giving all T2s a meter. Just how many of them would learn from it, or even use it? Very few. We are a very small percentage of T2s on this forum.
I did nag my nurse for a meter some time after diagnosis, and explained why. She knew I was proactive and would gain some advantage from it, so she gave in and gave me a meter that had one cartridge of 50 strips, but no repeat prescriptions. She said I was on my own after that, as far as funding was concerned. Had I not been so proactive, been like most of the T2s she saw who continued eating cakes and taking the pills, I doubt very much I would have got one.

Maybe if doctors stopped telling T2s not to test but provided them with meters and strips and instruction and guidance on how best to use them that may change.

 

[Resurgam]

Giving someone newly diagnosed a meter and test strips for maybe six months, along with useful advice rather than the nonsense I got should be beneficial.
It will perhaps help stop misdiagnosis - the people turning up in A and E departments with blood glucose in the 20s and needing to be admitted because they did not have type two after all.
Lucky type twos can, in six months sort out their dietary needs and start to lower their Hba1c - or even return to normal numbers - but that seems to be a strange concept.

 

[Numan]

I spoke to a friend in passing yesterday who asked if I had been given a new meter by my doctor? He told me that he had been given one as the strips are cheaper for the nhs. He’s T1 I’m T2 and self funding my testing.

 

[christine1974]

I get meters just by contacting the supplier, a quick email or phone call and they usually send one out.

 

[Listlad]

Lucky type twos can, in six months sort out their dietary needs and start to lower their Hba1c - or even return to normal numbers - but that seems to be a strange concept.

As I explained in another thread, the concept has indeed travelled the 10km distance, probably during a Sunday morning jog between Southport and my local GP surgery. It is just that they seem not to want to hand out to or encourage people like myself to use a meter.

 

[OrsonKartt]

I get meters just by contacting the supplier, a quick email or phone call and they usually send one out.

If they give them or not patients should not be told by their doctors that testing causes anxiety as mine did. Honesty please !

 

[Listlad]

Last night I was seeking to explore the Palaeo or is it Paleo diet as the nurse I spoke to yesterday told me she herself followed such a diet. I searched through the forums to find out a bit more about the diet and what had already been said and settled on one thread, that I posted on. I think however that it has been deleted.

The relevance is that at the time of Palaeo man, the hunter went out to bring home the kill and the wife stayed at home to look after the kids and cook the kill. The roles were set in that way. In modern times the arrangement is typically different where both parents go out to work rendering a Paleo diet a little more challenging and requiring a helping hand from the local supermarket. I am not saying that the modern way is the correct way but am saying that it is prevalent.

I was about to ask @kitedoc about the Inuit or indigenous Australian diet that he had previously alluded to. Interestingly the blame for introducing carbs into our diets lays fairly and squarely with Neolithic man, many many years ago.

 

[kitedoc]

One point I think is pertinent here is my feeling on cost. It would be prohibitive to give all T2s a meter and free strips as this would bankrupt our already overstretched NHS. There is also the immediate question of who would benefit more, a T2 on no meds or insulin or T1 who would benefit from the use of a CGM?

At this time I think that the CGM trumps a meter (in my circumstances) all day long.

The thing is though that there are about 90 T2Ds for every 10 T1Ds. How do you divvy up the costs? All to one 'side' or some % to each with them self-funding the rest, with compensatory reductions for those on low-income maybe?

 

[kitedoc]

Mind you if the LCHF diet catches on more and more there will be more money saved.
And the UK Govt like any Govt will generously put that saved money into meters for T2Ds and CGMs for T1Ds wont they ?? LOL, that will be the day which ever country or Govt !

 

[Listlad]

Mind you if the LCHF diet catches on more and more there will be more money saved.

When I walked out of my doctors surgery the other week, the bill for me was for the blood test and his time, the rest of the bill fell on me in the form of “dietary” medication.

BTW It is definitely catching on here.

 

[kitedoc]

When I walked out of my doctors surgery the other week, the bill for me was for the blood test and his time, the rest of the bill fell on me in the form of “dietary” medication.

BTW It is definitely catching on here.

Good to hear @Listlad !!! I wonder whether there are any posters available for the surgery? Never seen a LCHF poster but it might spur things along if one can be found or made !!!

 

[bulkbiker]

The relevance is that at the time of Palaeo man, the hunter went out to bring home the kill and the wife stayed at home to look after the kids and cook the kill.

An interestingly sexist way of looking at it? Maybe they hunted in packs and harvested together. I'm not sure your rigid way of looking at it is correct.
A modern Paleo diet is based far more on what food types you eat and is far closer to what I usually recommend... fresh ingredients prepared from scratch. There are arguments about dairy and honey of course but these are mere sidelines. Paleo/Low Carb/Keto are all variants of the removal of highly processed food types from our diet and reaping the benefits thereof.

 

[Listlad]

Good to hear @Listlad !!! I wonder whether there are any posters available for the surgery? Never seen a LCHF poster but it might spur things along if one can be found or made !!!

No posters at all. I looked specifically and found nothing yet. Yes I agree. My feeling is that it is in the pipeline and as you know I have good reason to say that. At my surgery at least I sense that it is in the midst of change and Rome was never built in a day.

Thinking about it, for anyone trying to launch a revolutionary NHS dietary strategy for diabetes they would hopefully want to get it right and personally speaking it isn’t a straight forward solution. It works but is quite complex for many people to get their heads around and implement as it isn’t a hear thake one of these three times a day type of solution.

 

[Listlad]

An interestingly sexist way of looking at it? Maybe they hunted in packs and harvested together. I'm not sure your rigid way of looking at it is correct.
A modern Paleo diet is based far more on what food types you eat and is far closer to what I usually recommend... fresh ingredients prepared from scratch. There are arguments about dairy and honey of course but these are mere sidelines. Paleo/Low Carb/Keto are all variants of the removal of highly processed food types from our diet and reaping the benefits thereof.

You misunderstand me. I am the ( genderless) individual at home doing the cooking and looking after the kid. But also earning the bacon. Taking it to the extreme conclusion I find any holier than thou stance that says get into the kitchen a cook from scratch from raw ingredients a little objectionable. It isn’t as straight forward as it might seem.

And I will wager that when the solution is “prescribed” nationally it will not be easy to implement and administer.

 

[kitedoc]

Yep @Listlad, Diet is more complex than we imagine. Perhaps Dr Unwin's surgery has some posters etc.
He is said to be keen on informatics.
You sound like you are the Jack and Jill of all trades - meant without wishing to give offence !!