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Definition of Diabetes

Couldn't sleep, so went to look at the diet booklet I was given by the DSN.

What a shock! It is published by Diabetes UK, so here is what it recommends for breakfast.

Eating well with Type 2 diabetes
Breakfast cereals

All breakfast cereals are fine. More filling choices, like porridge and All-Bran or fruit and fibre, will see you through the morning. Add semi-skimmed or skimmed milk, and try adding fruit to notch up a portion towards your five-a-day target early in the day. You can use any fruit and it can be fresh, frozen, stewed, canned or dried.
Juice

A small glass of unsweetened fruit juice can count towards one of your five a day, but no matter how much you drink, fruit juice can only count as one portion in any one day. Some people find it affects blood glucose levels quickly so it’s not the best choice for quenching your thirst.
Bread, muffins and crumpets

Bread, toast, bread muffins and crumpets are good alternatives to cereal. All are fine but wholegrain and granary versions are better for making you feel fuller for longer. Choose a low fat spread or one based on monounsaturated fat. Ordinary jams and marmalades or reduced sugar versions are okay too.

And the justification for pumping the carbs?

Why does my body need carbohydrate?

Carbohydrate is the body’s preferred source of energy in the diet. All carbohydrates are broken down into glucose, which is essential fuel for the body – especially the brain. High-fibre carbohydrates such as wholegrains and fruit play an important role in the health of the gut.

I am almost speechless.
 
Trust your health service (what) I would rather walk blind folded across the M6 at rush hour than eat all those Carbs. I just threw that in the bin and told the NHS dietician I was on low carb diet, she was ok about it once I showed her all my own charts and readings regarding BG control and food intake. She then discharged me I will have round two with my DSN in August she will be a different story, I am expecting fun and games with her; Nelly know it all, Yes from 30yrs ago.
 
My DSN was a bit pompous and patronising too. She was talking to me in deliberate, slowed-down speech, and treating me like a doddery old fool. My first thought was "Do I really look that old?"

I would really like to find out WHY they are still issuing this booklet. It's absolute ****.
 
If you go back a few posts Borofergie explains why, and it's out of date ****, even if you go on most BG meter sites they are peddling the same ****. I think it is criminal that they are telling Diabetics this information and not giving them the whole truth, or informed education and that also apply's to those that are not DB. I have read lots of material and looked all over the Internet, listened and watched Dr Richard Lustig, Andreas Eenfeldt, and many more, their conclusion all! put the brakes on the Carbohydrate intake. Yet the NHS just quote the NICE guidelines, It is so irritating. If you go through this forum you will find masses of good sound information ask any of the prolific posters what they think of NHS diet and they all will say the same. BIN IT.
 
Since my diagnosis at the start of May I have lost 26lb in weight, my energy levels have bounced back, I am exercising for 2 hours 4 times a week now at Gym, do a full weight circuit and 30mins on treadmill 15mins of swimming, sauna and steam bath, and feeling better than I have done in years. And that is not on NHS diet but low carb diet, I just up my fat and proteins to compensate for what I am burning. after training my BG drops to the low 4'rs and does not go above 4.8 even after eating my meal after training. It's hard work but paying dividends. To add to that I was diagnosed with Hypertension 7 years ago BP always in the 130/78 range I am now getting 115/68 readings so I must be doing something right.
 
Sorry - not sure how I got two posts out of one.
 
You certainly must! That's fantastic.

One point about blood pressure, though. 130/78 is by no stretch of the imagination hypertension, not in terms of health risk. This is something I know a bit more about, as it was a major topic in my ethics module. Years ago the recommended pressure was 140 or less, and then this was revised down to 130. Not satisfied with the vast number of new 'patients' that created, the drug industry produced a further category called 'pre-hypertension'. Anyone between 120 and 130 had this. They couldn't call it hyper, because there was no evidence that it carried any health risk, so they had to label it to imply that anyone with 120-130 was at enhanced risk of going over the 130 mark in future. Hence the 'pre', which carries connotations of an inevitable progression.

