Conflicting advice

[davd]

After reading the posts on this forum which has been very helpful. I have been given conflicting information by my practice nurse who said she didn’t do carb counting. She gave me a GlucoRX Q meter to use and in 5 days I have got my mmol readings down from 15.7 to 8.5 this morning fasting readings. Saying that I had to do two tests this morning as first one on right hand gave a reading of 4.5 , i thought that was a big drop from yesterday so I did another test on left hand straight away which gave the 8.5 reading. Why the difference I don’t know.
As well as the meter the nurse gave me a lot of reading material including a book called Diabetes Everyday Eating by the Independent Diabetes Trust and all the meals in the daily menus about 6 pages of them include meals like pasta bake and loads of meals which include potatoes, the total daily carbs range from 140 to 270 .
The advice on here seems to be low carb which seems sensible to me but my practice nurse an the book says low fat balanced meals even though high in carbs .
My medication is 1mg of Glimepiride daily

 

[xfieldok]

Can you complete your profile, we don't know what Type you are.

 

[davd]

Sorry T2 diagnosed 10 days ago

 

[xfieldok]

Thanks, it is unusual for a T2 to be given a meter. It will be your new best friend.

T2 is a metabolic disorder. We can't process carbohydrates. I started off with a very high hba1c and thank goodness I found this forum before I was given the diet talk.

I cut right back on carbs and got back to normal numbers in a few months.

I actually went keto, less than 20g carbs per day.

 

[davd]

Just wondering why the nurse and the booklet she gave me is contradictory to advice on here Regarding carbs and why 2 different readings within 1 minute this morning , is the meter Ok giving a 4.5 and 8.5 so close together.

 

[Resurgam]

The different readings might be down to not enough blood on the strip, usually you get an error, but when the amount is just on the edge - anything could result.
The training thinking and experience of nurses is beyond me.
Diabetes is an inability to deal with carbs, but fats are blamed for that - fats are blamed for everything as far as I can tell.
The concept is that if you don't have fat you regain the ability to deal with carbs. I'd just say 'good luck with that'.
Personally I eat a low carb diet, and my results are so close to normal I'm not all that concerned.

 

[xfieldok]

Some hpcs are still in the dark ages. They churn out the same outdated rubbish.

However, if you read around this forum, read the success stories and listen to the people who live with, and control T2 and make your own mind.

As regards the readings, you can always get the odd rogue strip. If you get an unexpected reading, wash your hands and try another strip.

 

[bulkbiker]

my practice nurse who said she didn’t do carb counting

my practice nurse an the book says low fat balanced meals even though high in carbs .

She also doesn't have your diabetes.. you do. Take control yourself and prove her very wrong indeed?

 

[davd]

Thanks everyone I am going down the low carb route . Just wondered about the booklet ,
I have uploaded photos of it

 

[bulkbiker]

Thanks everyone I am going down the low carb route . Just wondered about the booklet ,
I have uploaded photos of it

Bin it!

 

[xfieldok]

Thanks everyone I am going down the low carb route . Just wondered about the booklet ,
I have uploaded photos of it

I don't need to look at it. Put it in the bin.

 

[Lamont D]

The thinking behind the out dated advice to those with insulin resistance and of course as mentioned the intolerance to carbs, is that each of us need to have a certain amount of glucose for brain function, how much is individual and other than that no one knows. The thinking is for you to have a varied diet based on 'complex carbs', because these carbs are low GI, high or medium GI carbs are not usually recommended but because it is individual and of course portion size, the amount of glucose still derived from these carbs do not help.
With protein, you can still gain enough glucose to get by without carbs, and add in natural healthy fats to help with satiety and giving you much needed energy efficiency regeneration.
A low carb diet somewhere under 100g per day is usually enough to get you on the way to gain good control of your blood glucose levels.

As for blood glucose monitoring, the best way to test to see if you are doing things right is to test pre meal, then two hours from first bite, if you are two mmols higher than the pre meal reading, then something or the combination of food is too high, anything under two mmols is okay.
Keeping a food diary is a good idea.

 

[NicoleC1971]

Thanks everyone I am going down the low carb route . Just wondered about the booklet ,
I have uploaded photos of it

Glad you are going down the low carb route; it is a lot more main stream that it used to be. You will know by how you are feeling and your bg readings/blood pressure/lowered triglycerides but how you are feeling will keep you motivated the most IMO!
The mainstream belief is that the best way to manage diabetes is via a low fat diet. Low fat because it has less calories and is therefore helps patients to lose weight and improve their control but most diabetic nurses only experience their patients getting worse on the high carb diet and expect to be giving them more and more drugs over the years. The low fat diet is also supposed to help diabetics keep their hearts healthier. Again this is just a hypothesis that has never been proved and there is now plenty of evidence to support the opposite theory on high fat/low carb diets hence they are given as an option by DUK and ADA.
If you did want to find out more about this, although some people just want to try it without knowing anything more, then see Diet Doctor which is a low carb site with some useful stuff for beginners.

