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Had a visit with my dietician and diabetes nurse.

Troubled1

Well-Known Member
Messages
352
Type of diabetes
Type 2
I haven’t posted in quite a long time now. I still drop in to read up but I have been dealing with various things over the last year so posting hasn’t been a priority.

Last Wednesday I had my bi-annual appointment with my dietician and diabetes nurse. They went over my latest blood work, asked about foot care, dental and eye care. I let them know I am keeping up on all of that plus losing weight and reducing stress in my life. When the topic of diet came up I refrained from using the term low carb but said I was following a modified Mediterranean diet and it was working very good at keeping my blood glucose in check. We also discussed exercise and whether or not I was on any meds. They did a blood pressure check and I was bang on 120/80.

After some more back and forth banter the appointment was over. I asked when they wanted me to come back again. This is the best part...... they said unless something changes, they see no reason for me to come back. I was told that the way I focus on my overall health and to a greater extent, my diabetes, I should just keep doing what I’m doing.

It felt kind of weird that someone with a progressive and chronic disease (as they call it) would be told that they do not need to be monitored anymore. I’m sure if I mentioned low carb or Keto, I would have gotten and earful from them. But since I’m on a “modified Mediterranean diet” things are just peachy.

My last Hba1c level was 6.1 so just in the pre-diabetic range where it has been for about 2yrs now. My goal is to keep reducing carbs and get myself into the normal range. I’ve been doing omd plus some 5-7 days fasts so eventually I’ll reach my goal. I just thought I would share this as I found the whole thing amusing.
 
Troubled1 said:
I’ll reach my goal
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also awesome! Really encouraging for a newly diagnosed Type 2 with a "chronic and progressive disease" that hopefully won't need to be monitored do they even listen to themselves?
 
What a fabulous post.
Quietly determined. Thinking in the long term. Making the most of what HCPs offer, and being selective about how that applies to you personally.
I take my hat off to you.
 
i think that's brilliant but it is a shame you couldn't 'come out' of the low carb closet though I perfectly understand your reasons for obsfucation. That is one less lots of pills and NHS team time that's been saved and I think it would be amazing if more pre Ds and type 2s could do the same.
 
Troubled1 said:
I’m sure if I mentioned low carb or Keto, I would have gotten and earful from them.
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You will never know. I agree that a lot of forum members meet the same old "eatwell plate" dietary advice from their medical team, but there are some very progressive thinkers out there. I'm surprised they didn't ask for your definition of "modified".

Well done by the way.
 
I had my review today and honestly my diabetes nurse was grinning from ear to ear! She was genuinely excited for me and it was so nice to see. We've been on this journey together and I am grateful to her. I was diagnosed in April 2018 with an hba1c of 88. Today I am at 49 with a healthy liver, thyroid and cholesterol and I'm 5kg lighter since 3 months ago. I'm grinning too. All without meds and just sheer determination. Not sure if I'm keto but LCHF and the brilliant NHS 0 to 5k have sorted me. Want to lose another 10 points and another 20kg but it's all going in the right direction!

And I have to say the nurse has been really supportive. And i did tell her I was low carb and I did say they need to change their advice and she couldn't argue because she is gobsmacked by my results. And i told her how disappointed I was that I wasn't the 47 mysug was saying! The NHS must hear it from us that monitoring is the way to go. Now I just have to persuade my Mum!
 

I think sometimes we have a duty to out ourselves in a way that doesn't immediately sned the other person's hackles up.

I don't want to be arguing or making my HCPs feel compelled to reject my actions, so I have a different approach.

HCP: So how's your diet these days?

Me: It's pretty fine. I've had a stable weight for over 5 years now and the bloods all seem very acceptable.

HCP: So, how did you actually achieve that.

Me: To be honest, my biggest educator was my meter. I ate and still do eat to me meter. If I eat something and my test a couple of hours later is a bit high, I either eat a bit less of that, or leave it to one side in future. That has led to me reducing my carb content.

HCP: Don't you find that leaves you hungry?

Me: Not really. I've found if I am finding myself a bit hungry, I can add a bit more butter to my mountain of vegetables, or have a slightly bigger steak/lamb chop/chicken leg next time. It seems to work very well for me.

HCP: The scales and bloods tell the story, so stick with it.