Again, there was no evidence that being 120-130 was in any way the cause of a future increase. Statistically, because many people were already experiencing a steady rise in BP for various reasons, many 'pre-hypers' would end up as hypers, but there was no identifiable causal link between being pre and being hyper.

Finally, by another very clever sleight of hand, the new recommendation based on the 'pre-hypertension' alert was that it was preferable to see a pressure well under 120.

The whole thing about blood pressure categories is a scam fuelled, again, by corporate greed. The Ray Moynihan book has a good chapter on it.

http://books.google.co.uk/books/about/S ... 2ihjm_kwsC
 
Hi Bellx15. I think the NHS position on carbs baffles most of us. It is obviouly plain stupid and dangerous but it makes you realise how much 'group-think' influences many in the medical profession. The food lobby is always lurking in the background throwing in mis-information. There are many issues with the way GPs work i.e. they prescribe rather than measure and listen hence there isn't a closed feedback loop that you need when applying any management process. My db GP said she has 500 db patients (which is a ridiculous number) and when I challenged my diagnosis and diet etc she claimed with that number of patients she was the expert. Did she listen to my feedback ref diet? No, of course not so even with that number of patients she wasn't learning. Do GPs have any time to read research papers, look at this forum etc? Of course not so the treadmill continues churning out the same old dated nonsense. Sadly I see nothing that can stop this broken process and all we can do is carry out our own research and take control.
 
Hello Daibell -

that name has a certain ring to it!

Yes, you've said all the things I wanted to say but was afraid to. The idea of us knowing better than the GP, and 'having to take control', smacks superficially of arrogance, denial, conspiratism, etc., so I hesitate to stick my neck out. But you are right; we do know better about our own case, and in some respects about the general case (e.g. diet), than they seem to.

Perhaps you could have asked her: "Really? So without listening to all those patients, how have you become such an expert on them?"
 
Yes I am of the same opinion re blood pressure, yet they shoved me on tablets and told me it was high at 135/ 80 and here I sit at the mercy of my GP, but I will not let him win over my diet and BG. I intend to drop the BP medication soon. But again I am only getting this control because of eating correct diet and exercise. Which if we are all honest, is nothing more than being normal human beings and doing what we where designed to do. Hunt, Foraging, eat, propagate, and sleep.
 
It can't, and the added risk to health is zero. For diabetics, zero multiplied by any factor you care to conjure up is zero too.

On every medical front we are under pressure to keep those readings down - it's a scam. Blood cholesterol is another example.
 
On the carbs thing - I suspect one motivation is that for obese people with a very poor diet, changing them to a healthy diet for non-diabetics is likely to lead to a significant improvement in weight control and overall fitness.

[It does, of course, put them right down the route of haevily marketed 'healthy' foods.]

Going really low carb is likely to be such a radical change that there would be a very small takeup so the 'healthy diet' is seen as a workable compromise; not ideal but reasonably achievable.
It also means that all the training and all the literature and publicity can focus on a single message; "This is a healthy diet".
Some of our HCPs advising on diet may not have the breadth of intellect to take on board a more complex approach.

However there should be a seperate category of advice for people with diabetes who are in the 'normal' BMI range with a reasonable diet - a sort of Stage 2 of diet control.

This is the bit which seems to be mainly missing.

Cheers

LGC
 
LittleGreyCat said:
.
Some of our HCPs advising on diet may not have the breadth of intellect to take on board a more complex approach..

LGC
Click to expand...

You mean they don't have the bandwidth
 

I agree with you - to an extent - about cholesterol, but I'm pretty sure that the same thing is not true of BP.

High blood-pressure will literally take years off of your life.

S.
 

Actually scrub that, you were right, I was wrong:
http://summaries.cochrane.org/CD004349/ ... beneficial

(another example of how the consensus medical opinion is wrong).
 
I agree, but it is the level set as 'normal' or 'healthy' that is in question.

Good find.

