Frowned at by Nurse when I mentioned LCHF

Dr__Mesh

Member
Verified HCP
Messages
18
Type of diabetes
Doctor
Treatment type
I do not have diabetes
Welcome Dr_Mesh, and may I applaud you for looking at things from the patients point of view. I had this discussion with my HCP when I pointed out that she had had contact with me not more that 6 hours over 10 years, while I had been dragging myself around for over 500,000!
As you read further you will discover that LCHF isn't very new, and before the discover of insulin was the only way for T2D. Back then T2D was called Sugar Diabetes, which I think was a more accurate description. And if your body is intolerant to sugar, or sugars worth (carbs) why put it in your mouth in the first place?

I do appreciate the difficulties you have in that if you go 'off piste' and your patient drops dead, it could end your career, whereas if you follow the NICE guidelines, and can evidence that then the patients death will not be attributable to you in any way.
I do hope you find this forum of use, and that you do not suffer any 'troll' abuse


Thanks for your kind words.

Yes, I suppose that is a factor, though I tend not to base my practice on that fear. But thanks for understanding that that is a factor too :)

I can understand why someone may feel annoyed when a doctor may say something that doesn't agree with their view. But in my case, I'm not saying what I'm saying because I'm a doctor and I know best, because I don't. I'm giving my opinion based on what I know (which is limited at this point in time), but am all open to learning and improving from those experiencing the problem first hand, and from those dedicated professionals who are really looking into the problem to make a real difference.
Already from the replies I have received, I have become aware of a lot more than I knew, and I'm thankful for that :)
I have a lot to go away and reasearch on! :-D

Thanks again for your kind message :)
 
  • Like
Reactions: 4 people

KevinPotts

Well-Known Member
Messages
2,606
Type of diabetes
Type 2
Treatment type
Diet only
Dislikes
Unkind people, failure to take personal responsibility.
Li4m79, if I were you I'd do what I did. I bought two copies of the book I've just referenced, read one, got excited, bided my times which for me was only a couple of weeks, for you it might be when you have your next HbA1c, and the give the second copy to your Dr. Certainly helped my relationship and his understanding of the current thinking.


Sent from my iPad using DCUK Forum mobile app
 
  • Like
Reactions: 4 people

Dr__Mesh

Member
Verified HCP
Messages
18
Type of diabetes
Doctor
Treatment type
I do not have diabetes
Hi Mahesh, as a practising Dr and somebody who is presumably used to reading some thought provoking but well reasoned scientific literature, I suggest you get hold of a copy of The Art And Science of Low Carb Living" Phinney & Volek, written principally to help the trained community and arguably the best reasoned, evidenced based treatise in book form.


Sent from my iPad using DCUK Forum mobile app


Many thanks for this information Sir. I shall certainly have a read of this.

I certainly do agree with a low carb diet, just to clarify with those who thought I may not be :)
 
  • Like
Reactions: 2 people

bulkbiker

BANNED
Messages
19,575
Type of diabetes
Type 2
Treatment type
Diet only
Hi Mark,

Thanks for your reply.

No no it's okay, I completely understand why people may feel some bitterness towards GPs/doctors.

I agree, it would be interesting to read up more on LCHF and read about the success stories. I'm sorry if I came across as not accepting of it or damning it, I'm not like that at all. As I mentioned, I'm open to new ideas, and certainly shall look at the link you have shared :)
I guess I was just sharing my limited views, but I know that I can learn so much more from those actually experiencing diabetes on a daily basis. So I thank you once more. Forgive me if I have angered or hurt you in any way.

Kind Regards,

Mahesh
You certainly haven't angered or hurt me in any way at all..in fact I'm very impressed to see you here and hope you find it informative. We need a lot more of the open minded type of GP's a rare breed...Enjoy your reading.. there's quite a lot!
All the best
Mark
 
  • Like
Reactions: 4 people

Totto

Well-Known Member
Messages
2,831
Type of diabetes
Type 2
Treatment type
Diet only
Thanks for your kind words.

