xyzzy said:
lucylocket61 said:
Thanks. I got confused with this bit:
I still think that's a valid position to promote to a new person as they have to be pointed in a direction away from "starchy carbs" but still feel confident when they read the new advice that its coming from a reliable and trustworthy source.
and I think I misread the 'new advice' bit and thought that Daisy1's advice was not up-to-date and was being replaced with new stuff.
Its been a long day.......
I'll try and make that a bit clearer. So...
New T2 member arrives with their first post. In
my head it then goes likes this...
1) Am I sure they really sound like a correctly diagnosed T2 if so...
2) Must warn them off 50% total carbs of which 33% must be starchy ones as that will hurt them
3) Tell them to cut out sugar and at least half starchy carbs as a simple portion control method to get them going.
4) Tell them to replace the difference with list of food stuffs the Swedes recommend (i.e
a trustworthy source)
5) Point out advice in 3) & 4) is what would be given by another modern health service (i.e
a trustworthy source)
6) Point out everyone is different and they may need to go up or down from half starchy carbs.
7) Mention 130g as a good start as 130g is the latest American recommendation so again is
a trustworthy source.
8 ) Nod to GI by mentioning swap to "brown" rice, pasta etc but secondary advice to cut carbs.
9 ) Nod to VLC by mentioning some people can give up meds and "the trustworthy source" doesn't say no
10) Introduce carb counting as a concept.
11) Introduce importance of testing and meters.
12) Introduce importance of safe levels ( 8.5, 7.8 ) and why those numbers are trustworthy.
I'm going to counter debate here..
1) you aren't medically qualified to determine if somebody is correctly diagnosed, even if you were you it's illegal to make a diagnosed without being privy to the patients medical records etc..
2) Again you don't know if the 50% carbohydrate ratio, will hurt that individual at all, again the individual requires assessment to what their individual needs are by a qualified persons, who needs to be privy to the individuals medical records.
3) Yes I would agree that suggesting the cutting out of sugars, such sweets, sugar in coffee, cakes etc is good advice and one that will give a good reduction of carb intake.. (my sister who's not a diabetic, lost 4 stone just by doing this and made no other adjustments to her main diet)
4) Sorry you don't tell people what they may or may not eat, or able to determine what is or isn't a trustworthy source of information...
5) Yep, point people into what other modern health service is saying, but we all need to remember 'that' modern health service might be different to ours, so their polices might be based on different criteria than ours, such as in America Health Care Service is purely based on the patients ability to pay for treatment and may be dealing with different factors within their own society.
6) So Far you've neglected that everybody is different, as you are telling what they have to do, based on your own opinion and what you suggest to us works for you... You are also pointing people in one directions and classing only the information that agree with your personal opinion... Not what I call an 'we all different' approach.
7) Again you telling somebody what to do... Problem is that without a medical history, and a assessment of the individual actual needs, such as activity levels do they have weight issues to address, what sort of appetite they have in general etc...
8 Again, you'll telling somebody what they must do, yes the GI diet often can improve control for an individual without having to faff with changing their carb intake..
9) Again you are giving misinformation, VLC diets do come with problems and doesn't always mean that the individual can stop taking or reduce meds hence why even the Swedish and American's don't mention it...
Again problems surrounding this type of diet, is adherence to the diet, having to have an in-depth knowledge to nutrition to ensure that your nutritional needs are being met... And several others as well
10 and 11), Yes carb counting is a must, what ever regime you decide on with the backing of a meter and testing is a must, as it's a lot easier to make any necessary lifestyle changes when you can see an impact it having on your control..
12) The figures given are based on continuing data collection and research and is based on WHO recommendations, where the patient can reasonably expected to achieve with or without medication... And studies has shown to attempt to drive these figures lower with high dosages of medication may be detrimental to the individual rather than help.. And again they are a guideline and each individual needs to be assessed to what...
There is one important thing you are leaving out with your message...
And that's the individual :shock:
Which means you are instructing them, and not educating them!
See I don't inform people how many carbs they shouldn't or shouldn't be eating... What I prefer to do is actually educate them about carbs and there probably reaction, and what options are open them to change that reaction, and when needs be give them the pro's and con's of various different options...
This way I'm treating the person as an individual, giving them information so that they can make their own choice what is right for them, the advantage is that they not only have full information to make a justified choice but it's more likely to lead to long term better control because they've are happy with what they are doing and how they got to what they are doing...