Experts that do not know what they are talking about

[JohnEGreen]

When I told one of the GP's at the surgery that I have Myasthenia Gravis hence have been taking preds for years and that that is the reason I am diabetic her response was that's some thing I read about in the text books but have never encountered in real life.

 

[Squire Fulwood]

Do you mean like this:
https://www.amazon.com/SlimFast-Replacement-Whipped-Triple-Chocolate/dp/B07H7PZXG2

Yes, that's exactly what I mean. Especially the whipped triple chocolate. Very keto.

 

[Listlad]

When I told one of the GP's at the surgery that I have Myasthenia Gravis hence have been taking preds for years and that that is the reason I am diabetic her response was that's some thing I read about in the text books but have never encountered in real life.

So there we have it. Is that acceptable I wonder, on the grounds that they are General Practioners?

Perhaps a Trustpilot type system should be implemented? Just wondering.

 

[Goonergal]

So there we have it. Is that acceptable I wonder, on the grounds that they are General Practioners?

Of course it’s acceptable. GPs can not possibly expect to encounter every possible illness/condition. Admitting this is not an issue at all, so long as they are open to finding out more/referring to specialists.

 

[Robbity]

Yes, that's exactly what I mean. Especially the whipped triple chocolate. Very keto.

I came to the conclusion some time ago that there are two versions of "keto" diets: a healthy eating version for the likes of us who may need to eat this way to help control our diabetes, and a "fad" version for those who think its trendy, but don't actually want to give up their existing way of eating.

Now we have the Keto diet. I am sure that even prepared meals will soon be saying that they are Keto. .
....
Sorry about being gloomy but that's just the way I am this morning.

I saw a firm offering similar online 2-3 years ago - as far as I can remember their meals contained more carbs per serving than you'd eat in a day on a "proper" ketogenic diet..

I'm having a grumpy rather than a gloomy day though.

Robbity

PS The single piece of accurate information I got from my DN just after diagnosis was to avoid anything edible that was labelled as "diabetic"..

 

[Goonergal]

I came to the conclusion some time ago that there are two versions of "keto" diets: a healthy eating version for the likes of us who may need to eat this way to help control our diabetes, and a "fad" version for those who think its trendy, but don't actually want to give up their existing way of eating.

Completely agree, with the addition that the second option is the one likely to be picked up on by those with a vested interest in promoting processed food.

 

[Mr_Pot]

Of course it’s acceptable. GPs can not possibly expect to encounter every possible illness/condition. Admitting this is not an issue at all, so long as they are open to finding out more/referring to specialists.

I don't know if they all do it, but my doctor is quite open about looking up anything he doesn't immediately know in detail. He has a sort of on-line text book which I think is NHS, and we can look at the screen together to discuss symptoms and possible treatments. Even if a condition was covered in his training and he has encountered it before he can't be expected to remember everything about the possible treatments and their side effects, prognosis etc. for hundreds if not thousands of conditions.

 

[millenium]

I suspect most people that do keto are not doing it correctly because they miss out on carbs in certain food that they are taking. That may not be totally a bad thing as long as the carb eaten are not overboard.

 

[ickihun]

Head dietician told me they don't know how much weight I will lose. They are going to see what happens.
Thankful my confidence is only due to having strict low carbing as a last reort. Palpatations can be treated. However I'm having low carb compared to a decade ago but I'm not in dietary ketosis. I'm losing due to no hunger and 3 set meals. Low calorie, low fat and low carb.
All our needs are different. My thyroid hasn't complained once so I'm assuming either less levothyroxine being absorbed so I'd normally need less with this weight. I didn't absorb well in pregnancy either.
We are all different so how can a GP cope with that demand. Only answer is to find out yourself what works for you, then ask for GP support.
In my case listen to my endo/diabesity specialist and resolve together.
My GP is more than capable of sticking to what works for me. I'm confident of that.
Get to know your professional care giver. Make sure they listen and understand.

 

[Lamont D]

When I told one of the GP's at the surgery that I have Myasthenia Gravis hence have been taking preds for years and that that is the reason I am diabetic her response was that's some thing I read about in the text books but have never encountered in real life.

As in my case, my then GP, who was head of surgery and on the local GPs committee, called me weird! He had heard of RH and never met another case and admitted that he needed to research the condition.

 

[Squire Fulwood]

I came to the conclusion some time ago that there are two versions of "keto" diets: a healthy eating version for the likes of us who may need to eat this way to help control our diabetes, and a "fad" version for those who think its trendy, but don't actually want to give up their existing way of eating.


I saw a firm offering similar online 2-3 years ago - as far as I can remember their meals contained more carbs per serving than you'd eat in a day on a "proper" ketogenic diet..

I'm having a grumpy rather than a gloomy day though.

Robbity

PS The single piece of accurate information I got from my DN just after diagnosis was to avoid anything edible that was labelled as "diabetic"..

Can I interject with a whinge?

In 2011 I was testing my blood sugars and keeping spread sheets to find out what foods spiked me. My quest was to eat in a manner that didn't give me high blood sugars.

Exactly when did this process turn into an obesity quest where everybody only talks about this in terms of losing weight?

Exactly when did this turn into a fad called Keto which is now going to replace all the Low Fat signs on processed foods and not necessarily be aimed (or helpful to ) diabetics.