Yes, I suppose that is a factor, though I tend not to base my practice on that fear. But thanks for understanding that that is a factor too :)

I can understand why someone may feel annoyed when a doctor may say something that doesn't agree with their view. But in my case, I'm not saying what I'm saying because I'm a doctor and I know best, because I don't. I'm giving my opinion based on what I know (which is limited at this point in time), but am all open to learning and improving from those experiencing the problem first hand, and from those dedicated professionals who are really looking into the problem to make a real difference.
Already from the replies I have received, I have become aware of a lot more than I knew, and I'm thankful for that :)
I have a lot to go away and reasearch on! :-D

Thanks again for your kind message :)
If you read the forum you will, hopefully, get to understand a lot of things about living with diabetes. I'm T2 on diet, in my case LCHF as a way of living, no meds, HbA1c of 32 but I get a limited supply of test strips on prescription as the way I handle my diabetes obviously works and they want me to keep it up. I don't need to test in order to get any doses of insulin right, but I do need to test in order to see what different kinds of food items or combinations do to my BG. When I want to know this, I test before a meal and then at least every hour until I'm back to baseline. So have ruled out most carby things, including low and slow carbs as they will only make my BG stay high for many hours and I prefer to be back to baseline after an hour or two. And baseline in my case is usually 4.8.

As I understand things, being both diabetic and vegan will be a bit of a problem but I'm sure it can be managed. I think it's a great thing to be able to eat eggs, cheese and stuff like that though.
 
  • Like
Reactions: 2 people

Finsky

Well-Known Member
Messages
437
Type of diabetes
Prefer not to say
Treatment type
Other
Mahesh...I like your friendly attitude but as regarding your opinions of the diet...it goes in line with 'general' recommendation with health professionals. That is one reason many of us....from around the world here are not succeeding to keep their diabetes under control.
I agree that it is 'the whole' package..not just diet, or just life style..everything has effect to our health..it is same for EVERY BODY ...not just diabetics.
What is frustrating that many GP's or doctors in general are very ready to write prescriptions and then patients are left to cope with rest of the care by themselves OR given standard dietary advice that is time and time again proven not to work.
You admitted yourself that do not know about LCHF diet..and that is the core point of the problem...most doctors do not (I've seen many during my years and none has been any different from another one)
But yet diet based into same basics is the foundation how diabetes was long ago controlled/managed before all the medicines was even available. There is absolutely loads of scientific research to back these kind of diet's benefits.
I don't want to sound negative..it is encouraging we have doctor here who dare to come and talk...but please keep open mind and really look into how we are managing AND succeeding to get better results. I think evidence only speaks volumes.
What you have written to us sounds to me so much like standard information that is repeated over and over again..but relevance to 'better ourselves' is not quite correct (in my opinion). If you are interests to know more about LCHF LIFE STYLE...you can find all the basics and more from here..http://www.dietdoctor.com/ and here...http://realmealrevolution.com/start-for-free/informative-content
Many of us see type 2 diabetes as 'carbohydrate intolerance'...there is direct link. You eat carbs, regardless of the source /type...and your blood sugars go up. Now, different people react some carb sources much stronger than to others.
That's where blood testing comes to play..IT IS SO IMPORTANT! One can find out those foods that that create worst reaction for blood sugars...hence avoiding or limiting the quantity consumed to achieve less spikes. It really is hard work to get levels down once they go up. And why to rely to medications if it is not necessary or take them in such a quantities if it is possible to achieve good control by selectively choosing better, more suitable food options.
That's where fats come to the play. They don't increase insulin response in a body...or raise blood sugars. I'm sure you are aware that insulin tends to cause weight gain AND send those hunger messages..well, fat doesn't...with the effect that we don't need to eat as much and as often as we don't feel as hungry>>>weight loss>>>less insulin resistance, increased insulin sensitivity.
Most of us who have been on that diet.....no, life style..have improved our diabetes AND come off or reduced need for medication AND lost weight.
Very little of such a success is achieved with conventional recommendations....oh, and I won't even start about cholesterol and saturated fat..another myth...:rolleyes::banghead:
My post did turn a bit of a nag...:rolleyes:...sorry...but when you have been living with this condition over 20 years and it has progressed only to go worst...now that I've found the right info, I have managed to make such a difference to better it, I would not have believed it is possible after all these years. And neither can my diabetes nurse believe it!:D
I wish you well!
 
Last edited by a moderator:
  • Like
Reactions: 2 people

Dr__Mesh

Member
Verified HCP
Messages
18
Type of diabetes
Doctor
Treatment type
I do not have diabetes
You certainly haven't angered or hurt me in any way at all..in fact I'm very impressed to see you here and hope you find it informative. We need a lot more of the open minded type of GP's a rare breed...Enjoy your reading.. there's quite a lot!
All the best
Mark


Thanks for your reply Mark.

Yes, I have in fact dipped in and out of this site on a number of occasions to find out things, and now am glad to have come across LCHF.

Lots and lots to read up on and enlighten myself with!

I think it's really important to be open minded and accepting of different views, especially as a GP. I'm a GP, not so that I can dictate, but so that I can be there for those in need and develop into a better human being, by learning and experiencing from, and interacting with, the people and the community.