Mind you, there is an important point to make here: There is firm evidence that in epidemiological studies heart problems, etc., are clearly linked to blood pressure. The lower the BP, the less the likelihood of such problems. But that is not the same as BP lowering by clinical intervention. There is no evidence that intervening to bring BP down below 140/90 has any benefit.

I am sure there are a number of ways these findings might be interpreted. The most obvious one is that BP in epidemiological studies is typically associated with other disorders, and that it is either one or more of these, or else an underlying cause of the associated cluster (e.g., lifestyle differences) which are causally linked to heart problems. I don't know what the ultimate explanation for the BP findings is, but the point is that lowering the BP by clinical intervention has been shown to have no benefit.

My intuition is that any BP lowering by way of a healthier lifestyle will be beneficial to health. It would be interesting to see whether a parallel study has been done for blood glucose levels. Again, it might be that BG reductions achieved by a change in lifestyle are beneficial, but reductions achieved by clinical intervention are not. I simply don't know.
 
Hello Bellx15,

You are right in you intuitions relating to blood glucose. The ACCORD (Action to Control Cardiovascular Risk in Diabetes) study was conducted by the NHLBI (National Heart, Lung, and Blood Institute) and completed in 2008. More accurately it was stopped on Feb. 6, 2008 due to safety concerns for exactly the reasons you laid out in your last posting. Aggressive lowering of serum blood glucose levels by various pharmaceutical agents were found to cause an increase in total deaths from any cause over those being treated in the "traditional treatment" group. People in the aggressive group were being targeted for an A1c level of 6 or below vs. the 7.0 to 7.5 treatment goal of most medical professionals in standard settings.

I've reviewed the conversation string here and find many of the points discussed here are shared among the dozens of chronic T2's I talk to every week. I don't know how beneficial the definitions are you are struggling with; rather the important point is that most T2's will respond to "self lifestyle intervention." Not all T2's fall into this category as some bloggers have pointed out, but most will. T2 is a progression that is part of the Western lifestyle and the only real question is when are we going to deal with it on a personal basis--know enough about the disorder before it manifests and eliminate most processed foods of any kind and get fit, or wait until blood glucose levels rise (over 50% of the ballgame is over by then) above normal and try to deal with what we should have been doing all along then.

I can tell you this. From my experience, chronic or even newly-diagnosed T2's must take responsibility for their own behavior. You cannot rely on traditional diabetes treatment recommendations to help with T2. Obviously, you are receiving equally as bad dietary information from your medical professionals in the U.K. as we are in the U.S. As I tell people, reversing the symptoms of T2 for most people, is not rocket science. And even for those T2's who do not see complete symptom reversal with proper lifestyle change, the health benefits will be very significant. A healthy discussion from a number of well-informed people. My hat is off to all of you for stepping up and making a difference in your lives.

Ken Hampshire
Denver, Colorado, USA
 
Hi everyone - just back to report on progress!

I have not been on any meds. All I have done is go a bit steadier on the sweet beer, and also kep[t to a low-sugar diet and tried to do some daily exercise. Also lost a couple of kilos.

Latest blood test readings - all normal!!! Just now I got a preprandial 4.8. I have at the very least established that it is quite easy for me to control my blood glucose without meds and living a normal life. So I'm elated, of course. My intuition turned out to be true.

Here's the shocker. The 'Diabetes Nurse' at the local GP practice told me that:

1. I am still a diabetic. Why? Because of those high readings six months ago. So how long do I have to labour under this label? For life. So what makes me diabetic when, leading a normal lifestyle, I get normal readings? Answer: If you were to consume excesses of carbs or sugar you would see high levels of BG again. Ergo - diabetic for life. A non-diabetic would not get those levels under any circumstances.

2. Diabetes type 2 is progressive, so we'll just have to keep monitoring you to see how you get on.

3. Low carb and higher protein diet is no good - protein does not supply your body with energy!! You do need the carb ratio advocated in the NHS literature.

At this point I thanked her for her time and made for the door. "I won't be back unless I see my BGs going back up", I said.
 
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