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Diabetic Nurses - Discuss

Discussion in 'Diabetes Soapbox - Have Your Say' started by LoubyLou 2, Oct 13, 2018.

  1. LoubyLou 2

    LoubyLou 2 Type 2 · Member

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    Are they are all super rigid bossy types? Does that type of personality attract them to the role? Or do they just treat everyone with the same manner, because the majority don't listen to them anyway?

    Also why are they so rigid in their viewpoint against the Low Carb diet?

    Discuss....
     
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  2. urbanracer

    urbanracer Type 1 · Expert
    Retired Moderator

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    1/ Mine isn't.
    2/ I imagine that a nurse's basic training probably includes some coaching on how to deal with Joe Public without becoming emotionally involved.
    3/ They can't openly endorse LCHF because it's not NHS policy. If some decide to accept new models then they are essentially breaking ranks.
     
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    #2 urbanracer, Oct 13, 2018 at 11:03 AM
    Last edited: Oct 13, 2018
  3. Squire Fulwood

    Squire Fulwood Type 2 · Expert

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    One of the first things my DN said to me was that she wished the dietitians would stop telling people to eat more carbs and that was in 2009. She is not bossy and knows her job very well indeed.

    She acknowledges that she has to toe the party line but there have been times when she was not happy doing it.
     
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  4. Johnroy

    Johnroy Type 2 · Well-Known Member

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    Its like most things in life they are not all the same and that goes double for people. My DN for my recent review was not only positive but fully encouraging wanting to know about what I ate and of course lifestyle, and not negative in my response of statins or use of blood pressure tablets. Also making a further appointment for three months time to see if I am maintaining my results. In all departed on a high. Fully appreciate from posts not all get the same treatment.
     
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  5. eventhorizon

    eventhorizon Type 1 · Well-Known Member

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    My DN is lovely. She freely admits that after 20 years I probably know how to look after my t1d better than she does but still always available for frank, open and various treatment / care options. Similar experience with my endocrinologist as well.
     
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  6. Deleted Account

    Deleted Account · Guest

    My DN is amazing.
    She gave me the best diabetes advice I have ever received: “diabetes should not stop you doing what you want”.
    I have pushed that advice a few times and she has been there to help with how to manage my BG at altitude (when walking in the Himalayas), how to stop the spikes when rock climbing, what o do when I am seasick when sailing across the channel and can’t keep anything down, what to consider when tracking gorillas in Uganda (dealing with the heat, managing contagen, etc) and how to walk 26 miles through the night a couple of months after diagnosis.
    My attitude (and management) to diabetes could be very different if she was not one of the first people I met.
     
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  7. Smallbrit

    Smallbrit Type 2 · Well-Known Member

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    This is a bit of an odd thread to post a welcome message on, but seeing as it is your first message, I'm tagging @daisy1 for her welcome info email.

    My answer:
    1) Happily my DN was the opposite - nice to the point of being useless, as she never went anywhere near close to giving me targeted advice - if prediabetes numbers were edging high towards T2, "eat more healthily, exercise more". Which I suppose is better than telling me how and advocating carbs.

    2) I have no idea what her thoughts on carbs/low carbs were as my DN retired. To be replaced by my GP who seems to want to add wholemeal bread entirely for the 'niceness of eating it' factor, but has taken my feedback of what one slice does to my blood sugar numbers as proof that doesn't work for me. And that if we're going with niceness of eating, then I'm not using wholemeal bread as my 'treat'!
     
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  8. Phoenix55

    Phoenix55 Prediabetes · Well-Known Member

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    My DN and I took agin each other at the first meeting.
    1) I must be eating lots of biscuits, cakes and desserts, drinking fizzy pop, not enough veg, wholemeal pasta, baked potatoes etc. I had been following the low fat, 5 portions of veg a day for years. No more than one pack of biscuits a week (at that time now I can't remember the last time I bought any) Over the entire previous year I had treated myself to two bottles of 'pop'. In short she was a fully paid up member of the Eatwell plate.
    2) Then diabetes must run in my family, neither of my parents have/had it , I have done the research and there is no trace of it. Heart disease yes on both sides of the family, diabetes no.
    3) When I buy a ready meal was I aware of the traffic light system? My last ready meal had all green except for salt (it was liver and bacon).

