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Confused after BERTIE course

PeteN11

Well-Known Member
Messages
81
Location
Staffs
Type of diabetes
Type 1
Treatment type
Insulin
Hi!

Just finished a BERTIE course in Staffordshire and have to say that some of the advice from the Dietitian has left me very confused indeed.

On the first day we were asked what are "goal" for the course was and I stated mine was to help me find a way to lose some weight. Stating that I had read quite a lot in the Daily Mail by Dr Michael Mosley for those with T2 and recently articles by Dr Ian Lake dealing with T1 and lowering carbs.

The dietitian dismissed all of these as being rubbish and going on to have a minor rant about the DM and people pushing these views because they all have something to sell.

Later when calculating the carbs per day at 225g she stated that we must stick to that and not aim for any less. I told her that I often only have a couple of pieces of wholemeal toast a day with no other major carbs with other meals and was basically told off.

She also stated that eating wholemeal bread (or pasta/rice) does not have any affect at all either on carbs or general diet.

I would be interested to hear the views of others and especially those that have successfully lost weight by lowering carb intake.

Thanks
 
I was diagnosed T1 in my 40s and the carb counting course actually recommended more carbs than I've ever eaten.

Given I can monitor the impact of bread, pasta and rice I make the conscious decision to have smaller amounts. I have less of a problem with rice ( I wash it well) than the processed carbs, but ultimately I'd take smaller portions over BG spikes any day.
 
Hi Pete and welcome to the forum.

There are loads of low carbers here, predominantly Type 2s like myself. However there are some type 1s, who’s names escape me just now (sorry!), that low carb and hopefully will come along soon.
I went low carb on diagnosis in 2017 and lost 6 and a half stone with very little effort.
 
Hi @PeteN11 Personally I wouldn't be happy with this advice at all, given that I have very little tolerance to carbs I struggle to maintain normal blood glucose levels eating what dieticians would call a 'normal' amount of carbs, so I avoid them, as a by product, the more carbs I eat the more insulin I take, the more weight I gain, so it's an easy decision to avoid them. Daily I eat yoghurt, berries, soups, salads, nuts, cheese and meat, and this helps keep my levels stable, I probably average 80g of carbs a day, I take less insulin so less margin for error and the easier it is to manage my levels. I will also eat carbs though, so if out for dinner, at a friends etc I eat what's given and bolus as required, am not one to start making any amount of fuss, but that's the best part about taking insulin and matching it to carbs eaten as I have that degree of flexibility.

I know other type 1's who manage carbs more easily than me, don't gain weight etc, which is why even as a type 1 we are still unique in our own ways, but for me eating more than 100g would pose issues which I wouldn't be happy with managing daily.
 
Hi @pete11 welcome to the forum

Before i went to the course i was eating about 250 g of carbs a day. I wanted to lose some weigh so cut right down on potatoes rice pasta and bread. I managed to lose around a stone by doing this. Instead of having a meal of say chicken and chips/potatoes I would simply substitute the potatoes for lots of veg. Over the past year or so i have never eaten so much veg in my life.

Dont get me wrong, if I fancy some rice etc, I do just eat it
 
Sigh @PeteN11, I am type 1 and generally low carb (between 50 and 100 a day, sometimes a lot less). This advice, in my opinion is outdated and old fashioned. My Mum was a type 1 between 1970 and 2015 and the advice re diet and insulin clearly has not changed. I think it started off in the days when they said, 'you're type 1, we will give you a guestimate of how much insulin to take and then YOU can match your carbs to your insulin'. This led, I am sure to thousands of people taking fixed amounts of insulin and trying (unsuccessfully in my Mum's case) to match their carbs to it. The advice to my Mum was exactly that of your dietician, you 'NEED' carbs & lots of them, no questions asked. Well of course she did because she was having to eat to the insulin which was impossible anyway and if she didn't, hello hypo (of which she had hundreds over the years with many hospital admissions).

The advice does seem to be very slowly changing in that they now say eat what you like and learn how much insulin you will need for it. Now that I do agree with, I am not one of those who dictate to others what they should and shouldn't be eating, it's up to them and their aspirations. So, 'eat what you like' must logically include low/lower carb for those that want to so they need to update the advice to incorporate this instead of assuming that ALL diabetics on insulin are as high carb as the non diabetic population (which most might well be but not all) and get themselves updated with the many ways we all control our diabetes.

