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Carbohydrates

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Django

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Good morning all,

I was diagnosed Type 2 a year ago. Initially controlled by diet but now on 2 x 500 mg Metformin per day. I attended my review yesterday. HBA1C was 8.1 and I was given a target of 7.
I have reduced my carbohydrates by cutting out or reducing bread, pasta, rice, potatoes etc.. I am also testing before and after meals to identify which foods have the greatest effect on my glucose level.
I was told by the nurse yesteday to stop doing this (in no uncertain terms). She said I must have carbohydrates at every meal , but to eat "healthily",and to only test once a week to monitor progress. My Metformin has now been increased to 4 x 500 mg per day. There is a lot of conflicting information or advice knocking around and I'm really unsure on the best approach now.
 
Find out what works, and keep doing that. There's a lot of trial an error involved, but, essentially, it's worth it.

You'll have to become more of an expert on Diabetes than the *ahem* "Diabetes Specialist Nurse". And you will - because YOU'RE living with it, right?
 
Have you noticed the inconsistency in the attitude of your nurse. She wants you to drop from an Hba1c of 8.1 to below a target of 7 and yet you have to eat carbohydrates at every meal. This is the diet versus pills argument and many people on here will attest to the fact that you will have much greater success sorting out your diet. The pills often have side effects which can be quite unpleasant.

It is my opinion that testing as much as you wish to is essential to finding out which foods raise your blood sugar to unacceptable levels. Having, by a process of elimination, discovered the problem areas then reduce the portion. It is possible that you could have carbohydrates at every meal but not very much of them. This could keep everyone happy and save you lying to your nurse.

There is another issue which is worth mentioning here. Your current menu has food in it that you enjoy. I would say that you should use your meter to move to a position where you still enjoy the food but get lower sugar levels. This transition is personal to you since I may not like the foods that you like etc. Everyone has a personal journey in that respect. Your nurse will be of limited help with that. She will probably push the party line on "healthy" eating because that's all she's got.

It's not my place to encourage you to disobey your nurse ..........but .................
 
Django said:
Good morning all,

I was diagnosed Type 2 a year ago. Initially controlled by diet but now on 2 x 500 mg Metformin per day. I attended my review yesterday. HBA1C was 8.1 and I was given a target of 7.
I have reduced my carbohydrates by cutting out or reducing bread, pasta, rice, potatoes etc.. I am also testing before and after meals to identify which foods have the greatest effect on my glucose level.
I was told by the nurse yesteday to stop doing this (in no uncertain terms). She said I must have carbohydrates at every meal , but to eat "healthily",and to only test once a week to monitor progress. My Metformin has now been increased to 4 x 500 mg per day. There is a lot of conflicting information or advice knocking around and I'm really unsure on the best approach now.
Click to expand...

Read the posts on this forum, the DN is wrong, most Diabetecs have issues with carbs, ea what your body says and can cope with.. All DN's and dieticians say eat carbs, I cannot eat carbs, most probably same as you.
 
Django, you probably do have carbs with most meals, just small amounts.
I'm a relative noob to T2, as I was only diagnosed the end of July this year. I spent the best part of a month testing levels 6 times a day, that cost me a few shilling, but I have a really good understanding of what increases my levels. I now only test before my meal in the evening, but if I was planning to eat something out of the ordinary or go out for a meal, I would test before and after.
To cut a long story short, my 100 or less carbs per day has taken me from HBA1C 8 to around 5
 
It's a bit of a balancing act you need to test eat wait 2hrs test, I don't eat more than 60g of carbs a day, But I sometimes go a bit daft if I go for a meal or out for the day I may indulge in a big mac, or a few chips, piece of birthday cake etc, and to date it has not had a dramatic effect on my levels, I have never had a reading above 7mmol, while keeping my carbs low. But each person is different and you wont know what does what unless you test on a regular basis. I have totally ignored the dietary advice offered by my DN and dietitian, I have showed my DN all my readings and my diet the fact that it works, and I have now lost 31/2 st. She was made up with my hba1C result and said I wish all my patients were as good "YET" it does not seem to sway her ideas to others in the same boat! she still proffers her normal diet high in carbs. You just cannot win with some, they seem to just toe the line with indifference.
 
Hi. I think you know your nurse is giving very bad advice. There is no evidence whatsoever that you need carbohydrates with every meal; it's NHS fantasy. Ask your DN or whoever what the advice is based on; they won't be able to produce any. There IS plenty of real evidence on this forum and in some other countries that controlling carbs is vital. As others have said your meter won't lie; just test and find what foods affect you the most. My diabetes expert GP also said I should stop 'starving' myself and eat a 'healthy' diet whatever that is. I just don't discuss diet anymore or the meter. Through keeping my carbs down I've been able to delay going onto insulin by several years. You are already on the right track so keep it up.
 
