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Confusing advice - diabetes diagnosis

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Neliel2

Member
Messages
6
hi all,

When i was first diagnosed about 8 weeks ago my lovely practise nurse had a long chat with me about diet, she talk about many diffrent ways but her main advice was to reduce my carbs as much as i could, explaining that the body turns them to sugar and there fore would up my BG when i tested. She advised me of a book to read and to go research low carb diets. All which i did and i dicided that it was something i would embrace and after years of yo yo dieting fads i finally feel like i have found something i can do and stick to and already im losing weight ( i dropped from 158kg to 157kg in about 4 weeks not alot i know but its a start) my engery levels are up and my BG is coming down nicely.. yay go me

then yesturday i went for my first appointment to see the diabetic dieticain at the local hospital... having told her what i was doing the fact i had researched it and what i was eating in a day, she basicly told me that it was wrong to not have a starchy carb at every meal, thats i should be calorie counting (something i hated with a passion cause it made me think about food all the time) and turned everything i had read and had been doing on its head.

Surely if im losing weight and all my levels are dropping and i have no adverse reactions to my diet then it cant be wrong. She was a nice enough lady but i just feel like she was not even listening to me and when it came to exercise advise she went on about in chair exercises because "your such a big lady and you need to start easy".. i dont drive.. i walk everywhere up to 5or 6 miles a day.. im a carer for my son that invovles lifting and carrying so i hardly feel that holding my arm out in front of me for 10 seconds is going to help get me fit.

my issue is she has now put that little seed of doubt in my mind about wether im doing the right thing.. and all the possativeness and motivation is seeping away because of it.
 
Re: confussing advice

You are very fortunate to have such a pleasant and enlightened practice nurse. As you are so recently diagnosed it is niot surprising that you feel confused by the dietitian seeming to differ from her.

If you read around the forum you will see that the general consensus from most other diabetics here is that everyone has to find their own way and what works for them and this takes time.

It was always the standard advice to eat starchy carbs at every meal but this advice is under review
and many HCP's ,like your practice nurse, recognise the fact.

In the meanime i suppose many people are in limbo and confused.

My personal opinion is that diets and arges should be agreed with the individual. Many problems have been caaused by treating everyone in the same way- "one-size fits all".

If you are doing well by following your practice nurse's advice, so soon after diagnosis, then that is wonderful and you shouldn''t worry,

You are very unlikely to ever find two HCP's to agree on anything- and that doesn't just apply to diabetes.

Just give it a little time. there is a great deal to absorb and you can't do that all at once. In the end we all have o find our own way but there is a lot of help available here- I wish I had known about it when newly diagnosed, Good luck!
 
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Hi,

Dieticians often recommend to have starchy carbs with everymeal. Unfortunately this can make your BG's high like your practice nurse said, which means you will have to either go onto medication to control this or up the medication you are already taking.

It will also make you feel cr*ppy having high BG's alot.

Many people on this forum, successfully reduce carbs and in turn which reduces BG's, helps with weight loss and in some cases enables people to reduce medication if they are on any.

Well done on your weight loss by the way

Aslong as your getting all the vitamins, minerals and nutrients you need on a low carb diet, i dont see a problem with continuing how you are.

You've seen that it works for you, with a drop in BG's, weight and generally feeling better.

Nobody will ever agree on the best diet for anyone, it's on an individual basis.

It would be a good idea to note down your diet and BG's to show the dietician that it works for you and she/he may be less inclined to encourage you to do something that doesn't really work.

Don't let it de-motivate you, you sound like your doing a great job. Let the weight loss, good BG's and feeling better be your motivation
 
Re: confussing advice

Hello Neliel2,

You are stuck in the confusing and contradictory orthodoxy of current advice to diabetics. A lot of the problems with the dietary advice is that it is focused on fat being the main problem; so if you can't eat fat then what are you left with? Protein and carbohydrate.

The thing is as you have discovered that's really bad advice. Fat is not the problem; for diabetics and arguably everyone on the planet, carbohydrates are. The faster they are broken down the worse things are.

Carbohydrate drives insulin which drives fat. That is a firm biological fact yet that statement never seems to factor in the dietary advice we are given. If you want to reduce weight make sure you have less insulin in your blood; the only way to do that is to drop carbohydrates.