 

[xfieldok]

Your mission, should you choose to accept it :
Go low carb, knock T2s bottom then go back and educate your nurse

 

[Vicky14]

When I was diagnosed my doctor pointed me to LCHF but 3 weeks later a nurse gave me a eat well booklet which sounds a bit like yours and advised against the LCHF. So glad I listened to the doctor, 2 months in and my BS is generally under 7 from a fasting of 16 as well as a 21 pound weight loss. My diagnosis was a wake up call and I feel better than I have in a few years. Reading the posts on here was a great help in this journey and I hope yours starts as well as mine did, good luck.

 

[Sarah82]

Thanks everyone I am going down the low carb route . Just wondered about the booklet ,
I have uploaded photos of it

Wow. I mean, I'm not actually that surprised but it's still disappointing they are suggesting diabetics eat some of the things on that menu.
Low carb is the way to go imo. My blood would be sky high if I ate most of those meals in that booklet. Good luck

 

[EllieM]

Thanks, it is unusual for a T2 to be given a meter. It will be your new best friend.

@David said he was on glimepiride, which is an insulin increasing drug, so the NHS have to supply a meter in case of hypos.
David, do you know your hba1c, as most doctors try diet and metformin first, so I'm guessing you may have had very high levels?
Be aware that the glimepiride acts by making your pancreas produce extra insulin, so low blood sugar may be an issue if you drastically reduce your carb levels while introducing the drug. Maybe call your nurse and tell her you are adopting a low carb approach and ask if you can delay taking the drug (though I think that is a pretty low dose). If you are taking it, make sure you always have some form of quick acting carbs with you (eg jelly babies, glucose tablets etc etc) in case of an unexpected hypo.

Generally T2s over produce insulin in a vain attempt to process the carbs that they can't tolerate, so taking a drug that makes you produce yet more insulin seems slightly counter productive to me, but that is pretty well all you can do if you don't reduce the intake of the food your body can't tolerate, carbohydrates.

If you're newly diagnosed you should also be aware that some T1s get initially misdiagnosed as T2s - ideally they should do GAD antibody and c-peptide tests to confirm the diagnosis but if you aren't young and thin many doctors don't bother. T2s outnumber T1s by a factor of 10 so the diagnosis is usually right. In case of T1 then low carb will only be a temporary cure for your condition, as the problem is a gradual destruction of all insulin producing cells, and insulin is the only long term solution. Luckily you have a meter so it should become obvious if that is the case.

Good luck.

 

[VashtiB]

Hello and welcome,

I'm another type 2 who went low carb contrary to my doctors advice. Now less than a year later she still doesn't really believe in low carb but agrees that the way I am eating is such that my blood sugar levels are no longer a concern. I've also lost weight without counting carbs.

Really it all comes back to the meter. You will need to be careful going too low carb with the medication you are on but try testing for various meals and work out the carbs in each meal and see if there is a pattern, For me the clear pattern is lower carbs= lower blood sugar levels. It is that simple (apart from dawn phenomena).

I really believe in trusting your meter and testing regularly.

Good luck and welcome.

 

[Member496333]

Just wondering why the nurse and the booklet she gave me is contradictory to advice on here Regarding carbs...

Because evidence beats eminence. When it comes to diet-related chronic disease - acolytes, academics and payroll scientists don't impress me much

 

[JoKalsbeek]

After reading the posts on this forum which has been very helpful. I have been given conflicting information by my practice nurse who said she didn’t do carb counting. She gave me a GlucoRX Q meter to use and in 5 days I have got my mmol readings down from 15.7 to 8.5 this morning fasting readings. Saying that I had to do two tests this morning as first one on right hand gave a reading of 4.5 , i thought that was a big drop from yesterday so I did another test on left hand straight away which gave the 8.5 reading. Why the difference I don’t know.
As well as the meter the nurse gave me a lot of reading material including a book called Diabetes Everyday Eating by the Independent Diabetes Trust and all the meals in the daily menus about 6 pages of them include meals like pasta bake and loads of meals which include potatoes, the total daily carbs range from 140 to 270 .
The advice on here seems to be low carb which seems sensible to me but my practice nurse an the book says low fat balanced meals even though high in carbs .
My medication is 1mg of Glimepiride daily

After diagnosis I still kept getting the same advice I got beforehand: Low fat, high carbs. Some just aren't all that clued in.

If you have any doubts about whom to listen to, the medical pro's or random people on the internet (who have been in your shoes), your meter'll give you answers. It won't try to sell you on anything, it'll just tell you how your body of coping with what you put in it. For me, that settled the whole matter when it came to diet, in no time at all. After that, the hospital's dietician could've stood on her head, and I still wouldn't've eaten the poison she came up with, much to her chagrin.