Type 2 Annual DN visit

Tell the truth, they may not like it, but tough.

No point telling a lie and getting good results and having them think high carb rubbish is good for you or that what they are advising and treatment offered is working. It's misleading.

Stick to your guns and don't let anyone talk down to you about diet. No one has any business dictating to you what you eat. Don't put up with it. Get your results, if you are happy with them, let them know you are happy with your progress.

And good luck!

Personally I'd be the one doing the rollocking.. but then again that's just me..

No. Don't lie. They will never learn if patients who are beating diabetes lie to them about how they are doing it.

Stand your ground and do not be spoken down to. Certainly that is what I do, and they are left in no doubt that I am not interested in being judged according to the dietary advice that gave me diabetes.

I don't lie, but I smile, nod and go my own sweet way

Don’t lie. It prolongs the false beliefs these hcp’s have and potentially could affect your own future care. See it as a chance to educate her perhaps. As suggested emphasis you are happy with your results and progress and that these results have come only when carbs are reduced and in fact increasing carbs makes you worse. She can hardly say you’ve failed if you’re doing better.

If she is rude, dismissive or otherwise negative in a way that makes you feel bad then tell her how she is making you feel. Tell her you would like her support in the lifestyle changes that make you feel better and improve your health. Point out the nhs support Dr Unwins low carb training for health care professionals and ask her what she thought of the course? (Is she going to admit not staying up to date in her training.) Ask her why you should stop doing what works for you? Ask her why you should do the things she suggests when it makes your diabetes worse?

If she wants to give you a rollicking (very unprofessional) then push back. You can do it ultra politely and nicely but you don’t have to take it. Or failing that state your case, smile politely and say nothing more. Walk out and feel sorry for her not down about yourself. You know the truth for you.

Hi Cana, I appreciate it can be easier to go along with it all but why do that? YOU choose what YOU do, not them and what you have chosen is working. Simply tell them 'I eat fewer carbs and check my levels regularly', end of. If it's anything like my surgery there will be a gazillion diabetics (all types) traipsing through the surgery, in through one Drs door and out through the other, believe me when I say they are reading a script when it comes to 'advice'.

KK123 said:

Hi Cana, I appreciate it can be easier to go along with it all but why do that? YOU choose what YOU do, not them and what you have chosen is working. Simply tell them 'I eat fewer carbs and check my levels regularly', end of. If it's anything like my surgery there will be a gazillion diabetics (all types) traipsing through the surgery, in through one Drs door and out through the other, believe me when I say they are reading a script when it comes to 'advice'.

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Although that could perpetuate the problem. I got told off forLCHF/keto and was told that they have ours if patients who reduce their carbs a bit and do just fine. That may be true but make me wonder if the patients are too scared to say how low they go. If every one of us was honest it would paint a very different picture and the hcps would have to take notice.

Cana, is be honest and gentle and go armed with knowledge. I showed my dn what my readings were after the bread she insisted I ate and she was surprised. Of course no one else could show her that as they are told not to test. She was very quiet after that!

Hi Cana, please try to educate your nurse p, I know it’s hard. If you want back up take a copy of this document:
https://www.practicaldiabetes.com/w...etes-experience-from-one-general-practice.pdf
Dr Unwin saved his practice £1000s in drug budget and has helped many patients put their numbers into the non diabetic range.
Best of luck, let us know how it goes.

Rachox said:

Dr Unwin saved his practice £1000s in drug budget...

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Of course, whether or not this a good thing depends on which side of the chequebook you’re standing. Saving money means costing someone else money. It all depends who’s pulling the strings.

Flora123 said:

Although that could perpetuate the problem. I got told off forLCHF/keto and was told that they have ours if patients who reduce their carbs a bit and do just fine. That may be true but make me wonder if the patients are too scared to say how low they go. If every one of us was honest it would paint a very different picture and the hcps would have to take notice.

Cana, is be honest and gentle and go armed with knowledge. I showed my dn what my readings were after the bread she insisted I ate and she was surprised. Of course no one else could show her that as they are told not to test. She was very quiet after that!

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Sorry Flora, perpetuate the problem how? Cana does eat fewer carbs??

Jim Lahey said:

Of course, whether or not this a good thing depends on which side of the chequebook you’re standing. Saving money means costing someone else money. It all depends who’s pulling the strings.

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I thought it might appeal to the nurse to save her surgery money, of course the drug companies will think otherwise

Rachox said:

I thought it might appeal to the nurse to save her surgery money, of course the drug companies will think otherwise

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Yeah sure thing. I wasn't challenging your statement. Just going off on a bit of a tangent. I tend to do that

I have, several times, avoided conflict by merely stating the facts:

- I test my blood glucose in order to learn which foods send it high.
- Then I avoid those foods, or dramatically reduce their portion sizes.
- Therefore my blood glucose levels came under control and remain that way.

No one has given me a rollocking for this, although a couple have rolled their eyes a little.
Works like a charm because it isn't really something they can argue with, without evidence. And in order to see that evidence, they would need to see my blood testing results, and of course they can't ask for those because they don't approve of me testing...

You notice that none of my statements are defensive, or detailed, or mention LCHF, keto, carnivore, or running on ketones.

Rachox said:

Hi Cana, please try to educate your nurse p, I know it’s hard. If you want back up take a copy of this document:
https://www.practicaldiabetes.com/w...etes-experience-from-one-general-practice.pdf
Dr Unwin saved his practice £1000s in drug budget and has helped many patients put their numbers into the non diabetic range.
Best of luck, let us know how it goes.

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...and he did it because one patient showed him the way. Just one.

I agree with the others. My DN now accepts that my low carb has got me into remission and did not lead to any of the terrible effects she expected.
I took in the letter from the lowcarbprogram the first time but she ignored it and handed it back to me, a few weeks later she asked me for the web address!
If yours is still stuck on the out-of-date path to destruction, and doesn't know that lowcarb is now accepted by the NHS, then just smile, say thank you, and know you are doing really well.

KK123 said:

Sorry Flora, perpetuate the problem how? Cana does eat fewer carbs??

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I know! It was suggested she doesn’t mention it to her nurse but smile sweetly but If every patient who succeeds on lc lies about how few carbs they actually eat as they are too scared to face an uneducated dn then it continues the problem of said dn believing that it doesn’t work or is bad for you or isn’t the way forward. Hope that makes sense!

Flora123 said:

I know! It was suggested she doesn’t mention it to her nurse but smile sweetly but If every patient who succeeds on lc lies about how few carbs they actually eat as they are too scared to face an uneducated dn then it continues the problem of said dn believing that it doesn’t work or is bad for you or isn’t the way forward. Hope that makes sense!

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Ah, I see, yes I absolutely agree. Nobody should be scared of saying anything to their DN should they, we are adults not naughty children! x

DCUKMod said:

@Cana - I would never lie when it comes to my approach, or other aspects of my health. There are always potential repercussions if something is recorded wrongly.

When I went for my first review after diagnosis, I had slimmed up, and dropped my A1c from 73 to 37. My nurse was obviously very happy with my A1c and that I had become very trim, but she was supremely disinterested in how I had done it. Her only remark was "whatever you're doing, keep doing it."

I've had various discussions over time, but I find, in my surgery, the ladies are usually busy and keen to tick the required boxes in the review process.

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Apart from telling I would get sore fingers if I carried on testing my DN doesn’t ask how I control my BS.