DUK conference - Self Management

Hana & I joined the 1-day conference.
On arrival we were offered choc digestives & custard creams with our tea.
I had previously phoned regarding the lunch provided, & was told sandwiches, so I explained I was diabetic & did not eat bread. They still let me in.

There's a lot to report, so I'll summarise some points.

1. A major problem is the emotional impact of diagnosis - diabetics are often observed to be depressed. I reported that when I was diagnosed, Redgrave was winning gold medals, so diabetes didn't seem to be much of a problem ... but Dr assured me that I was now in line for heart attack, stroke, kidney disease, blindness, amputation .... & helpfully computed my probability of a heart attack at 25% :evil: Was I depressed :?: I left the surgery in a state of shock that lasted months

Mine is a common experience, which needs to be addressed. Specialist psychological & emotional support is needed. Then self management is more likely to be successful.

2. The ongoing need is for a care plan & progressive care planning. Patients may be given information & diet plans on diagnosis & the care then provided is medication based on annual HBA. Self measurement is commonly discouraged.

After diag I was given a one day programme of talks by nurse, dietitian, pharmacist, podiatrist, & prescribed test strips. I was also put in touch with the local support group. (Hounslow.) I will endeavour to report back to them. Meetings I have been to have not been very helpful.

3. Local patients meeting & sharing.

I pointed out that I do not know of any other diabetics in the practice. We are assured on diagnosis that our condition is progressive - diet/exercise > medication > insulin > complications. We have no opportunity to compare notes with other patients.

Others there were members of specific & useful support groups, including parents & schools.

[My Dr was impressed by my recovered mobility I achieved by a reduced carb diet. I offered to share information with other patients in the hope that my experience would be helpful. It hasn't happened.]

I shall suggest to the Dr a surgery meeting for patients to discuss problems & solutions.

4. Publicity of the needs of diabetics.
Representations to PCTs, MPs, local magazines, local radio, etc, are possibilities for action.

5. Several of us pointed out the counter-productive dietary info & the need for DUK & professionals to listen to patients, & learn from our experience. In particular the scary warnings in the very latest DUK diet booklet were pointed out - "we NEED glucose from carbs for brain function, so carbs should comprise half our diet."

There seems to be no mechanism nor procedure even for DUK to learn from its members.

Bed time.

As a 70 year old T2 for 10 years, & having progressed (following professional advice)
from diet
to metformin
to complications (disabling muscle pains & background retinopathy, chronic tiredness)
(& following low carb advice from forum contributors)
to carb reduction
freedom from pain
to normal activity

My self management plan is
carb reduction & exercise; taking 3 metformin a day; singing & playing music
monitor BS overnight & once or twice more through the day
monitor weight (stable at BMI 24.5-25)
awareness of general health

The results are:
freedom from pain (though I do have occasional problems, currently leg discomport through travelling by train & tube to the DUK conference)
stable retinopathy
active life
no depression
greatly reduced tiredness

An important aspect of self management is to be aware of our bodies & our general health.

It is too easy to think, "I am getting older" or to accept, "what do you expect at your age?"

I did - I bought larger size trousers & shirts, & accepted increased tiredness. John Peel did, until he was taken to hospital with diabetes. Some will accept stronger glasses, though a competent optometrist will see the signs of diabetes.

We can manage our health to a great extent, & our aim should be to stay healthy, even with diabetes. We can make the supposed "inevitable progression" as slow as possible, rather than accept it.

With diabetes, control by diet & exercise is a much better option than control by ever stronger medication, though of course medication is a valuable recourse. My Dr always advises, "we could prescribe ... but you could try ... See how you go."

Please folk - what is YOUR strategy for "self management" :?:

I reported back to the local support group, I found someone who also was horrified at the latest "Healthy Eating" booklets for T1 & T2. He has already queried them & had the booklet in his hand while we were talking. We had a very long phone conversation.

He has realised that there is no way of teaching DUK the wisdom gained from patients' experience.

They trot out the "received wisdom party line" so often that they believe it, & dare not say anything other than, "If reduced carbohydrate works for YOU, do it, but WE cannot recommend other than our standard 'lots of starchy carbohydrate' line."

How often does a lie have to be repeated before it becomes the truth :?: :twisted: :?:

I have been encouraged now to represent the support group, & get more involved. PTL!

This is their report received today.

Now the DUK Balance mag tells us that 800,000 diabetics are not achieving recommended BG levels & are at risk of serious health problems. They repeat the targets for adult T2 - 4-7 before meals, below 8 after.

How those targets can be achieved with a 50% carb diet is unclear ....

The case for really really positive self-management assisted by informed HPs is evident.

ally5555 said:

Who knows what is going on there - they are certainly out of touch. I belong to the diabetes group as part of the british dietetic association and carb counting is the norm - not this wooly advice they are giving.

Ian - there are many diabeteics who will never manage their diabetes because they dont care - I find it very frustrating but that is life i am afraid - bit like smoking!

Click to expand...

Ally, Please don't try & make a case from those who don't care.

I care - & I believed the starchy carb line - until the predicted complications set in.

Trouble is, diabetics who care DO seek advice from DUK & HPs & they get misinformation that is "proved correct" simply because they predict progressive deterioration which inevitably occurs if we follow their diet recommendations :evil: That progression does NOTHING to suggest to them that that advice they give is WRONG.

This thread is about self-management, obviously for people concerned about their health. That surely counts in everybody on this forum.