Please message me if you come across any interesting articles that you feel I would benefit from :)
I shall also do my own searching about.

Thanks!
 
  • Like
Reactions: 4 people

Dr__Mesh

Member
Verified HCP
Messages
18
Type of diabetes
Doctor
Treatment type
I do not have diabetes
If you read the forum you will, hopefully, get to understand a lot of things about living with diabetes. I'm T2 on diet, in my case LCHF as a way of living, no meds, HbA1c of 32 but I get a limited supply of test strips on prescription as the way I handle my diabetes obviously works and they want me to keep it up. I don't need to test in order to get any doses of insulin right, but I do need to test in order to see what different kinds of food items or combinations do to my BG. When I want to know this, I test before a meal and then at least every hour until I'm back to baseline. So have ruled out most carby things, including low and slow carbs as they will only make my BG stay high for many hours and I prefer to be back to baseline after an hour or two. And baseline in my case is usually 4.8.

As I understand things, being both diabetic and vegan will be a bit of a problem but I'm sure it can be managed. I think it's a great thing to be able to eat eggs, cheese and stuff like that though.


Dear Totto,

Thanks for your info! I'm really starting to grasp a better understanding of blood sugar checking. I guess this is something I haven't really had a chance to explore with my patients up to now...

But all your feedback is really enlightening, and it's great that I'm being made aware of this early on in my career.

Thanks so much :)
 
  • Like
Reactions: 6 people

bulkbiker

BANNED
Messages
19,575
Type of diabetes
Type 2
Treatment type
Diet only
Thanks for your reply Mark.

Yes, I have in fact dipped in and out of this site on a number of occasions to find out things, and now am glad to have come across LCHF.

Lots and lots to read up on and enlighten myself with!

I think it's really important to be open minded and accepting of different views, especially as a GP. I'm a GP, not so that I can dictate, but so that I can be there for those in need and develop into a better human being, by learning and experiencing from, and interacting with, the people and the community.

Please message me if you come across any interesting articles that you feel I would benefit from :)
I shall also do my own searching about.

Thanks!

Ok now you have opened the floodgates..
Have you heard of Dr Jason Fung? he is a Canadian nephrologist (excuse spelling)
He has a website
https://intensivedietarymanagement.com
he is a fan of both LCHF and fasting..
Also you should check out www.dietdoctor.com lots of info on there.. you don't need to sign up just read some of the articles..
 
  • Like
Reactions: 2 people

Dr__Mesh

Member
Verified HCP
Messages
18
Type of diabetes
Doctor
Treatment type
I do not have diabetes
Mahesh...I like your friendly attitude but as regarding your opinions of the diet...it goes in line with 'general' recommendation with health professionals. That is one reason many of us....from around the world here are not succeeding to keep their diabetes under control.
I agree that it is 'the whole' package..not just diet, or just life style..everything has effect to our health..it is same for EVERY BODY ...not just diabetics.
What is frustrating that many GP's or doctors in general are very ready to write prescriptions and then patients are left to cope with rest of the care by themselves OR given standard dietary advice that is time and time again proven not to work.
You admitted yourself that do not know about LCHF diet..and that is the core point of the problem...most doctors are not.
But yet diet based into same basics is the foundation how diabetes was long ago controlled/managed before all the medicines was even available. There is absolutely loads of scientific research to back these kind of diet's benefits.
I don't want to sound negative..it is encouraging we have doctor here who dare to come and talk...but please keep open mind and really look into how we are managing AND succeeding to get better results. I think evidence only speaks volumes.
What you have written to us sounds to me so much like standard information that is repeated over and over again..but relevance to 'better ourselves' is not quite correct (in my opinion). If you are interests to know more about LCHF LIFE STYLE...you can find all the basics and more from here..http://www.dietdoctor.com/ and here...http://realmealrevolution.com/start-for-free/informative-content
Many of us see type 2 diabetes as 'carbohydrate intolerance'...there is direct link. You eat carbs, regardless of the source /type...and your blood sugars go up. Now, different people react some carb sources much stronger than to others.
That's where blood testing comes to play..IT IS SO IMPORTANT! One can find out those foods that that create worst reaction for blood sugars...hence avoiding or limiting the quantity consumed to achieve less spikes. It really is hard work to get levels down once they go up. And why to rely to medications if it is not necessary or take them in such a quantities if it is possible to achieve good control by selectively choosing better, more suitable food options.
That's where fats come to the play. They don't increase insulin response in a body...or raise blood sugars. I'm sure you are aware that insulin tends to cause weight gain AND send those hunger messages..well, fat doesn't...with the effect that we don't need to eat as much and as often as we don't feel as hungry>>>weight loss>>>less insulin resistance, increased insulin sensitivity.
Most of us who have been on that diet.....no, life style..have improved our diabetes AND come off or reduced need for medication AND lost weight.
Very little of such a success is achieved with conventional recommendations....oh, and I won't even start about cholesterol and saturated fat..another myth...:rolleyes::banghead:
My post did turn a bit of a nag...:rolleyes:...sorry...but when you have been living with this condition over 20 years and it has progressed only to go worst...now that I've found the right info, I have managed to make such a difference to better it, I would not have believed it is possible after all these years. And neither can my diabetes nurse believe it!:D
I wish you well!


