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Do your HCPs REALLY listen to good news?

LittleGreyCat

Well-Known Member
Retired Moderator
Messages
4,392
Location
Suffolk, UK
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Diet drinks - the artificial sweeteners taste vile.
Having to forswear foods I have loved all my life.
Trying to find low carb meals when eating out.
As noted in my last post, I am a bit euphoric at the moment because my numbers have suddenly improved.

I am being particularly good on the 'low cab' front at the moment and also increasing my exercise levels.

When I had my first significant improvement last year (before I went on an extended holiday which made dietary control more difficult) my diabetic nurse was very impressed by the fact that I'd lost weight and my numbers had improved, but when I told her that it was due to really cutting back on the carbs she still said that I had to be careful to not cut out too many carbs.
This is still the party line for the NHS.

So - for the people on this forum who have achieved good results by diet and exercise (with or without medication), particularly if they are going medium/low/no carbs; is anyone at your practice actually listening and feeding this information back into the health service?

If not, how does the evidence get picked up for future guidance of other diabetics?

I have the suspicion that if you politely ignore the advice of your HCPs then when your results improve they give themselves credit for giving you good advice, instead of really listening to what you say about how you have achieved these numbers.

So is there any way to feed this information back into the system?

Is there a route into people who are currently researching diabetes and looking for new treatments?

The Swedish review I posted some days back didn't seem to have located any strong research showing that low carbohydrate diets has a positive impact on diabetic control but many posters here believe that this is a factor in their control.

I was particularly interested in the reports over the crash diet which cleaned out the fats from the liver and pancreas in overweight Type 2 diabetics and would like to know if this is more broadly applicable.
Can I check if I have fat in my liver and pancreas?
Is there a variant of the diet suitable for people with a BMI lower than 30?

I am going to write to my doctor (who I rate very highly) and ask some of these questions but it seems to me that there should be some kind of centre for excellence where people who are taking active control of their diabetes can interact with HCPs and researchers so that there is more awareness by researchers of what diabetics are doing and going through in the general population.

Something like the discussion and feedback on this forum but feeding back up the official chain to influence future policy and research.

Cheers

LGC
 
It would be good to be able to influence the diet treatment of Type 2s, but I wouldn't have a clue as to how to go about it. My doctor likes the idea of low carbing but I doubt he'll share his views with anyone.

Ailz
 
I agree with you, LGC. My own GP and the practice nurse know I low-carb and are supportive - they were very good in monitoring me when I went on Atkins the first time - but whether it gets back into the system I really don't know. I doubt it - both the other doctors, including the diabetes 'specialist', are anti-low carb, so the fact that I'm back on Atkins is probably a deadly secret!

I really wish we could have an open, honest round-the-table discussion between HCPs and diabetics, with everyone, but particularly the HCPs, leaving their prejudices at the door and really listening. A proper long-term study of diabetics who follow low-carb (say, less than 100g per day) would be very useful.

Please note that I think a study of every type of diet used by diabetics would also be useful, so don't jump on me! We need someone who knows how to devise an acceptable study for us!

I'm currently participating in the 'Million Women Study' which is about heart disease; I wonder if they could add on diabetes to their work - they look at diet and exercise. I'll ask.

There's also the study at the James Cook hospital that I posted about, that they wouldn't let me on 'cos my figures were too good :shock: . I'll contact them as well.

Viv 8)
 
Being type one I haven't kept up with type two treatment, but the last I heard, some years back, was that the primary treatment for anyone who is type two, was to cut carbohydrates right down so your body's remaining insulin is enough to deal with them. Then to use tablets only if dieting does not do the trick, and then progress to insulin if the tablets don't work. It seems pretty logical to me. What has changed? Why is it now different? It seems completely counter to all logic.
 

Thast doesn't seem to be in the current guidelines.
It is eminently sensible and is, I guess, what low carbing is all about.

The current emphasis is on eating a "healthy diet" which is aligned with the recommendations for non-diabetics.
This includes a load of "healthy carbs" instead of unhelathy fats.
Unfortunately for BG control carbs are a problem and fats slow down the absorbtion of carbs and sugars so can be good.

High protein, low carb. and statins seems to work for me but doesn't seem to fit the guidelines.

Cheers

LGC
 

I agree that reducing carbs is a must for diabetics but what does "low carb" and "load of healthy carbs" really mean in reality?

For a non-diabetic "loads of carbs" means in excess of the RDA but do the HCPs mean that diabetics should be eating the same amount of carbs as the non-diabetics when they tell us to eat "loads" or "plenty" of carbs or what exactly do they mean by that?


Unfortunately for BG control carbs are a problem and fats slow down the absorbtion of carbs and sugars so can be good.
Click to expand...

If diabetics cut out both the sugar and carbs completely or even low carb (less than 50 a day) then what are the fats going to slow the "absorption" of when there is nothing (or hardly) anything to slow down?

My GP didn't tell me to cut out both sugars and fat but he also didn't tell me to eat "loads" of anything, never mind telling me to eat in excess of the RDA. What he suggested was that I "cut down" on foods that will raise my BG.
 
Don't they normally tell you to eat a "normal healthy diet" whatever that might be and some will then add "eat some starchy carb, pasta , rice, potatoes with every meal?

Over tha last few years a GP advised me to eat "meat and eggs" but wouldn't elaborate. In my one and only discussion with a dietitian 4 years after diagnosis she told me I had just said the "magic word" when i mentioned carbs.

When I achieved much better results after low -carbibg together with increased exercise I told the consultant and the GP. Both said "Good , good" but didn't comment further.

