diabetes nurse clueless

deb1960 · Jan 9, 2018

I have just read Michael Mosleys blood sugar diet and I feel like a lightbulb has just gone off in my head! I am type 2 and inject insulin twice daily. My readings have been a bit erratic the last 3 months or so anything from 6..5 to 11. I rang my diabetes nurse today to tell her that I have started the blood sugar diet and to ask her advice about whether I should take the insulin if I'm not having a meal. She was horrified when I told her that I hadn't had any carbs today and told me to eat a crumpet straight away! She told me that they didn't agree with "these fad diets" and told me to eat low GI carbs 4 times a day. Apart from anything else I haven't got crumpets in my house...how remiss of me. I don't have much of an appetite and before reading the book I would eat bread, baked potatoes crackers and crisps oh and crumpets! No wonder I felt ill so much of the time. I need to lose about 5 stone and get my blood sugars down and feel that low carb is the way forward for me. When I told the nurse my readings she said that they were fine as long as I wasn't going over 12 regularly.
I can't help feeling that this advice and attitude made me feel that diabetes wasn't really anything to worry about, just continue with my various medications and accept that I would gradually need more and more medication.

pleinster · Jan 9, 2018

deb1960 said:
I have just read Michael Mosleys blood sugar diet and I feel like a lightbulb has just gone off in my head! I am type 2 and inject insulin twice daily. My readings have been a bit erratic the last 3 months or so anything from 6..5 to 11. I rang my diabetes nurse today to tell her that I have started the blood sugar diet and to ask her advice about whether I should take the insulin if I'm not having a meal. She was horrified when I told her that I hadn't had any carbs today and told me to eat a crumpet straight away! She told me that they didn't agree with "these fad diets" and told me to eat low GI carbs 4 times a day. Apart from anything else I haven't got crumpets in my house...how remiss of me. I don't have much of an appetite and before reading the book I would eat bread, baked potatoes crackers and crisps oh and crumpets! No wonder I felt ill so much of the time. I need to lose about 5 stone and get my blood sugars down and feel that low carb is the way forward for me.

Hi. It is frustrating to say the least. I would stress, however, that while, like many, have managed to get control of my blood sugar levels through a pretty low carb diet...one I could realistically sustain...I did not do so while taking insulin. I would seek advice from others here on how wise it is to really cut carbs dramatically while injecting. I know that with a number of meds (particularly drugs like Gliclazide) the blood sugar can drop dangerously low if the carbs are also very low. I'd suggest recording meter readings before and 2 hours after meals as well as recording the kind of food eaten...but I would really advise you do it slowly and do some further research into the impact of low carbing while on insulin. That said....crumpets? Your naive nurse has probably been on more fad diets that you or I ! Good luck.

Guzzler · Jan 9, 2018

Health Care Professionals are there to advise and they usually stick to the NHS script. It is your decision whether you take that advice or not. She obviously did not answer your question about the insulin and, frankly, I cant because I am not an insulin user but there are many members here who are on insulin and can answer you. You should be commended for trying to improve your health, well done.

Struma · Jan 9, 2018

I think the answer will depend on which insulin you're taking?

LouWilk059 · Jan 16, 2018

deb1960 said:
I have just read Michael Mosleys blood sugar diet and I feel like a lightbulb has just gone off in my head! I am type 2 and inject insulin twice daily. My readings have been a bit erratic the last 3 months or so anything from 6..5 to 11. I rang my diabetes nurse today to tell her that I have started the blood sugar diet and to ask her advice about whether I should take the insulin if I'm not having a meal. She was horrified when I told her that I hadn't had any carbs today and told me to eat a crumpet straight away! She told me that they didn't agree with "these fad diets" and told me to eat low GI carbs 4 times a day. Apart from anything else I haven't got crumpets in my house...how remiss of me. I don't have much of an appetite and before reading the book I would eat bread, baked potatoes crackers and crisps oh and crumpets! No wonder I felt ill so much of the time. I need to lose about 5 stone and get my blood sugars down and feel that low carb is the way forward for me. When I told the nurse my readings she said that they were fine as long as I wasn't going over 12 regularly.
I can't help feeling that this advice and attitude made me feel that diabetes wasn't really anything to worry about, just continue with my various medications and accept that I would gradually need more and more medication.