    I have learnt more about diet from my mother (SRN from 1950's) and online here combined with my own testing regime. After a couple of appointments my dn and I have not met. It is a sad tale but true. I monitor my own bg closely and have promised myself that I will seek help if the numbers start to creep upwards, but so far LCHF is working a treat except during a period of hot weather, but in the cool of the autumn things have returned to normal.
     
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  9. hankjam

    hankjam Type 2 (in remission!) · Well-Known Member

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    My current one is really really on the ball, full on interaction, happy to listen happy to give. We could have some interesting discussions on my high TC's but I'm not holding that against her.
     
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    #9 hankjam, Oct 13, 2018 at 1:47 PM
    Last edited: Oct 18, 2018
  10. Dr Snoddy

    Dr Snoddy Type 2 · Well-Known Member

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    I met a new Health Care Assistant yesterday who now has responsibility for diabetic patients at my surgery. Unlike the last one who was largely indifferent and whose notes on the consultation were a fabrication, this young lady was on the ball. Having congratulated me on maintaining normal blood glucose since shortly after diagnosis 4 years ago she asked me how I did it. I explained about LCHF. I could see that she was not convinced but at least we had a discussion. I asked why the NHS sticks to its current dietary guidelines. She was open about the levels of non-compliance generally amongst local Type 2 diabetics and her efforts to get people to at least reduce their carbohydrate and saturated fat intake and/or change their dietary sources of these macronutrients. I had some sympathy for what she is up against and more insight into the problem of those people who cannot or will not change their lifestyle.
    However, according to this website, many people are trialling low carb diets and hopefully the NHS will change it guidance soon. Lots of NHS staff are having to compromise between the official guidelines and an increasing body of contradictory evidence.
     
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  11. Guzzler

    Guzzler Type 2 · Master

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    "... the majority don't listen to them anyway"

    Depends very much on what the majority are being advised, don't you think?
     
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  12. daisy1

    daisy1 Type 2 · Legend

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    @LoubyLou 2
    Hello LoubyLou 2 and welcome to the Forum:) Here is the Basic Information we give to new members and I hope you will find it useful. Ask questions when you need to and someone will help.


    BASIC INFORMATION FOR NEW MEMBERS

    Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

    A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 235,000 people who are demonstrating this.

    On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

    The role of carbohydrate

    Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

    If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

    The bad news

    Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

    The good news

    People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

    Controlling your carbs

    The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

    There are two approaches to controlling your carbs:
    • Reduce your carbohydrate intake
    • Choose ‘better’ carbohydrates
    Reduce your carbohydrates

    A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

    The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

    Choosing better carbohydrates

    The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

    Read more on carbohydrates and diabetes.

    Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

    Eating what works for you

    Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

    To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

    The blood sugar ranges recommended by NICE are as follows:

    Blood glucose ranges for type 2 diabetes
    • Before meals: 4 to 7 mmol/l
    • 2 hours after meals: under 8.5 mmol/l
    Blood glucose ranges for type 1 diabetes (adults)
    • Before meals: 4 to 7 mmol/l
    • 2 hours after meals: under 9 mmol/l
    Blood glucose ranges for type 1 diabetes (children)
    • Before meals: 4 to 8 mmol/l
    • 2 hours after meals: under 10 mmol/l
    However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

    Access to blood glucose test strips

    The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:
    • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
    • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

    Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

    You may also be interested to read questions to ask at a diabetic clinic.

    Note: This post has been edited from Sue/Ken's post to include up to date information.
    Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

    • Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why

    • Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
     
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  13. therower

    therower Type 1 · Well-Known Member

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    On a personal level I’ve had dealings with 2 DSN’s. The first was on my second day of diagnosis 27 yrs ago. She spent a good 6 hrs with me. The advice she gave me set me off on the right foot going forward. Over the years I’ve learnt more and some things from that day weren’t quite right, but the information was given with all the best intentions. The underlying message she gave me was that diabetes was controllable and not the end of the world.
    My second DSN meeting was within the last year. I was asked if I would visit a DSN by my consultant on account I was using a CGM and my experience with it might be beneficial for others. My meeting with this DSN was unbelievable, probably the best hour talking diabeties with anyone.
    In between these 2 DSN meetings I’ve had countless DN meetings at my local GP surgery.
    Some of these DN’ s have been very pleasant, some inquisitive, some uninterested.
    One thing all the DN’s I’ve met have in common is an extremely basic knowledge and insight into type 1 diabetes.
    It always feels that they see a lot more T2’s and struggle to differentiate.
     