Exercise will help a little by making your muscles more sensitive to insulin but it won't have any direct effect on your fat cells, what it probably will do is make you hungrier and that is hardly conducive to weight loss..!

Your hospital dietician is wrong, try and ignore her. If you want to read a very good book setting this all out incredibly well and incredibly clearly try Gary Taubes' book 'Why We Get Fat'. I've just finished reading it and am tempted to immediately start again - I can't recommend it highly enough.

Also, if you haven't read Dr. Bernstein's 'Diabetes Solution' I'd make sure you pick up a copy of that as well.

Best

Dillinger
 
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I listened to the NHS dietician very politely, discussed one or two points with her, then went on doing my own thing, which is low-carb. My weight loss and my BG levels speak for themselves.

As long as you eat plenty of low-carb fruits and vegetables, and eat fresh unprocessed foods, you'll get all the nutrition you need.

Viv 8)
 
Re: confussing advice

Hi Neliel2,

Just stick with what you were doing before, as Ebony says as long as you feel you are getting sufficient vitamins and nutrients from your food and you are happy then why change it!

My diabetes nurse is all for my reduction in carbs and is pleased with the results, I use my dietitian to check my diet to see if I am not lacking anything nutrients and to check that I am not exceeding my fat /protein intake, she rarely comments on my reduced carb/low-gi diet and is more than happy that I have found a diet that works and produces good results.

Good luck!

Nigel
 
Re: confussing advice

Hi Neliel2,

Weed out that 'little seed of doubt.' let your positivity grow...you were doing well, felt confident in what you were doing and were getting positive results. The answers were all well with you until this seed landed. ithe seed's a weed, so weed it out: regain your confidence and your control.

good luck.
sparkles.
 
Re: confussing advice

Thanks guys.. i have decided to stick with my practise nurses advice and the low carb diet because it makes me feel better, and im losing weight.. also she has known me for a few years not just from notes and a 20 min appointment.

Thanks for the confidance boost and the "weedkiller" to root out that little seed
 
Re: confusing advice

I have had email correspondence with a hospital where low carb treatment is being studied on a long term basis.

They report:

The experience of most of us on this forum is that a low carb diet does give a vast improvement in health, with better control & weight loss, etc.

That is in direct contradiction to the advice given by Diabetes UK - whose advice is followed by Drs & dietitians. I followed their diet for 7-8 years until the complications became crippling. Then I found this forum. 3 months of low carb & I was fit & well.

 
Re: confusing advice

I don't count carbs - I just don't eat bread, potatoes, rice, biscuits, pasta .... I have counted carbs & the DUK diet amounted to 300-400 daily, &the low carb diet less than 100 g.

I eat more cheese, meat, veg, etc, & use ground almonds instead of flour. There are lots of recipes on the forum. I only drink water when playing tennis - NO extra carbs.

The Hounslow dietitian who gave me the original advice now has revised her recommendations & gives out my almond bread recipe.

You may find my report & discussion on the Diabetes X-PERT course helpful.
 
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Hi IanD

I found your posts very interesting. The hospital report seems to indicate that all types of diets work equally well. It would be interesting to know whether those diabetic people who lose weight via low fat or other diets also report vast improvements to health and better control as well as their weight loss.

I was talking to my partner earlier in the day and I was mentioning diet differences (low fat v low carb eg.) and weight loss. He said something along the lines of … well perhaps their weight loss isn’t due to burning fat. When you consider that often water loss accounts for some weight loss perhaps there could be some shred of truth there. I suppose those people who can do low fat diets don’t crave carbohydrates the way I do so they can stay in control while taking in larger amounts of carbohydrates than we do but less fat. If it works for them then I can’t knock it but I’d love to know iff they also report improvements in other health conditions and better diabetic control.

I like to think there is something in this Low carb thing but then I know I am biased, because it is suiting me where low fat diets didn’t. Also, I have suffered a mysterious skin complaint for two years which made my life hell. I am on antibiotics but its interesting that the spots have improved greatly in this the first week of my diet. Now is that the antibiotics or the diet? I have had several courses of antibiotics over this two years but none have touched it. (but then I believe different antibiotics attack different things, so may be they just got it right this time.)