 

[Listlad]

Of course it’s acceptable. GPs can not possibly expect to encounter every possible illness/condition. Admitting this is not an issue at all, so long as they are open to finding out more/referring to specialists.

We will have to differ on that. There are so many examples of the wrong advice being given out for T2 diabetes. Patients are losing legs, eyesight owing to that advice. I cannot think that is acceptable. But I suppose we are all entitled to an opinion.

Having said that, meantime I am trying to do something about that by providing support at surgery level.

 

[Listlad]

I don't know if they all do it, but my doctor is quite open about looking up anything he doesn't immediately know in detail. He has a sort of on-line text book which I think is NHS, and we can look at the screen together to discuss symptoms and possible treatments. Even if a condition was covered in his training and he has encountered it before he can't be expected to remember everything about the possible treatments and their side effects, prognosis etc. for hundreds if not thousands of conditions.

You are of course right in terms of every piece of minutiae, but something as important as dealing with T2 diabetes? Surely yes?

Maybe not?

I get the distinct impression that many conditions are databases nowadays. So if certain patient data is punched into the software they use then certain flags are waved in the system. In other words the GP doesn’t need to know every fine detail as he or she has the support of a knowledge base. I saw that in action at my surgery in IOM, but maybe that isn’t the case in the U.K.

So, if a patient has high blood sugars of a level leading to a diagnosis of T2 then the knowledge base ought to be flagging up “Dietary Control” and “Low Carb” etc rather than rely on an old timer’s medical school notes and that wants to pump you full of carbs or drugs.

I do know that the specific GP I now rely on has it all in his head. He talks freely and lucidly without hesitation about T2 diabetes and the low carb dietary solution. I have also had appointments with him on other ailments and he seems, as far as I can tell, pretty good with those too.

 

[DCUKMod]

We will have to differ on that. There are so many examples of the wrong advice being given out for T2 diabetes. Patients are losing legs, eyesight owing to that advice. I cannot think that is acceptable. But I suppose we are all entitled to an opinion.

Having said that, meantime I am trying to do something about that by providing support at surgery level.

Personally, I would far rather an HCP stated they know nothing about x, y or z than they try to bluff their way forwards and make it up as they go along.

Obviously, it would be better if they had good expertise in everything, but that's just not realistic, in my view.

All I ask for in an HCP is that they are honest and can practise listening as well as talking.

 

[Goonergal]

We will have to differ on that. There are so many examples of the wrong advice being given out for T2 diabetes. Patients are losing legs, eyesight owing to that advice. I cannot think that is acceptable. But I suppose we are all entitled to an opinion.

Having said that, meantime I am trying to do something about that by providing support at surgery level.

If you read the thread and my response, I was clearly saying that it was acceptable that GPs may not have encountered every illness/condition. Diabetes brought on by use of steroids is not particularly prevalent, so why would all GPs be expected to have come across it? I was not referring to poor advice in relation to type 2. I would not make a blanket statement that that is always the case either.

 

[Mr_Pot]

something as important as dealing with T2 diabetes

I am not sure I would agree with type 2 or prediabetes being at the top of a list of important if I had cancer or kidney failure or a heart attack. Besides which they are doing what they are supposed to do to treat diabetes following orders as it were. We would be horrified if we thought that GPs were all doing their own thing rather than follow guidelines for other diseases. It's the central guidance from NICE or whoever that needs to change.

 

[Listlad]

I am not sure I would agree with type 2 or prediabetes being at the top of a list of important if I had cancer or kidney failure or a heart attack. Besides which they are doing what they are supposed to do to treat diabetes following orders as it were. We would be horrified if we thought that GPs were all doing their own thing rather than follow guidelines for other diseases. It's the central guidance from NICE or whoever that needs to change.

So what about the GP’s that ignore central guidance and advise the right solutions for T2 diabetics? Like my GP.

Presumably Dr David Unwin ignored central guidance?

 

[Listlad]

Personally, I would far rather an HCP stated they know nothing about x, y or z than they try to bluff their way forwards and make it up as they go along.

Obviously, it would be better if they had good expertise in everything, but that's just not realistic, in my view.

All I ask for in an HCP is that they are honest and can practise listening as well as talking.

Well the GP that told me she knew nothing about feet, shocked me a little at the time. But at least she was honest. Her advice was actually to go private at the time for what turned out to be a plantar fascia type injury. About a year later she removed a section of both of my ingrown toenails on each big toe. But she wasn’t that great at that- I checked in over in Blackpool when visiting and the nurse there was shocked at the job. Nice woman though.

Her advice on T2 diabetes was the Eatwell plan, incidentally.

 

[Mr_Pot]

So what about the GP’s that ignore central guidance and advise the right solutions for T2 diabetics? Like my GP.

They need to be very cautious and do a lot of research to ensure their approach is at least harmless or they will be struck off. Changing diet is a fairly benign treatment if it is not too extreme, so some experimentation with willing patients is practical, this is not the case with most other diseases, we don't want GPs, convinced of their own private theories, killing people trying to prove them.

 

[Listlad]

.......we don't want GPs, convinced of their own private theories, killing people trying to prove them.

Exactly. I wasn’t really stretching things quite that far.