I don't really blame DSN's for just passing on the "received wisdom" . It is what they are supposed to do and many do nothing more. Those more enlightened and interested may well advise hie r patients differently but risk conflict with the GP's.

Allowing them to treat patients as individuals is the only answer surely?
 
Unbeliever said:
Don't they normally tell you to eat a "normal healthy diet" whatever that might be and some will then add "eat some starchy carb, pasta , rice, potatoes with every meal?
Click to expand...

Yes, my GP did mention "normal healthy" diet but at the same time told me to "watch the carbs" and cut down if necessary.


Any Dr giving advice outside of the box stands a very good chance of getting sued and struck off for negligence should something happen to their patients. Let's face it, if a patient's health gets worse following the advice of their Dr then the minimum that patient will do is complain about the advice he/she got and the Dr will be crucified by the authorities for not sticking to the guide lines. If the patient does sue the Dr what chance does that Dr have for winning the case? He/she will be all on his/her own because experts in the field will have to testify against him/her otherwise they too will be crucified for backing up advice that is not accepted by the health authorities. It's not as if this sort of things happened, especially in the USA where Drs get sued for millions.

Until low-carbing is accepted (if ever) bythe authorities, you will find b=very few Drs who will take that chance and advice their patients to low-carb. Like my GP, they might say "cut the carbs down" but most will not go any further than that. That's probably why your Drs didn't make any further comments on hearing about your low-carbing.
 
I'm T2, diet controlled, and needing to lose weight. After complaining to nurse that nothing that used to work for me in losing weight now worked, and that bg levels were all over the place, she agreed to prescribe me some test stips (hurrah!!!) and asked me to keep records. Then I found a book where the author said everything that I'd just said to nurse, so I bought it and followed the eating plan. Very low carb for 8 weeks, then can re-introduce the carbs that cause less stress to body (but still low-carb). Just seen nurse again. HbA1c from 6.7 (December) to 6.2, cholesterol 5.2 to 4.7, triglycerides 1.3. And lost 9 pounds. She was delighted and asked how I'd done it, so showed her the book (Metabolism Miracle by Diane Kress) and she is going to try to get a copy!!! Be interesting to see if she does read it, and if she acts on what it says with any of her other patients. No way will I be going back to following the 'official' guidelines.
 
Doh!

Google, as always, is your friend.

Just found http://www.ukdrn.org/eastern/team.html


This sounds like just the process I was asking for in my original post.

I have contacted them via the web form and will notify my HCPs that I have done so.

Cheers

LGC
 
Do your HCPs REALLY listen to good news?


Yes in my opinion they do and if yours dont then walk, simple
 
So, Sid, are you certain that your HCPs pass on good news up the chain to researchers?
 
While I cant be certain I see no reason why they wouldnt if they where asked for such feedback.

I merely posted that my 'team' have always given me good advice and have always been very supportive and have never given me any reason to doubt their good intentions, too often I read people saying their diabetes team dont listen to them or tell them not to low carb but I have never experienced that. Just wanted to speak up for those without a voice who do excellent work within the NHS
 
If HCP's give good advice from Day1 and it works then I would suggest that that advice is already in the chain?
 
Great article, CC! I definitely give my doctor a headache - to the extent he'll give me the name of something (the last was lumbar spinal stenosis) and tells me to go away and look it up :lol:

But I do bow to his training and experience - after all, what do I know?

Viv 8)
 
catherinecherub said:
Thought this was particularly relevant to this topic.

Are you giving your Dr. a headache?
http://edition.cnn.com/2011/HEALTH/07/0 ... index.html
Click to expand...

Groan!

How many people have read "Three Men in a Boat" by Jerome K. Jerome (or was it "Idle Thoughts of an Idle Fellow"?).
This is nothing new - people used to read the home medical companion and discover they had all the diseases listed.

Bunch of arrogant medics who believe they are the fount of all knowledge and the patient is dumb.
Who seem to have forgottten they went to school/college/university with others of similar or higher intelligence who didn't chose to specialise in medicine.

Grumble...chunter...chunter...grumble. :roll:

People who visit the doctor should always research as much of the subject as they can so that they can appreciate (and if necessary query) the advice being given.

It can make life harder for the doctor, but can also make the discussion very rewarding.

I have been lucky with my HCPs who have in general been very supportive when you show an interest and are always willing to discuss options and new research.

Bottom line is that it is your body and your life.
Doctors provide a wonderful service but the final decision is yours and you should know as much as possible about the subject.

Cheers

LGC
 
LGC,

I have tried a number of times to get involved with the eastern diabetic research team and each time I am told that my control is two good... It seems that to be involved with diabetes research you need to have poor control so that they can try and improve it... rather than actually discussing with people with good control how they achieve it?!

That said the consultant that I see at the diabetes centre has been very good... I think once he realised I researched and made informed decisions although he has often asked questions reference my opinion and given his own he has always been supportive in the choices I have made reference my treatment and diet etc... I think he just likes my meticulous spreadsheets?!! he often asks if he can keep them to show to his Jr Doctors
 
As a HCP perhaps I can give a perspective from the other side!

Yes most of us do feel pleased when pts get good results but have to be very professional about it. As far as feeding results back well in way that happens - most surgeries have computerised systems so it records HBA levels, wt etc so if you want to look at results you can pull off all pts with a recorded wt or cholesterol etc. This data is fed into government stats . It is probably true that there are still some arrogant HCP but not so many but it works both ways - there are some equally arrogant pts! In general the people I work with are hard working and approachable - but then the Welsh are a chatty bunch!
 
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