Dietary Advice. Are We Surprised?

[Guzzler]

We hear often, from doctors themselves, that little to no instruction is taught at med school wrt to nutrition/diet.
In the case of Pre Diabetes and Type 2 Diabetes the bulk of reviews, advice and prescriptions are given by nurses. Not all of these nurses are registered DSNs. I suspect that outside of the EatWell Plate these nurses are not taught anything on nutrition either.

One may be referred to a registered dietician but the chances of seeing one that has eschewed EatWell for those of us with Metabolic Syndrome is low.

So if one is on hypoglycaemic drugs or on insulin and needing support and guidance from HCPs to reduce these treatments with the aid of a diet lower in carbs it really comes down to luck in whether or not your nurse or GP is on board with this approach. Doesn't seem fair to me.

 

[Caeseji]

We hear often, from doctors themselves, that little to no instruction is taught at med school wrt to nutrition/diet.
In the case of Pre Diabetes and Type 2 Diabetes the bulk of reviews, advice and prescriptions are given by nurses. Not all of these nurses are registered DSNs. I suspect that outside of the EatWell Plate these nurses are not taught anything on nutrition either.

One may be referred to a registered dietician but the chances of seeing one that has eschewed EatWell for those of us with Metabolic Syndrome is low.

So if one is on hypoglycaemic drugs or on insulin and needing support and guidance from HCPs to reduce these treatments with the aid of a diet lower in carbs it really comes down to luck in whether or not your nurse or GP is on board with this approach. Doesn't seem fair to me.

With the low carb approach being adopted lately I am hoping that the tide will turn soon with even the nurses but it will be slow as I heard that most of the time the education seminars are optional for them thus a lot don't go beyond the initial sessions.

I know that my own nurse is that way personally, crying out that I would become type-1 and not an insulin dependant type-2 (world of difference there).

 

[Guzzler]

The problem can be twofold. The dietary advice given by HCPs wrt cholesterol stymies LCHF/Keto.

It may take a while...

 

[Bluetit1802]

I think I am lucky with my nurse. At diagnosis in 2014 she pushed the Eatwell Plate, told me to have a jacket potato with baked beans for lunch, low fat and low salt. Then she became a course leader on the X-Pert course and had training from Trudi Deakin. She had a copy of Dr. Deakin's "Eat Fat" book on her desk and said she was following all the advice herself, despite being petite, slim and not diabetic. She is now perfectly happy with my diet in as far as she can be, working for the NHS. At each review we discuss my diet, albeit briefly, and she has to tick the boxes on her computer screen as to what my diet is like. They are just tick boxes. There aren't any for low carb, and only low fat appears. She has to chose one, so she ticks high fibre, and the comment "good diet" My diet is not high fibre, I must add!

I have never seen a doctor for my diabetes, not once, not even on diagnosis.

 

[Bluetit1802]

To add to my above post. I have just looked back at my on-line records and see she added as an afterthought "advised re low fat diet". That advice was not given! I imagine that is to cover her back for when the GP reads it.

 

[Rachox]

During my nursing training I remember very little being taught about nutrition but then I only ever worked in hospitals so dietary advice came from the dietitians. My only role was to help point out the supposedly diabetic friendly choices marked on the menu if patients needed help making their selections. As for nurses furthering their knowledge, as the years went by it became more and more difficult to get time off or funding for courses, so if you wanted to do anything bar the mandatory stuff you had to use holiday and fund it yourself. I’m hoping the tide is turning, my GP and DSN are onside with me taking the low carb approach as they have seen my results, but I don’t know yet if they are recommending it to other diabetics?

 

[Mr_Pot]

My DSN is a low carb enthusiast but she told me that when she suggests not eating bread, potatoes, rice etc the response from patients is that the whole idea is ridiculous. I think it will be a long time before there is general acceptance that the staple foods are not good for us. Not having sugar is easier for people to understand as sweet things are often regarded as "naughty" anyway, so seem more reasonable to give up.

 

[Guzzler]

For those of us who do really well on this lifestyle choice, beating the dogma of 'chronic progressive' disease do HCPs have no curiosity at all? I have not been asked how I have put all of my metabolic markers (that have been measured - an important fact there) back to within normal parameters. If I ever go for another review, yes I'm back in that mindset, and this question is asked my answer will probably be 'Well, it wasn't the Metformin or the statin or the dreadful dietary advice I got here'.

 

[jjraak]

....at each review we discuss my diet, albeit briefly, and she has to tick the boxes on her computer screen as to what my diet is like. They are just tick boxes. There aren't any for low carb, and only low fat appears. She has to chose one, so she ticks high fibre, and the comment "good diet" My diet is not high fibre, I must add

Sad that the potential has been missed to follow a different course and measure it's success, and is actually baked into to the system there.