I was going to just bump this so you could get an answer with respect to your insulin question but I think you should instead re-ask the question in the type 2 forum if the bump doesn't work.

dbr10 · Jan 16, 2018

deb1960 said:
I have just read Michael Mosleys blood sugar diet and I feel like a lightbulb has just gone off in my head! I am type 2 and inject insulin twice daily. My readings have been a bit erratic the last 3 months or so anything from 6..5 to 11. I rang my diabetes nurse today to tell her that I have started the blood sugar diet and to ask her advice about whether I should take the insulin if I'm not having a meal. She was horrified when I told her that I hadn't had any carbs today and told me to eat a crumpet straight away! She told me that they didn't agree with "these fad diets" and told me to eat low GI carbs 4 times a day. Apart from anything else I haven't got crumpets in my house...how remiss of me. I don't have much of an appetite and before reading the book I would eat bread, baked potatoes crackers and crisps oh and crumpets! No wonder I felt ill so much of the time. I need to lose about 5 stone and get my blood sugars down and feel that low carb is the way forward for me. When I told the nurse my readings she said that they were fine as long as I wasn't going over 12 regularly.
I can't help feeling that this advice and attitude made me feel that diabetes wasn't really anything to worry about, just continue with my various medications and accept that I would gradually need more and more medication.

So, absolutely overwhelmed with help and advice then! 12 is way too high. It has been suggested to me recently that I make an appointment with the DN. I have, but am thinking of cancelling it and seeing one of the more amenable doctors instead. I imagine it is because the surgery want paying for an annual review; but, I get so irritated having to listen to someone telling me I can eat porridge and low fat yoghurt full of sugar that I usually feel like exploding.

Dr Snoddy · Jan 16, 2018

dbr10 said:
So, absolutely overwhelmed with help and advice then! 12 is way too high. It has been suggested to me recently that I make an appointment with the DN. I have, but am thinking of cancelling it and seeing one of the more amenable doctors instead. I imagine it is because the surgery want paying for an annual review; but, I get so irritated having to listen to someone telling me I can eat porridge and low fat yoghurt full of sugar that I usually feel like exploding.

Bit like my my DN congratulating me on getting my HbA1c consistently into the mid 30s but telling me that I could afford to go into the 40s because I was a diabetic! She then said that she wished that all her patients could do as well as me. I resisted telling her that I had largely ignored her outmoded NHS advice. Thank heavens I stumbled across this forum and found a young, recently-trained dietician who agreed with a LCMF approach!

ickihun · Jan 16, 2018

@deb1960 I low carb and take insulin.

I think just bad timing on your part with your question as one 'removed' member first told us he was type2 then on insulin then dramatically died. Of course a con man (and his wife).
Which has left a nasty taste in our mouth and may have dampened our enthusiasm to post heavily with the same advice.

Low carb eating is fantastic for keeping your insulin needs to its minimum. Injected insulin too.

The advice thou comes with strong advice on reducing your insulin at the same time as hypos can occur, nasty ones at that.
You've seen the support most DNS give to low carbing.
You're on your own which is where this brilliant forum used to replace that lack fantastically.
Until 'the con'.

I can try and help you but I'm advised by mods never to give medical advice. Rightly so as we are not medically trained.
However I can tell you what I do and how I've lost nearly 4st and reduced my insulin need. Is that any help?

dbr10 · Jan 16, 2018

Dr Snoddy said:
Bit like my my DN congratulating me on getting my HbA1c consistently into the mid 30s but telling me that I could afford to go into the 40s because I was a diabetic! She then said that she wished that all her patients could do as well as me. I resisted telling her that I had largely ignored her outmoded NHS advice. Thank heavens I stumbled across this forum and found a young, recently-trained dietician who agreed with a LCMF approach!

Yes. It's unbelievable.

dbr10 · Jan 16, 2018

ickihun said:
@deb1960 I low carb and take insulin.

I think just bad timing on your part with your question as one 'removed' member first told us he was type2 then on insulin then dramatically died. Of course a con man (and his wife).
Which has left a nasty taste in our mouth and may have dampened our enthusiasm to post heavily with the same advice.

Low carb eating is fantastic for keeping your insulin needs to its minimum. Injected insulin too.