Hi Django, they cannot stop you from testing, they can only take your testing strips off your prescription - which they have done for me. But you can buy your own, you still have free will. (And Boots have a 3 for 2 offer on, and you don't pay VAT on diabetes products).

Have a read of 'Gary Taubes - Why we get fat ..' which is a real eye opener on the subject of carbs!

Stick to your guns, best of luck!
 
Sod the DN! It's YOU who has diabetes, keep testing and learning what suits you and what doesn't. If she's not the type who's up for discussion, don't tell her, it's none of her business whether you test or not.
 
Great post Fraddycat, down with the proliteriate, take them to see Madame la guillotine !
On the subject of good books to read, some full of hypotheses just like the NHS !
Some full of hard clinical evidence against the NHS suicide advice on carbs.

To Read : Diabetes? No Thanks! by Lars-Erik Litsfeldt
The Great Cholesterol Con by Dr Malcolm Kendrick

2nd one mostly anti the NHS cholesterol myth but has some advice on diabetes.

also if you can get through it Trick and Treat by barry Groves

If you are aware of these tomes then I apologise, but maybe other forum readers will find some useful info there.

Best regards Superchip
 
It is difficult to go against your medical advice.

I have 3 people 'interested' in my diabetes. My GP and DSN and the consultant who heads up the diabetic unit at my local 'world famous' hospital.

I have reduced my hba1c from 10% to 6% in 7 months by low carbing. My GP and DSN think this is fantastic and give me loads of encouragement. The consultant thinks I am an idiot and should eat carbs with every meal.

So who is right - my consultant who is ignoring my figures and suggesting I add carbohydrates or my GP and DSN who say my bloods, lipids, blood pressure etc are all excellent and that I should keep doing whatever it is I'm doing.

There are rubbish car mechanics and there are brilliant ones. There are rubbish health professionals and there are good ones. Only difference is that you can't shop around, so you need to test, test and test again and make up your own mind.
 
Well said swimmer2, seems to me that you should stay away from your local world famous hospital.
Get your advice on carbs here where people actually have rigid experience of what works.
Forum members on here KNOW what works. I liked the analogy to car mechanics !
Keep testing is **** fine advice, don't assume the so-called professional has a clue.

Fraddycat - Liked the - Go the Proles ! - I say DOWN with the Plebbs !
 
It's a bit of a balancing act you need to test eat wait 2hrs test,....
Click to expand...

I tried a 1 hour test to see the effect of a cereal b'fast compared with my usual almond porridge.

Cereal - 14.3 after an hour, but down to 5.1 after 2 hours
Almond - 7.4 after an hour, but down to 5.5 after 2 hours

If I had only tested after 2 hours, I would not have seen that massive spike.
 
Django said:
Good morning all,

I was diagnosed Type 2 a year ago. Initially controlled by diet but now on 2 x 500 mg Metformin per day. I attended my review yesterday. HBA1C was 8.1 and I was given a target of 7.
I have reduced my carbohydrates by cutting out or reducing bread, pasta, rice, potatoes etc.. I am also testing before and after meals to identify which foods have the greatest effect on my glucose level.
I was told by the nurse yesteday to stop doing this (in no uncertain terms). She said I must have carbohydrates at every meal , but to eat "healthily",and to only test once a week to monitor progress. My Metformin has now been increased to 4 x 500 mg per day. There is a lot of conflicting information or advice knocking around and I'm really unsure on the best approach now.
Click to expand...

Think you've got a consensus on here now!! What you were doing was spot on. Stick to it, but maybe MORE of it not less to get that HbA1c down further. If you're higher than 7.8 two hours after eating, cut down, or out, the carbs in that meal.
Good luck.
 
A lot of 'Diabetes Nurses' at GPs are not DSN's and its incorrect to call them that.. most have an interest in diabetes (or have been given the job) and have done some rudimentary training. As such they tend to give out the 'booklet' advise which is 30+ years old and in massive need of an overhaul to take into account modern science.

I am involved with my local PCT and the hospital diabetes team and most of them would advise based on what works for the patient.. if its working for you and you aren't endangering yourself.. i.e. your blood pressure and cholesterol are also good and you have no other relevant medical conditions then keep doing it.. you would just get described as 'un-orthodox'.. better that than dead hey!

Also it's worth noting that at the sharper end of diabetes treatment.. i.e. in dedicated diabetes centres.. low-carb is now seen as a valid way to treat diabetes and more and more people are looking into and recommending it... like any advice however it is going to take some time to filter down the food chain..

Until then my advise would be to educate yourself and do what you think is best.. there are 100's of examples of people on this forum that follow low-carb very successfully... I would suggest they are a better example than the current NHS type II crisis.
 