How can we possibly measure the success of EATWELL V LCHF for example if no one measures it, and in many cases we, as T2D's dare not discuss it openly

Smacks a tad of Stalinist Russia, where the plan, no matter how badly it failed was ALWAYS a GREAT SUCCESS ..

Viva la revolution

 

[jjraak]

My DSN is a low carb enthusiast but she told me that when she suggests not eating bread, potatoes, rice etc the response from patients is that the whole idea is ridiculous. I think it will be a long time before there is general acceptance that the staple foods are not good for us. Not having sugar is easier for people to understand as sweet things are often regarded as "naughty" anyway, so seem more reasonable to give up.

Wonder if the same approach is taken with drug, alcohol, allergies etc...

Use other class A's but not heroin, only drink alcohol under 7%..and try and keep the nut allergy down by only eating a 'few' nuts each day. ...

No wonder the numbers keep saying it's a 'progressive' disease, when the choice is so skewed as to MAKE that the most likely outcome.

 

[Daphne917]

For those of us who do really well on this lifestyle choice, beating the dogma of 'chronic progressive' disease do HCPs have no curiosity at all? I have not been asked how I have put all of my metabolic markers (that have been measured - an important fact there) back to within normal parameters. If I ever go for another review, yes I'm back in that mindset, and this question is asked my answer will probably be 'Well, it wasn't the Metformin or the statin or the dreadful dietary advice I got here'.

My DN has never asked me how I maintain my hba1c within the normal range but is quick to point out when my cholesterol figs are, according to her, high for someone with diabetes.

 

[Guzzler]

My DN has never asked me how I maintain my hba1c within the normal range but is quick to point out when my cholesterol figs are, according to her, high for someone with diabetes.

Same here but I'm hoping that the ding dong I had with the GP means I will not be having any more lipid panels done.

 

[Bluetit1802]

My nurse is well up on lipids. She knows all about LDL particles, the big fluffy ones that are good and the little hard ones that are bad. She knows all about trigs, and HDL, and that the total is meaningless. She had been on some sort of course. She is one in a million.

 

[ianf0ster]

It was mainly the South African Dieticians who attacked Tim Noakes. He said that those colleagues he was closest to and had helped most were forced (for their continued careers) to prove they had distanced themselves from him the most. He was fortunate to be retired by then and also in a stable marriage. Said he understood how similar treatment of a Canadian academic had caused both her and her husband to kill themselves!

Do not underestimate how strongly the Breakfast Cereal companies, 7th Day Adventist Church, Grain, Sugar and Processed Food Industries, plus many high level Doctors fearing being proved wrong will fight to crush any evidence that LCHF is actually good for us !

 

[ianf0ster]

Some may be shocked by me listing a religious organisation in the list of 'baddies' in my post above.
If so, remember that Kellogg (yes that one!) was both a doctor and a 7th Day Adventist who believed that eating meat was evil.

See videos by Dr Gary Fettke and his wife Belinda. He like Tim Noakes was nearly crushed, in his case by the Australian grain industry the biggest company of which is owned by the 7th Day Adventists.

 

[Guzzler]

Some may be shocked by me listing a religious organisation in the list of 'baddies' in my post above.
If so, remember that Kellogg (yes that one!) was both a doctor and a 7th Day Adventist who believed that eating meat was evil.

See videos by Dr Gary Fettke and his wife Belinda. He like Tim Noakes was nearly crushed, in his case by the Australian grain industry the biggest company of which is owned by the 7th Day Adventists.

Many of us are aware of Belibda's sterling and continuing work on the Seventh Day Adventist Church, Sanitarium, its roots in the US and it meddling in Australia and se Asia. We were glad that the case against Gary failed. There seems to be push back by Big Food which includes 7DA against doctors who dare to question the guidelines.

 

[Daphne917]

Same here but I'm hoping that the ding dong I had with the GP means I will not be having any more lipid panels done.

I’m waiting to see if she offers me statins at my next review because my GP has annotated my records as ‘statin intolerant’ after they increased my Hba1c from 48 to 54 within 6 months

 

[Robbity]

I was told more or less told to "Eatwell" by my DN on diagnosis, but to cut down on sugary foods and to avoid anything specifically labelled as "Diabetic"; a bit late my GP recommended trying Atkins for weight loss.

After seeing my early results, my DN was impressed - especially at the low number of carbs I was eating (around 50g) and told me to keep on doing whatever I was doing. Both have been perfectly happy supporting my low carb efforts for the last five plus years, and at my latest review my GP who is currently the practice Diabetes specialist, said that the low carb option is now being offered to all their diabetic patients.

Robbity

 

[Listlad]

My DSN is a low carb enthusiast but she told me that when she suggests not eating bread, potatoes, rice etc the response from patients is that the whole idea is ridiculous.

I put this to two people on Monday, one of which works for the NHS dealing with community support and their jaws dropped.