Diabetes care depressingly poor

1. Blood glucose level measurement
2. Blood pressure measurement
3. Cholesterol level measurement
4. Retinal screening
5. Foot and leg check
6. Kidney function testing (urine) (ie for protein/microalbuminuria)
7. Kidney function testing (blood)( ie creatinine levels)
8. Weight check
9. Smoking status check

The original reports
1) from DUK (there are actually what they call 15 Healthcare
Essentials which include the above checks and others like access to education)
http://www.diabetes.org.uk/Documents/Re ... n-2012.pdf
2) National Audit Office: full report including stats and list of Percentage of people with diabetes receiving all nine care processes in 2009-10, by primary care trust
http://www.nao.org.uk/publications/1213 ... vices.aspx

I too saw this on tv. But what actually does it mean. Ok so maybe not all the tests are being done, but surely that is only preventative measures, its not actually going to stop feet being chopped off or people going blind, its only going to make them aware that it will happen imminently. The appalling lack of advice about diet is what is going to kill people.

Whatever works for you, Mongoose39uk. We are all different!

Personally I enjoy eating low-carb, and exercise is unfortunately not an option for me - I can't do enough, even simple walking, to have much affect on my BGs.

Viv 8)

phoenix said:

1. Blood glucose level measurement
2. Blood pressure measurement
3. Cholesterol level measurement
4. Retinal screening
5. Foot and leg check
6. Kidney function testing (urine) (ie for protein/microalbuminuria)
7. Kidney function testing (blood)( ie creatinine levels)
8. Weight check
9. Smoking status check

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Are these listed in order of importance Phoenix? If so then it's an impressive list. I like the fact that "weight check" is down the list, and that BG, BP and Cholesterol are at the top.

My impression of the current standard NHS advice is that cholesterol is at the top, and that weight is nearer the top.

borofergie said:

phoenix said:

1. Blood glucose level measurement
2. Blood pressure measurement
3. Cholesterol level measurement
4. Retinal screening
5. Foot and leg check
6. Kidney function testing (urine) (ie for protein/microalbuminuria)
7. Kidney function testing (blood)( ie creatinine levels)
8. Weight check
9. Smoking status check

Click to expand...

Are these listed in order of importance Phoenix? If so then it's an impressive list. I like the fact that "weight check" is down the list, and that BG, BP and Cholesterol are at the top.

My impression of the current standard NHS advice is that cholesterol is at the top, and that weight is nearer the top.

Click to expand...

No idea. They use exactly the same list in here in France (hence I'm sitting here with a 24 hour BP monitor; it always goes sky high at my appointments so she makes me have it done every couple of years) I would think they are all equally important.

I did find this table in the audit which shows that the macrovascular complications are far more numerous

Mongoose39uk said:

Exactly Viv we are all different. What works for one will not work for another, it does not fit their life or body. I am getting a tad ticked with some peoples low carb is the only way. For some the NHS diet works. OK, it should be one of a range of options and I am glad the dietician discharged me before I called her an ill educated moron who could not be ***** to deliver research based care but there you go.

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I don't think that Low-Carb is the only way (although I think that some form of carb control is the only way, other than intensive medication).

Who does the NHS diet work for? We don't see many examples on this forum...

borofergie said:

Who does the NHS diet work for? We don't see many examples on this forum...

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didn't work for me... I followed it when I was told I had impaired glucose tolerance (ie. pre-diabetic) and I believe it actually made me T2 diabetic...

Mongoose39uk said:

I was aware of the 9 points and have to say my GP practice have gone way beyond this. The only **** service I have had, has been the dietician. I don't think there was any bit of me that had not been poked, prodded and tested by the end of week 2 from confirmation of diagnosis.

My point a bout the 9 points is if your one of the people getting **** service you see this article and you still don't know its **** care if they don't tell you what you should be getting. I dare say a lot of people go get the pills once a month and think that's it.

I here what you say about diet. I have seen the strict low carbing some people on here advocate. Its shouted loud enough. For me thanks for the advice but no thanks. My BG is going the right way with a few amendments to a normal diet and a good bit of exercise. Low carbish but not so strict.