Same for any type of diabetes of course, I feel a little for your Dietician because they are spouting the NICE advice/Drs advice/Consultant's advice, most of whom seem to be stuck in the old ages. I know there are some exceptions as people on this site have said.

As for her musings on carbs and wholemeal bread, is SHE diabetic and has she tested her responses to this stuff? If not (and I appreciate she can read) then she needs to open her mind up and LISTEN to those that are living with it. x
 
My view would be that we are all individuals. We live in a free society, and should control our own lives. Take the useful info away and everything you disagree with ignore. Manage your diabetes to suit yourself.
 

Hi! It sounds like your BERTIE course is the same kind of thing as the DAFNE course up in Lancashire, which is Dose Adjustment for Something Something.

First thing i'd recommend - low carbs. From your post i'm guessing you know this yourself. Have a look at the Harcombe diet, it was inspired by the authors T1 brother and how as children the whole family changed their way of eating to better manage it and support him. The first week is aimed on getting over carb cravings, its fascinating when you read into it. A lot of people on there lose over 8lb in the first week. It's all about eating natural food and some of the recipes are amazing!

Wholemeal bread absolutely does have an effect on carb intake!!! Less so than white bread (Warburtons for example, 16.1g carbs in 1slice wholemeal, 22g in 1slice orange toastie loaf. Thats 1u difference in dose right there for me!)

I wouldn't recommend sticking to a set carb intake per day, as that makes it all so much more difficult than it needs to be! Make a list of things you regularly eat for breakfast and lunch, with the carbs and doses based on your ratios. Then just figure out what you need for tea. Have you got the Carbs and Cals app? I don't think its free but has most foods, portion sizes with photos and carbs, fat and calories on there

Good luck, and don't feel discouraged! Its extra hard for us diabetics to lose weight, but stick at it and you'll reach your goal
 
225g is waaaay more than I eat daily and I don’t consider myself to be particularly low carb.
 
Your experience described is exactly why I will never see a dietitian. I low carb (20 to 35 carbs/per day, eaten with protein and plenty of fat). One thing for sure though, we have to carefully match the amount of carbs eaten with insulin taken to avoid our blood sugar dropping too low or going too high. This is essential and to do that effectively you must carb count, learn your ratio (insulin:carbs) and measure your blood glucose. How many carbs you want to eat is entirely your decision and it doesn't matter to anyone but you. As you can already see there are many Type 1s here who do not low carb and there are others who do. You have to wade through much conflicting advice and learn what suits you.
 
Oooh - I know that - the NE of DAFNE is Normal Eating - except of course, it isn't for a lot of people. SO many people simply cannot cope with the shedloads of carbs we are supposed to have in order to be healthy.
I have been trying to eat low carb from my early 20s and I am 68 now.
I have been raged at and insulted, called all the usual things for doing such a dangerous fad diet, any yet I never felt right when eating the 'proper' high carb foods in the amounts I weighed out carefully. When diagnosed type two I was just about spherical having been on a cholesterol lowering diet for almost two years.
On low carb I don't need any medication to get normal numbers - but I have noted how type twos on insulin have lowered their carb intake and either need less or even no longer need to use it, and also people with insufficient insulin for normal eating have reduced their requirements, and also their errors in dosing - which seems like a good idea.
My daily intake of carbs is under 40gm - and I find I can eat very well, and feel very well on it too.
 
Hi. A typical dietician who knows little about diet and diabetes. I have always avoided these courses as they are so often given by idiots. There is no such thing as a target level of carbs other than with diabetes you need to keep them down to a level where you have a sensible BS. Wholemeal carbs have a wider range of nutrients and are absorbed more slowly then while flour carbs. They also contain a bit more fibre.
 
Thanks for all your comments. I feel like I should take this further with the Hospital Trust that organised the course as the dietitian seems to have given out some bad information which could affect those that may have chosen to accept what she said as absolute fact.

For those that have commented on the Wholemeal Bread part the dietitian not only said that there was no benefit for those with DB but there was also no benefit for anyone in deciding to change from White Bread/Pasta/Rice.
 
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