The Diabetes UK report talks about NOT HAVING ANY carbohydrate in the diet. But am I right in thinking that we Low carbers always have some carbohydrate -just not very much. (20 gm per day on foundation.)

So we get the glucose from carbohydrate for our brains.
And I’m sure with all the vegetables I’m eating on Atkins foundation stage (even without wholegrains and fruit) I am getting masses of fiber to help the health of my gut.
And I’m not having those carb cravings at all ....and while I do sometimes feel hungry its not unbearable to me in the way hunger got me when on low fat diets.

What’s with the ‘no more than one fifth of your total carbohydrate coming from added sugar or table sugar. Why the magic 1/5th? What is it with table sugar and added sugar? ....I guess its just unnecessary addition to food, no goodness and unnecessarily bulking up already over-laden sugar levels. (but then still why the 1/5th? why not just say cut it out its not good for you.?)

You seem to do very well on your diet Ian. What was the Houndlow dietitian’s original advice? And what made her change it? (havent read the link yet -but will do)
SPARKLES
 
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Re: confussing advice

Hi Ian

The control group were put on diet that created an energy deficit - so based upon their calorie requirements to maintain the wt they were I believe they used a 400-500 calorie deficit. So I assume it was based on 50 % CHO.
The results are clear - at the end of the trial there was virtually no difference although the LC group lost wt faster in the initial phase - we know why as generally LC are consuming a lower calorie intake!
My own snapshot analysis on here showed that too!

When are they publishing the results - I have not had time to ring my contact!

I think the important point to note that anyone who is told to eat "loads of carbs" with each meal needs some advice on portion control! Plus to ignore what DMUK say about including some sugar in your diet - Ian and I have previously discussed the awful meal plans they have on their website!
Ally
 
Re: confussing advice

Hi Ian,

This is probably a daft question but is DUK the same as this website Diabetes.co.uk ? Hmmm… had a look at your thread in the link above re the X-pert course. It looked like a good course and great that patients can participate like that on a more equal footing with health professionals. You obviously were expert on your situation and had loads to offer and that seems to have been picked up too for all the right reasons, which is good.

I thought this ‘quote you below’ was interesting and put the major benefit of low carb diet succinctly… my question is…is this just your experience or do others here on the low carb forum have that same experience. I can’t relate because I’ve never had good control in either diet or BG before.

‘IMO - I did use the low-medium GI approach for several years the result was BG control at a higher level -

instead of the BG spike of high GI

I got a sustained BG above the level achieved by my present low carb diet.

A diet of veg & proteins including fats gives sustained energy without raising the BG.’ IAN

I was frankly gob-smacked today when I looked at the carbs in a medium tin of sweet corn. 1/3 tin had almost 20 gm carbs. Now, consider that I, on Atkins foundation, am trying to exist on 20 gm carbs PER DAY! (that’s 1/3 tinsweetcorn!)

It made me ponder how I’ve been eating all these years and wonder what huge sum I would get if I could go back in time and add up my gm carbs on an average day in the life of me.

THE PENNY DROPPED!… so this is what they mean when they say we are all eating too much carbohydrate. We are… we must be.. Everyone eats more than that. No wonder more than 50% the UK population is overweight. It’s chronic.

Hmmm… I haven’t read the diet leaflet yet but that does seem excessive to me now…
-though it might well have seemed little before I had this experience on this diet. I’m a gannet by nature and cereal, bread and potatoes would be three of my favourites. But look now -on how little I can survive (1/3 tin sweet corn.) without too much hunger or cravings.
….What is going on?

I am sold on this low carb diet experience. I invested some time into trying to understand the science behind it before starting. I got some of it.. but there is such a lot to learn. All I can say is from my limited experience, low carb is looking very good for me. Yet as well… I am thinking back to the slightly worried and hesitant look the Dr gave me a week ago when I told her I was intending to start a low carb diet. She quickly composed herself and said she would back me but I definitely got a feeling that at first she was not comfortable with the idea.

But I now think It’s a big shift the health service is going through… (if it is) health professionals, researchers and food companies etc. have given out low fat is good for you info/ propaganda for years. If time tells or is telling they got it wrong, that’s going to be very hard for some people to swallow. Like disproving an argument or denying a person his religion. But shifts like this do happen sometimes. When it settles things might move in great leaps. If there is truth in ‘Low carb diet has explainable benefits above low fat diets’ the truth will eventually come out.. And who knows where that could lead.
SPARKLES.
 