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  14. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Legend

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    1. Mine is gentle, flexible, kind, and listens.

    3. Mine is never rigid. Although I got the Eatwell Plate thrust at me when first diagnosed because it is the party line and she has to do this by order of the powers that be, once I started low carb/high fat she fully supported me and said that is how she tries to eat, but did insist I eat plenty of fibre in the absence of cereals etc.
     
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  15. Dr Snoddy

    Dr Snoddy Type 2 · Well-Known Member

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    I met my first DN four years ago. I was told that Type 2 diabetes was a progressive disease and that all I could hope to do was to delay the onset of complications. When I got my HbA1c's into the 30's the same DN told me that as a diabetic I could "afford to have an HbA1c reading in the 40s". I am so glad that others have had more positive and encouraging experiences!
     
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  16. Daibell

    Daibell LADA · Master

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    Hi. If you look at my post earlier this week (A Breath of Fresh Air) you will see that my DN is excellent and doesn't follow the party line on diet. She also shows a good degree of understanding of T1/LADA and the use of insulin. On the other hand my 'Diabetes' GP just told me to 'have a Balanced diet', didn't listen and said she was the expert. Thankfully when she finally allowed me to have insulin I was passed to my first DN who was excellent and now the second one is good as well.
     
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  17. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Legend

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    I forgot to add that my DN is very knowledgeable not just about Type 2, its causes and effects, but also about cholesterol and lipids. She even told me all about LDL particles, referring to big fluffy ones and nasty hard little ones. I already knew all this so we were able to have a good chat about it.
     
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  18. luceeloo

    luceeloo Type 2 · Well-Known Member

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    I have a GP based DN, a community DSN, and then a DSN attached to the Consultant's office (although I haven't actually met them yet).
    The GP based DN - very supportive, very friendly, and doesn't really enforce her views. She offers guidance and will listen to what I have to say.

    The Community DSN comes as part of a team with a dietitian. They believe that their way is THE way, there is no other way, and they don't listen to anything - I have to see them every six weeks. During my first meeting with them they told me that lchf is unsustainable so to forget about it. On Thursday last week they told me to reduce my carbs. I reminded them that I already have a reduced carb diet, and they shrugged it off and told me to reduce further. So I started Keto, and I know that they'll have something to say about that :-D Can't wait for their reaction!
    They are also obsessed with contraception. I was brow-beaten into going on to the contraceptive pill, but this isn't good enough for them. They want me to have the implant, or the coil. It's almost like an obsession for them. I'm a happily married 38 year old, serious fertility issues on both sides... so no real chance of conception. But still I get treated like a teenager who knows no better!
    I'm close to the point of checking in with my GP to find out if we can go back to a time when life was simple and I only saw the GP based DN!
     
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  19. Prem51

    Prem51 Type 2 · Expert

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    Welcome to the forum @LoubyLou 2. My DN has not offered me any dietary advice. My annual reviews with her are just for the foot tickling, blood pressure and weight checks. She hasn't tried to push statins or flu jabs on me.
    She has told me at my last two annual reviews that I am the practice's 'star patient' as I am the only diabetic patient who has reduced their bgs, all the others have got worse.
    Last year I told her it was because I wasn't following NHS advice, but eating Lower Carbohydrate Higher Fat. I was expecting a telling off as she is an older nurse and I assumed she would be old school in her dietary views.
    But she said lchf does seem to work, and couldn't understand why the NHS doesn't recommend it. She thought it was because of the High Fat part.
    I will probably be seeing her again next week for annual review. I don't know whether I will still be the 'Star Patient' as my HbA1c has gone up again, but it's still not in the diabetic range.
     
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  20. rob_tech

    rob_tech Type 1 · Newbie

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    A bit new to forum, but I have had many DN's over the years and from my experience they either follow the NHS guidelines exactly, no matter what, or they learn from seeing and listening to different diabetics, and can pass on certain gems of wisdom.

    Unfortunately at the moment I have a DN who seems to follow the route of standardised answers and cliches to explain my problems with insulin and carbohydrate absorption. Apparently I am trying to be too precise in my logbooks! Is that possible?

    Anyway if you have a good DN that listens and understands, the you are lucky, as the good ones tend to be moved on.
     
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