Sorry I want to live not exist and for me the low carb diet would be merely an existence.

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I'm glad there is someone else who says they won't strictly low carb. I have tried it but cuts out too much food I like. I certainly wouldn't be able to eat like that for the rest of my life!

I'm glad there is someone else who says they won't strictly low carb. I have tried it but cuts out too much food I like. I certainly wouldn't be able to eat like that for the rest of my life![/quote]

This is a little unfair. There are many people here who don't STRICTLY low carb .but will use a variety of ways to reduce their bg levels. You see more discussion of low carbing because some mebers like to experiment and others need help in dealing with it when they are new o the concept. Others have their own ways of dealing with it. I don't think it necessary for everyone to formally register how hey cope. Why on earth should anyone be afraid to post that low carb doesn't work for them?
Many have done so in the past.

For myself I use a combination of small portions Low GL and reducing starchy carbs, And I'm not and have never been afraid o say so.

perhaps you might like to post a question about this to see how many brave and fearlkess posters here are here.
Perhaps you have never noticed the constant repetition of the sentiment "whatever works for you"?

You seem to be making various assumptions. Different things suit different people and this can change at different imes.

If you don't like the low carb hreads then don't read them. Its not obligatory. I found a diet that suited me - it was acually my original diet before the NHS started to interfere and I have never been overweight. That is all any of us can say. It works for us..
It is interesting to me to read the experience of others to learn more about it .

I can't imagine which thread and which posts you have been reading. If people wanted o follow the GI way of eating they would be gal ad of tips from those experienced in it . Anything that helps people to gain and maintain good bg control must be worth telling others about. There is no compulsion for anyone to follow he low carb route. How could here be.

Good luck to anyone who finds a susainable way of conrolling their bg levels. However they do it. Why should anyone say otherwise?

Mongoose39uk said:

I get the feeling people it works for would be frightened of saying so on this forum. Me, it works for though I have chosen to modify it slightly from preference.

So no you won't find many on here, just look at the attitude I have gotten for even daring to mention it!

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Hi Mongoose,

I am trully interested to hear from those where the NHS diet has worked, hopefully with minimum med intervention. I would love to know that it can work, you're right,the most we hear from is the success stories of low/moderate carbers.

On diagnosis I decided I didn't want to add to the meds I was already taking and set about trying to control my BG;s myself. I tested and adjusted and by eating to the results ended up not eating 'added carbs'. It's all my own decision and I find the benefits of eating in this way far out-weigh going on an ever increasing regime of medication. Who knows a) how long I can maintain it - I certainly enjoy it currently and can't see me stopping :?: b) whether my body will need medication anyway in the future, even if I maintain low carbing. :?: I'm only 44 and I want to delay any 'progression' as long as its in my power.

For those who choose to not low carb - great, your decision. It is a personal life choice on what you are willing to do/want to do/can do.

I re-iterate I'm really interested to hear the non-low carb success stories because you're right it's very biased towards low-carb successes, surely it can't be becuase they are the majority of successes (not being sarky) I hope those who have had great results without cutting carbs or taking loads of meds would feel comfy to share as others may wish to share those tips?

Mary x

Sarah69 said:

I'm glad there is someone else who says they won't strictly low carb. I have tried it but cuts out too much food I like. I certainly wouldn't be able to eat like that for the rest of my life!

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That's true. But please be aware, especially as a diabetic, that your choice of what you eat has a direct influence on exactly how long "the rest of your life" will probably be.

I wonder what happened to my post suggesting that c-peptide was an essential additional test.

I think a little obsession isn't a bad thing in the short term. The retinopathy letter and the DN's attitude spurred me to fight back. It aint just diet and it ain't just exercise, it what kind of each you indulge in. I have my ppBGs and the fasting one mostly under 6 these days and I drank a Lucozade for a test of 4.9 two hours later. I just hope my meter isn't broken.

My real regrets are the damage done by B12 depletion and the possibility that the sight damage is irreversible.

Give up drinks like Coke, including the diet sorts and don't touch juices, most are fructose sweetened with fructose.

