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Confused after 1st Diabetic Nurse appointment

Jac25

Member
Messages
20
Type of diabetes
Type 2
Treatment type
Diet only
Hi all,

I've been prediabetic for a year, and thanks to this forum, switched to LCHF soon after diagnosis. However, I also have ME, which means I can't exercise. Part way through the year my GP said I was not diabetic, and didn't need to cut out everything. I stupidly let things like cereal and ice cream sneak back into my diet, and consequently my HbA1c, which just on diet change alone had dropped to 47, went back up to 50, tipping me into the diabetic range. This was despite otherwise sticking to LCHF.

Since diagnosis I have gone back to LCHF, rigorously testing, and avoiding foods that spike my BG. Today I saw the Diabetic Nurse for the first time, and she said a number of things that confused me:

'It's normal to have spikes in BG after eating, and I wouldn't worry unless it was over 13'.
I understood NICE guidelines were 8.5 after meals, and that spikes were dangerous.

'We don't advise self testing because it's invasive and anyway it's your HbA1c result that matters. Really the only time worth testing is first thing in the morning'
Huh???

'You need a balanced diet with 5 portions of fruit & veg a day. A portion of fruit would be a pear, an apple, a handful of grapes...' I was so shocked I queried that one. Pears, grapes, aren't they full of sugar? I was told I didn't need to cut them out.

'You can eat ready meals, just look for the low sugar, low fat ones'
But, I said, they're still high in carbohydrates. That didn't seem to matter. But I should be careful about eating too much fat.

I came out feeling as if I'd been given totally backward advice, albeit by a very nice Nurse. How does one know what advice to follow?

Thank you for any insights, my head is reeling.
 
Ah yes the good old NHS keeping us as repeat customers for the future....
Your nurse is preaching the current NICE mantra so she can keep her job (or she may even believe she is helping you)..
However you know that your LCHF diet helps you control your blood sugar so why doubt it now?
You were indeed given very backwards advice so please smile politely and completely ignore it. That's what a whole lot of us here have done and are far more healthy for it.
 
There is a video on here somewhere about the danger of sugar spikes. Hopefully someone will post a link.

Obviously people's bgl's will rise after eating but it depends on what you've eaten. I can eat say eggs and bacon for example and my bgl's go up by .3. It's what they are after 2 hours that matters. I aim for below 7.5. Others aim never to rise more than 2 from a meal.

Sorry couldn't bring myself to comment about your DN experience because I'd probably be banned for swearing.
 
Is it just me who believes that the NHS have decided to kill all of us T2's as slowly and painfully as possible.
 

Just to be clear, what was the HbA1c at diagnosis? Has it been noodling around in a pretty narrow range? (There is a margin of error, so the change from 47 to 50 is not necessarily that significant. In my opinion.)
 
Dearie me. This is just the sort of conversations many of us have with our nurses. It isn't their fault, or not entirely. They are churning out the NHS "Eatwell Plate" rubbish that just does not work for T2s, particularly those not on any meds and relying on diet only. You did well on a low carb diet, you clearly know which foods affect you, so carry on doing this regardless of what your nurse says. You will soon be back down again.
 
Hi. You know what's right and sadly the DN doesn't but it's not her fault. Blame the government PHE, DUK and the food & pharma industries for pushing out non-evidence based advice. The 5 a day came from the California fruit growers association. As you know, forget low-fat and think carbs. Testing 1st thing in the morning is not the best time and you need to test 2 hours after a meal and be within 8.5 mmol.
 
I’m in the low carb camp! Luckily I’ve never been lectured about a counter intuitive diet (yet!). I’m gradually drip feeding my GP with what I’ve done. I think I need to go for the whole reveal at my next review. Look at my signature for what it’s done for me!
 
I think you've been told the usual nonsense.
 
It is sometimes difficult to argue with a health care professional. Before dx as T2 I only ever argued about waiting times! Sadly, there are many DNs who know that the advice they give just doesn't work. They see their patients becoming worse on the advice that they give them. It must be hard to see.
However, you know what worked for you and you now know what didn't work. The answer is clear.
As for excercise, I would never say that it has no part to play but you and I know that we can't do it and I personally don't break my heart over it.
 
I went on the DESMOND course today. The nurses said that no food is 'banned' and grapes and bananas are fine. One woman was told that it's fine to have Christmas cake, Christmas pudding and mince pies. I was told that I check my bg too much - I test fasting, then pre and post main meal and it informs my food choices. Sorry, but I know what works for me and although I had a nice day out and met some interesting people, I won't be changing what I'm doing.
 
Actually I'm not sure that DN's do see that their advice doesn't work. I think that when they see their patients getting worse they just blame the patients and think that it is their fault. After all the advice as we've all been told so many times on here is based on scientific evidence whereas we might all know that low carb works .....................
 
Ha! On my first visit to the diabetes nurse, I didn't even know I was diabetic! I was just told to go and see the nurse before I saw my doc for a follow-up appointment about my first Hba1c.

She just barked at me to take my shoes off so that she could check my feet and to jump on the scales! When I asked her why she told me, with a duh! expression on her face, that it was because I was diabetic. She hadn't read my records which show I'd only just been diagnosed and hadn't even heard it from the doctor. I shouted at her.

Saw doctor, burst into tears. Once he'd given me some advice, attempted to press Metformin on me and let slip about the Newcastle Diet (which led me to this site), back I went to the nurse.

After checking weight, feet etc., nurse (after a grudging apology from her) then lectured me about what I should and shouldn't eat. This was her gospel:

Eat sweet potatoes, not ordinary spuds;
Eat egg whites and not the yolks;
Eat loads of pulses;
Eat pasta "because it fills you up";
Eat fat sparingly and don't touch butter
Eat loads of green veg (the only sensible thing she said).

Of course, I ignored her, went home and looked up this website. Bloody glad I did. Thankfully I have not had to see this particular nurse again.
 
I think the DN's see people getting worse and it confirms their preconception that diabetes is progressive. My DN aslo told me not to worry about my bloods unless i get over 15's consistently in the morning, if I really feel I have to test (said with her eyes rolling at my pernicketyness)

and nope, she cant explain why my blood sugar levels went down despite me losing virtually no weight. Cos the sugars are in the stored body fat, dontchaknow, so i have to lose the weight to release the sugar from the fat to bring my blood sugar levels down.

It would be funny if it werent so serious.
 

BUT if you stop testing then you can believe that the eat well plate is fine. It's only the naughty patients who test themselves that actually see the effects of Christmas cake or grapes on their bgl's and then the naughty people stop listening to the advice and stop eating the foods that are making them ill.
 
I left my very first DN appointment feeling elated because she said I could eat anything at all, but did say to limit fruit and sweets. She advised me to lose weight any which way I liked. I did as I was told. I cut out fat as I thought that was a good way to lose weight, and carried on eating everything else! Examples of food I should eat were wholemeal bread with every meal, and either a jacket potato with baked beans or beans on toast for lunches. That was nearly 4 years ago. I have managed to educate her since then.
 
The nurses told us that their dietitian 'likes and recommends' baked beans and the sauce they're in isn't too high in sugar.
 
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