That is all really good to know, thanks for your info!

Completely agree, that I would rather not just hand out a prescription, I would rather lifestyle changes.

I'm certainly going to read up on LCHF, and I can now see the importance of regular BG checking as you and others have mentioned.

This shall all improve my limited understanding of diabetes, and more importantly the thoughts, ideas, concerns and views of the people. This is turn will help in better joint-management with my local patients :)

My eyes have really been opened, and I can see how narrow and ignorant my views may have seemed and come across (even though that was not my intention). I'm glad I have realised this early on in my career, so that I can make the changes for the better from now :)

Thanks for everything guys!

Warmest Wishes,

Mahesh
 
  • Like
Reactions: 6 people

Dr__Mesh

Member
Verified HCP
Messages
18
Type of diabetes
Doctor
Treatment type
I do not have diabetes

Finsky

Well-Known Member
Messages
437
Type of diabetes
Prefer not to say
Treatment type
Other
Thank you!
Oh....and do us a favour and spread the word amongst your colleagues..it would make our and other diabetics lives,who are yet to know better, so much easier..;)
 
Last edited by a moderator:
  • Like
Reactions: 2 people

Dr__Mesh

Member
Verified HCP
Messages
18
Type of diabetes
Doctor
Treatment type
I do not have diabetes
Oh....and do us a favour and spread the word amongst your colleagues..it would make our and other diabetics who are yet to know better so much easier..;)

Hehe sure ;)

I'll read up on all your links first, so that I know what I'm talking about ha ha!

Thanks all, have a pleasant evening :)
 
  • Like
Reactions: 6 people

fene48

Well-Known Member
Messages
136
Well done Liam, you're doing everything right.
Sadly, too many HCPs are not as informed or up-to-date as members on this forum, so you'll have have to practise that 'disagreeing with a smile.'
However, more and more are learning about the validity of an LCHF approach. In the last six weeks, when my T2 turned into a LADA, I told both a GP and two Diabetes nurses about my low-carbing, and there was a simple acceptance of it. Quite surprised me !
One of the main effects of low-carbing is a reduction in the need for medication, so monitor your BS levels and if a reduction is necessary, that's better than taking unnecessary carbs.

You sound like a self-educator, which can only help you. You'll end up feeling you know more than the HCP dealing with you. There's so much good information out there these days. The days of higher carbs and the demonisation of saturated fats are numbered!

Keep up the good work !
Geoff
For heaven's sake mate!
Before you dismiss the warnings about saturated fats, check out the Joslin Diabetec Centre, Mayo Clinic, John Hopkins, Harvard Medical School, American Cardiologists Association for a start (by the way I am not a Yank but an Aussie). There is certainly a place and need for blogs like this - problem being too many people reading blogs and sites where where misinformation is in the majority.
Do you REALLY think all those medical people are idiots, or that it is just a great conspiracy to keep us T1's and T2's hooked on tablets.
You are quite right that there is a lot of good information out there, but please check your fact out at reputable sources.
 

KevinPotts

Well-Known Member
Messages
2,606
Type of diabetes
Type 2
Treatment type
Diet only
Dislikes
Unkind people, failure to take personal responsibility.
Hi fend48, thank you for providing a countervailing view. I would say that just because some people hold strong opinions that may not be currently mainstream, does not necessarily lead to the conclusion that they are "conspiracy theorists".

I am aware of highly credible scientists, some in the organisations you in fact list who would hold a strong contention that there is no link between saturated fat and CVD/CHD.

By way of at least trying to move us away from the foothills of conspiracy, let me provide you with a smattering of independent peer reviewed studies. There are over 150 of these, many of them RCTs, some in the range of the largest ever undertaken and amounting to In excess of 100,000 participants.