Re: confussing advice

Hi Sparkles

Many HCPs will look hesitant and worried when you say you're going low-carb - they, like all of us, were originally indoctrinated in high carb/low fat, and often cannot get their heads around a higher-fat diet, through no fault of their own. It goes against all their training, particularly for the younger ones.

There can often be conflict within practices, with some partners being okay with low-carb, others feeling it is a work of the devil!

In my experience, too, many HCPs at local practice level are very busy people and don't have the time to do lots of reading round in the same way that someone like me, now retired and with time on my hands, can do. They'll probably read The Lancet and take new courses provided by the PCT, but not much more unless they have a specialism. I understand this perfectly - I'm a professional archaeologist, and most emphatically DO NOT spend my spare time doing/reading about archaeology.

I'm still surprised by Ally saying that an Atkins-style diet is lower calorie than low-fat. I became expert at eating vast quantities of food on low-fat - a 10oz potato only has 250 cals! I could eat vast quantities of rice, pasta and potato without going over 1200 cals per day - and still put weight on! It wasn't until I read Atkins that I realised why!

Now, on less than 50g carb per day, I eat between 1400 and 2000 cals per day - and am still losing weight, though very slowly. Considering one of the on-line calculators worked out that I need 2200 cals just to sit in a chair all day, it's very frustrating! But I'm getting there

Viv 8)
 
Re: confussing advice

I have counted carbs & the DUK diet amounted to 300-400 daily, &the low carb diet less than 100 g.
Click to expand...
regardless of my views on very low carb diets I do think that the way DUK (the charity ) words things is ambiguous. They try to make things simple but it means there are many ways of interpreting what they say so .What does half your food as carbohydrates actually mean to most people? Weight, volume or what?
As Ally mentions the conventional diet( as used by the control group in the study) is 50% of energy ( ie calories.)
Someone eating 400g carbs would be eating 1600 calories from carbs, let alone what else they eat. On a sedentary day I only eat about 1800 calories in total, a bit more when I'm running. 400g of carb is sufficient to fuel a very active 15 year old boy (total calories in diet 3,200).
If Ian had been in training for a few sets with Nadal then maybe he would have needed that many but otherwise for a man of his age (sorry Ian) far too many.
 
Re: confussing advice

Hi Viv

I am frantically trying to finish an assignment for my masters - so will explain the calories etc later.
allyx
 
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Yes Viviennem,

Even if the low carb diet really is far more beneficial than low fat diets for people with Diabetes and other ailments I can’t blame Health Care Practitioners for not subscribing to it… like you say, they are human and busy and trained differently.

What I do expect though is that those who do the research and the government that fund it should be quickly stepping in at the very idea that there could be something in this
- because obesity and diabeties are huge in western society .
diabeties can be a disabler and a killer and must cost the NHS loads.
More than half the UK population is obese.
Children are now being diagnosed with adult onset diabetes.

…If it is that its our supermarket led eating patterns that are robbing so many of us of our health and well being ….and if this is true (that we actually THRIVE on much fewer carbs than the population actually eats and the reason so many (more than half ) are obese or ill is because we inadvertently OVER FEED our systems because we are ignorant of that idea.(at least of just how few carbs we actually need) ) Then surely, SURELY with the problem of obesity and diabetes Sooooo... rife in our society, those who lead and enquire and fund; in short the researchers and the government, have a moral obligation to jump on the idea and find out if there is truth in it. Well that much I do expect.
SPARKLES.
 
Re: confussing advice

Hi Viv andSparkles,

The BBC diet trials , was published in the BMJ but you may remember that it was also a TV program. They collected quite a bit of data from that trial and I believe they may even have more to publish. So the results were - you lost wt faster on Atkins but the food diaries showed that they were consuming the least amount of energy - so you might expect that. In fact after a year the slimming group (WW) had the best results. Now for a diabetic WW would be the last I would prescribe because of all the added sugar in a lot of the low fat products. Sparkles - that is actually the problem - many people do not realise that low fat products often have similar calorie contents as the "ordinary " version!