Pneu said:
I am involved with my local PCT and the hospital diabetes team and most of them would advise based on what works for the patient.. if its working for you and you aren't endangering yourself.. i.e. your blood pressure and cholesterol are also good and you have no other relevant medical conditions then keep doing it.. you would just get described as 'un-orthodox'.. better that than dead hey!
Click to expand...

It's part of the old NHS Diabetes Apartheid. Most of us T2s don't get anywhere near a Hospital Diabets Team or a DSN (let alone an Endocronologist or a Podiatrist or a Dietician that knows anything about diabetes).

My only encounter with a proper DSN was when (in my first few weeks post-diagnosis) I got dragged into hospital because my GP mistook Ketosis for Ketoacidosis. I was very impressed, they talked to me knowledgably about low-carbing and gave me encouragement on my great progress with BG readings. It was a tantalising glimpse into "how the other half live" and made me realise how much better off most T2s would be with proper diabetic care.

I've not had a positive experience with a HCP before or since. My GP has since taken my metformin away, knocked back my HbA1c to once a year, and never even bothered to look at my feet during the yearly review.
 
RoyG said:
It's a bit of a balancing act you need to test eat wait 2hrs test, I don't eat more than 60g of carbs a day, But I sometimes go a bit daft if I go for a meal or out for the day I may indulge in a big mac, or a few chips, piece of birthday cake etc, and to date it has not had a dramatic effect on my levels, I have never had a reading above 7mmol, while keeping my carbs low. But each person is different and you wont know what does what unless you test on a regular basis. I have totally ignored the dietary advice offered by my DN and dietitian, I have showed my DN all my readings and my diet the fact that it works, and I have now lost 31/2 st. She was made up with my hba1C result and said I wish all my patients were as good "YET" it does not seem to sway her ideas to others in the same boat! she still proffers her normal diet high in carbs. You just cannot win with some, they seem to just toe the line with indifference.
Click to expand...

The problem is - NHS clinical staff are PAID by the NHS to PROMOTE NHS guidelines whether they're RIGHT OR WRONG, whether their research is UP TO DATE OR NOT. They are NOT paid to listen to patients and report back to the NHS that some of us have a better handle on our own medical conditions than the NHS does. They also get paid at the end of the month whether or not they cure anyone, improve anyone's condition, worsen anyone's condition, or cause anyone's death.

Meanwhile WE have to be 'PATIENT' with them, nod our heads in agreement even if we don't agree, accept that they know best, even if they don't and often I think that's what really makes some people sick - following INCORRECT ADVICE from professionals.

Lots of people earn their living from YOU and ME being ill. That's a fact, not a myth. They follow the guidelines and instructions presented to them from within the system they work. There are limitations and constraints within all systems, including the NHS. Patients come in all shapes and sizes and OUR illness may have the same name but the way WE experience it will be unique to US. WE have more experience with our illness than ANYONE ELSE. WE are living with it and it's important to us. Our DN has probably done a two day course on 'Diabetes' which trots out the same OLD information over and over and pays little heed to anything that patients have offered by way of information from their own experiments with their own diet.

We have to accept that and be discerning where our own health is concerned and we have to show very clearly that WE have this medical condition, and WE want to have a say in how it's handled because we may be ill but that doesn't make us unintelligent. :)
 
borofergie said:
Pneu said:
I am involved with my local PCT and the hospital diabetes team and most of them would advise based on what works for the patient.. if its working for you and you aren't endangering yourself.. i.e. your blood pressure and cholesterol are also good and you have no other relevant medical conditions then keep doing it.. you would just get described as 'un-orthodox'.. better that than dead hey!
Click to expand...

It's part of the old NHS Diabetes Apartheid. Most of us T2s don't get anywhere near a Hospital Diabets Team or a DSN (let alone an Endocronologist or a Podiatrist or a Dietician that knows anything about diabetes).

My only encounter with a proper DSN was when (in my first few weeks post-diagnosis) I got dragged into hospital because my GP mistook Ketosis for Ketoacidosis. I was very impressed, they talked to me knowledgably about low-carbing and gave me encouragement on my great progress with BG readings. It was a tantalising glimpse into "how the other half live" and made me realise how much better off most T2s would be with proper diabetic care.

I've not had a positive experience with a HCP before or since. My GP has since taken my metformin away, knocked back my HbA1c to once a year, and never even bothered to look at my feet during the yearly review.
Click to expand...

When I read things like this it really concerns me. My GP supports my low carb diet, he supported me doing the Newcastle diet, I do get a small amount of strips on prescription (I used to have unlimited until I pulled out a 4.9 HbA1c :lol: ). Recently I have had retinopathy screening and been seen by a podiatrist. Why is the care I receive not available to all?
 
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