Hi Mongoose39uk and Mary

Okay, I'll join you Mongoose... I don't low carb either and, like you, I sometimes find that when I post, low carbers immediately mention carbs, like when I posted something about fruit smoothies with semi-skimmed milk recently and another post I read where someone was happily sharing his wife's cake recipe. At first I was annoyed but then I thought to myself, it's okay, they're just flagging up that semi-skimmed milk is quite carby for those following low carb.

For myself, I was diagnosed 6 months ago. My DSN suggested I swap white for brown, eat porridge instead of sugary cereals, eat fruit and vegetables, continue to eat bread, pasta, rice, etc but brown rather than white. I do all of those things. I would say I'm probably what you would call 'reduced carb' - I probably eat between 120-180g of carb a day. I eat smaller portions of food though and I eat more vegetables and fruit. Bananas and oranges don't work for me but berries, apples and pears do (and I know the former are low carb and the latter relatively high carb - but my BGs are fine when eating them). I eat Burgen bread (but other breads tend to spike my BGs). Pasta, rice and even potatoes don't give me high spikes but I eat relatively small portions (about 80g). I eat biscuits (rich tea fingers and even shortbread fingers) but can only eat 1 as a serving. I don't drink fizzy drinks (not even diet ones). I don't drink milkshakes. I mostly drink water, with maybe 2 cups coffee or tea a day.

I find it interesting to read about people's adventures with food on the forum but I take only what I need from them - I still learn a lot of useful things, like using lactose free milk as a carb reducer - but from all of my reading on here the biggest thing I've learned is what everyone says... everyone is different and you need to find your own way by testing/experimenting (and we should respect that, I think).

My stats - 27 mmol/L at diagnosis in May 2012. Average daily BG levels now - around 4-5 mmol/L morning fasting with a range of 4-7 across the day, average 5-6. I sometimes get things wrong and will get a spike to around 8-9 mmol/L but usually only if I try something new or a food I know is going to spike it, like if I'm being naughty with a cake or something.

I find the idea of high fat, low carb difficult because if you have other issues to deal with high fat or high protein can be an issue (like if you have problematic kidney function or something).

Following my own experiments and a low cal (1200 a day) diet with 5 mile a day exercise I've lost 2.5 stones since diagnosis (and lost 2 stones prior to diagnosis simply through having diabetes) including time off (don't diet when on holiday) - had a month off in October when I was fed up with dieting - didn't lose weight but didn't put any on either so that was quite pleasing. Back to diet/exercise now in a bid to shed final stone to get me to my ideal weight, after which I plan to keep up the exercise but gradually return to the recommended daily intake of calories of around 2,200.

Medication: I was on 3 metformin and 2 x 12 units insulin for first 6 weeks after diagnosis, then insulin was removed and metformin reduced to 2 x 500 mg daily. I was on statins for a month but then gave these up as I was unhappy taking them. They did reduce my cholesterol levels from a high of 7 to a low of around 2.5 but since giving them up, with my diet, I've stayed within the normal range and currently have a total cholesterol of 4.6, with an HDL ration of 3.6. First HbA1c - aug 10 was 45 (6.2) which I was happy with. Next one due end of this month, so hopefully it will have come down a little more, to within the 5% club.

Anyway, just wanted to say, great to have this thread and a chance to share our views on what food we eat and what it does for us, whether we are low carb or high carb or reduced carb... at least we all have one thing in common - we're all diabetics at heart (or should that be diabetics in the pancreas). :lol:

I think Whelks post is great. That's the right atitude. Tke wht you can from the forum but do what you find o be the right thing for yourself. Don't take the enhusiasms of others as a criticism of yourself or as an attempt to indoctrinate you.

The thing is to remeber that theis forum has been going for some time. It didn't start at the point most of us began to post.
Like everywhere else it has a history and things change very quickly. People who only began to post bout year ago are now forum stalwarts and are being challenged by the newcomers.

Tha s fine , of course but everyone ges bored constantly hbving to explain themselves and regurgitte everything they hve sid in the pst. New posters will get far more from he forum if they empt to red past opics. little research doesn't hur but helps o vaoid misunderstndings.