The advice thou comes with strong advice on reducing your insulin at the same time as hypos can occur, nasty ones at that.
You've seen the support most DNS give to low carbing.
You're on your own which is where this brilliant forum used to replace that lack fantastically.
Until 'the con'.

I can try and help you but I'm advised by mods never to give medical advice. Rightly so as we are not medically trained.
However I can tell you what I do and how I've lost nearly 4st and reduced my insulin need. Is that any help?

Good grief. Didn't realise that.

deb1960 · Jan 16, 2018

Thanks all. It's a shame that someone has to try to con you. What would they achieve? I've been really poorly since about 11pm last night with vomiting and diarrhoea. My husband had started with it on Saturday night. I've only been able to sip water all day. I did my bg about 11am and it was 8.4 so I haven't taken any insulin or metformin. I'm frightened of even having a cup of tea.

deb1960 · Jan 16, 2018

Oh and to add insult to injury it's my birthday today

NaijaChick · Jan 16, 2018

@ickihun Pls can you tell us how you changed things around. Thanks

ickihun · Jan 16, 2018

deb1960 said:
Thanks all. It's a shame that someone has to try to con you. What would they achieve? I've been really poorly since about 11pm last night with vomiting and diarrhoea. My husband had started with it on Saturday night. I've only been able to sip water all day. I did my bg about 11am and it was 8.4 so I haven't taken any insulin or metformin. I'm frightened of even having a cup of tea.

Were you advised no metformin at tummy upset times, like me? We had that bug in Xmas week. I felt at the time I was never going to feel normal again. Just keep in mind these bugs are normally fast to come on and fast to go. Keeping hydrated any way you can can help after hours of upset. Do you take multivitamins normally? I have too, especially in the winter.
That 8.4 increases on me without meds. What happens for you when not eating? Does your basal injection stop any increase? I think my basal needs increasing to cover liver dumps as its not at the moment.
I've stopped losing weight but once again I think due to not having enough basal to keep my bgs perfect.
I'm keen to lose more. As much as possible before bariatric op.
Keep warm and hydrated til your bug goes. I ended up with laryngitis afterwards.

deb1960 · Jan 16, 2018

I've just pretty much given up on obvious carbs ie bread, potatoes, pasta etc. I haven't looked into carbs in other foods yet. I do have jumbo oats for breakfast and that usually sees me through to my evening meal. I love bread but I think I'm better off not having any as I probably wouldn't be able to stop. I can't believe how quickly the low carbing has had on my readings.

deb1960 · Jan 16, 2018

The 8.4 was today when I haven't eaten anything since dinner last night. It has been about 4.5 to 6 since I cut out the carbs.

ickihun · Jan 16, 2018

NaijaChick said:
@ickihun Pls can you tell us how you changed things around. Thanks

I had to take enough insulin to gain perfect bgs and after a few days I started losing 1kg per week. I used protein based meals not carb based. I kept to a fairly low fat diet with metformin ticking me along nicely. I must admit my weight loss started on humulin M3 not toujeo300. I was very intense in my testing to encourage no big spikes.
I'm looking to mimic this for weight loss this year too. Currently I'm not losing but I'm using more novarapid and need to increase my basal so its just right.

ickihun · Jan 16, 2018

deb1960 said:
The 8.4 was today when I haven't eaten anything since dinner last night. It has been about 4.5 to 6 since I cut out the carbs.

How sensitive to your novarapid are you? What does 10units of it do to your resting bgs normally? I have to take 15units to bring an 8 down to 5 in resting and no food. On a morning I'm more insulin resistant so 25units helps in resting and to reduce 8s. Because we are all different everyone will have different unit needs.
I'm hugely insulin resistant.

ickihun · Jan 16, 2018

deb1960 said:
Oh and to add insult to injury it's my birthday today

Happy Birthday Debs!

ickihun · Jan 16, 2018

deb1960 said:
I've just pretty much given up on obvious carbs ie bread, potatoes, pasta etc. I haven't looked into carbs in other foods yet. I do have jumbo oats for breakfast and that usually sees me through to my evening meal. I love bread but I think I'm better off not having any as I probably wouldn't be able to stop. I can't believe how quickly the low carbing has had on my readings.

I love low carbing. It has given me my confidence back in my diabetes management. Irrespective of hospital advice on diet. None of it works for me.

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