I have collected a huge number of food diaries over the years and the recurring theme is a diet of high fat and high sugar , with a lot of alcohol as well. Often when I analyse them people are consuming massive amounts of calories from both fat and sugar - I think for most people it is important to make a distinction!
I am not convinced that fat calories do not matter - but I think we need to make a distinction about where they come from.
People like Taubes are theorists and actually have no experience with real people - I can see where the problem is for many people - too much food ! So called healthy eating does not say do not eat fat or protein and the funny thing when I analysed quite a few low carbers diets on here they were having less fat than the non low carbers!

Now I have a question for you - low carbers often say - I eat tons of meat and tons of fat. I can never get an answer out of them - how much? I am just curious!
If you are eating loads of fat how are you eating it?
I cannot bring myself to try coconut oil - now this may sound a daft question but if you cook with it what does the food taste of!?

Allyx
 
Re: confussing advice

As someone who always shied away from the idea of calorie counting and analysing food intake in favour of just bloody digging in and enjoy it I am now amazed at the amount of carbohydrate in things. Carbohyrates then convert to sugar and sugar can also be got from other sources.. I take it ’people are consuming massive amounts of calories from fat and sugar (where sugar largely = carbohydrate.) ,,,,Is this right? regardless of which macro nutrient its coming from I think its true to say MOST people are just over eating they just dont realise it. And like you say some get fooled into thinking they are eating well because they choose low fat but the fact is they are still over eating.

But your food diaries…. Are these from people trying to lose weight? Or just regular eaters? Surely on weight loss diets the calorie content (ie no of calories to be consumed) is strictly controlled.

I always knew I ate too much and just told myself and everyone around me…"I LOVE food! "
It didn’t make it ok but it was my best explanation to myself of why I would treat food like I did. After all an enjoyable experience is one likely to be repeated. (and it was!) And ever since being young it was always said I had a good appetite.…(and I understood that to be a good thing.)
My first personal excuse (I LOVE FOOD) made it ok to eat. (After all we all have to, and to eat with gusto -hey why not? ! ) My second excuse "I lack self-control" was more of an explanation than an excuse, an apology to myself of sorts, for being a pig ....and let me tell you at times it was also a big stick to beat myself with: 'Lack of self control,' unlike 'love of food,' was a real negative in my head.
But please; explain what is the distinction between calories from fat and calories from sugar? To a hog like me food is food and the majority of food is lovely! I am classed as pretty obese by someone else’s standards but I generally don’t see myself as obese and generally I’m happy with myself.. But then I sometimes consider other peoples' slimness and have to admit I do find it attractive. And there’d be more choice of ‘nice’ clothes if I were slim so I wouldn’t feel excluded (fatty!). But as I’ve got fatter (and older) I’ve also got unhealthier and there is no getting away from that! And the unhealthier I get it seems the less interested I am in doing and enjoying things. The less I love life.
But to get slim seems to requires giving up my lifetimes hobby (eating) and punishing myself with the thing I love the most. (food)

That was till I discovered low carb…. :lol:

Well to answer your question for me personally:
I have never had the kind of money to be able to indulge in really rich foods. I worked in pubs and restaurants for a few years and was amazed that some people could afford to eat out so often, even order things like steak and then leave half of it. This is not me. Even at home I rarely afford meat other than chicken. or sausages or mince (often the cheaper with high fat content.) I ate margarine (trans fats!) and only occasionally have butter. I cooked with vegetable oils. If I did have a chop I‘d cut the fat off. .Rarely ate nuts but keep some for baking. Used semi skimmed milk and low fat yoghurts. Ate lots of cheese.
Well this was before starting my Atkins diet a week ago.
Since then I only cook with olive oil, eat chicken and mince and sausage as before but not the sliced meats. Now have whole milk and butter - not marg and eat I fish more (esp canned in oil, mackerel, pilchards sardines) and have an occasional avocado. I can’t wait to use nuts but I’m not yet allowed them. I thought livng rural and on low income I thought I would struggle to keep in enough fresh veg to do this diet but I’m finding ways. I haven’t tried coconut oil - My son raves about it but its so expensive. I may eventually try it but its not a priority to me. Olive oil will suffice.
Hope this is helpful to you.
SPARKLES.
 
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