I never, ever refer to "high fat". That seems to me to be a bit like dropping a brick on their toe. It's a knee-jerk reaction trigger phrase. They won't like it, so why do it, yet I tell them exactly what I do and get positive feedback.

We've had similar discussions around lipids.

For me, I consider education to be a two way street. I would like to think I don't patronise, but I do ensure I'm well enough read to be able to discuss any concerns the HCP might have.

Almost 6 years in, I've never had a HCP tell me to eat more carbs. There was an interesting discussion with the Endo when having my Coeliac blood panel done, but even that went well, once we'd been around all the pros and cons.
 
Well done @Troubled1 and @Bec in Brighton ! I did tell my gp I was eating low carb, and she hadn't heard of that, but didn't object. I was more reluctant to tell my dn as she seemed to be more old school, but when I did she said lchf does seem to work and didn't understand why the NHS don't suggest it, but thought it was because of the 'high fat' part.
 
I think it will take the nhs a while but I think change is coming as the evidence stacks up and you people on here do such a great advocacy job.
 
Bec in Brighton said:
I think it will take the nhs a while but I think change is coming as the evidence stacks up and you people on here do such a great advocacy job.
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The NHS is changing. This site's Low Carb Programme is an NHS approved way of tackling T2 diabetes, and is available on prescription, via GPs and hospital staff.

It took more work that can be imaginable to reach this stage and a HUGH big up to DCUK for seeing this through and really sticking with it, against the flow of the then "common knowledge".

It takes a long time for a huge organisation, like the NHS to change, because information is not taken on board at the same pace and at the same time, across the board.

There is also a GP CPD approved learning programme for T2, also on the RCGP website. That is attracts CPD means it is approved. This was written by DCUK in collaboration with Dr David Unwin who is the "course" facilitator. It's only about an hour long.
 
All I get for treatment is a GP.I told him exactly what my plan was,LCHF.Told him I started weaning off the metformin at 4 weeks,he wasnt all that excited about that but agreed,just keep testing he said.
At 4 months going from A1c of 89 to 36,he had receptionist call and tell me "He said thats good"

Will see him in September and bringing in a ton of labs,including being off the blood pressure med of lisinopril 40 mg/day,Im sure he will see the LCHF is a good thing indeed.

Im real honest on my dealing with him,trust and honesty go hand in hand and makes for an honest relationship.Thats real important in my book.Like when my back goes out and I need a muscle relaxer and a serious pain med,he knows Im trustworthy and in the minefield of opioid problems today he can trust me not to be messing with him.
 

For me, the secret is not to make it easy for folks to be offended, and make it simple to be relaxed. Like, @1spuds , I don't lie.

My philosophy is I'll need them, before they need me.
 
DCUKMod said:
For me, the secret is not to make it easy for folks to be offended, and make it simple to be relaxed. Like, @1spuds , I don't lie.

My philosophy is I'll need them, before they need me.
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Yes.I will put it to him its not really high fat,its using fats to replace much of the high carbs that are so detrimental to us diabetics.
 
1spuds said:
Yes.I will put it to him its not really high fat,its using fats to replace much of the high carbs that are so detrimental to us diabetics.
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I refer to my increased fats as "balancing fats" - to balance out my intake, to prevent weight loss, without raising my blood sugars.

A very wise person I know reckons we moderate our carbs to satisy our blood glucose meters and we moderate our fats to satisfy the bathroom scales. It makes sense to me.
 
DCUKMod said:
For me, the secret is not to make it easy for folks to be offended, and make it simple to be relaxed. Like, @1spuds , I don't lie.

My philosophy is I'll need them, before they need me.
Click to expand...
Speaking as someone who has some serious NHS kit that require's consultant approval (pump and freestyle libre) I know what you mean. I am trying to be open to learning from the diabetologists that I see but it sometimes seems to be a numbers game where they track my various co-morbidities (lipids, hypertension, renal function) aka the conditions they want to fix with pharmaceuticals. I have questions and know I must be an annoying patient in my yearly reviews.
I can see why this might be appropriate for a type 1 who is never going to achieve normal bgs (even with low carb and great tools) but must be frustrating for you guys who've reversed out of the disease mainly by diet. Then again, I listen to Dr David Unwin and feel humbled by his low key, non evangelical but successful approach and admire his humility.
 
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