Here goes with my first few:

Siri-Tarino, P.W., et al., Meta-analysis of prospective cohort studies Eva,hating the association of saturated fat with cardiovascular disease. Am H Clin Nutr, 2010, 81(3): p535-46

Yamagishi, K, et al., Dietary intake of saturated fatty acids and mortality from cardiovascular disease in Japanese: the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC) Study. Am J Clin Nutr, 2010. 92(4): p759-65

Jacobsen, M.U., et al., Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies. am J C,in Nutr, 102099.89(5): p.1425-32

Foray the, C.E, et al., Limited effect of dietary saturated fat on plasma saturated fat in the context of a low carbohydrate diet. Lipids, 2010. 45(10): p 947-62

Howard, B.V., et al., Low-fat dietary pattern and risk of cardiovascular disease: the Women's Health Initiative Randomized Controlled Modification Trial. JAMA, 2006. 295(6): p, 655-66

McClellan, W. S. An E.F. Dubois, Clinical Calorimetry. XLV: Prolonged Meat Diets with a Study of Kidney Function and Ketosis. The journal of Biological Chemistry.

Phinney, S,D., J. A. Wortman...oolican grease: a unique marine lipid and dietary staple of the North Pacific Coast. Lipids, 2009. 44(1), p.47-51

The Lipid Research Clinics Coronary Primary Prevention Trial Results. I. Reduction in incidence of coronary heart disease. JAMA, 1984. 251 (3): p351-64

Taub, G. Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Duet and Health. 2098: Anchor

Even if we still remain at opposite ends, having sifted the evidence, I nevertheless appreciate your contribution

Warmly,

Kevin


Sent from my iPad using DCUK Forum mobile app
 
  • Like
Reactions: 5 people

MrsHutt

Well-Known Member
Messages
58
Type of diabetes
Type 2
I feel quite lucky! My consultant was enthusiastic about LCHF, but it doesn't lower my numbers enough without meds, so I am still on Gliclazide and Empagliflozin to keep under 10. I try to have very low carbs (under 30) most days and no white carbs at all. Both consultant and dietician were very happy last visit. Hb1c has gone down from 102 (!) To 53 in 6 months on this regimin and I've been discharged back to GP's care.
 
  • Like
Reactions: 2 people

Indy51

Expert
Messages
5,540
Type of diabetes
Type 2
Treatment type
Diet only
Hi fend48, thank you for providing a countervailing view. I would say that just because some people hold strong opinions that may not be currently mainstream, does not necessarily lead to the conclusion that they are "conspiracy theorists".

I am aware of highly credible scientists, some in the organisations you in fact list who would hold a strong contention that there is no link between saturated fat and CVD/CHD.

By way of at least trying to move us away from the foothills of conspiracy, let me provide you with a smattering of independent peer reviewed studies. There are over 150 of these, many of them RCTs, some in the range of the largest ever undertaken and amounting to In excess of 100,000 participants.

Here goes with my first few:

Siri-Tarino, P.W., et al., Meta-analysis of prospective cohort studies Eva,hating the association of saturated fat with cardiovascular disease. Am H Clin Nutr, 2010, 81(3): p535-46

Yamagishi, K, et al., Dietary intake of saturated fatty acids and mortality from cardiovascular disease in Japanese: the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC) Study. Am J Clin Nutr, 2010. 92(4): p759-65

Jacobsen, M.U., et al., Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies. am J C,in Nutr, 102099.89(5): p.1425-32

Foray the, C.E, et al., Limited effect of dietary saturated fat on plasma saturated fat in the context of a low carbohydrate diet. Lipids, 2010. 45(10): p 947-62

Howard, B.V., et al., Low-fat dietary pattern and risk of cardiovascular disease: the Women's Health Initiative Randomized Controlled Modification Trial. JAMA, 2006. 295(6): p, 655-66

McClellan, W. S. An E.F. Dubois, Clinical Calorimetry. XLV: Prolonged Meat Diets with a Study of Kidney Function and Ketosis. The journal of Biological Chemistry.

Phinney, S,D., J. A. Wortman...oolican grease: a unique marine lipid and dietary staple of the North Pacific Coast. Lipids, 2009. 44(1), p.47-51

The Lipid Research Clinics Coronary Primary Prevention Trial Results. I. Reduction in incidence of coronary heart disease. JAMA, 1984. 251 (3): p351-64

Taub, G. Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Duet and Health. 2098: Anchor

Even if we still remain at opposite ends, having sifted the evidence, I nevertheless appreciate your contribution

Warmly,

Kevin


Sent from my iPad using DCUK Forum mobile app
I'd also add Nina Teicholz's book "The Big Fat Surprise" to your list. Plus the paper by many leading low carb researchers that I have in my signature:

Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base. Nutrition Journal: http://www.nutritionjrnl.com/article/S0899-9007(14)00332-3/abstract