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How do we convince the healthcare professionals.

Dougie22

Well-Known Member
Messages
319
Location
Scotland
Type of diabetes
Type 2
Treatment type
Other
So I go along to my doctor, who is generally quite helpful and collaborative and I tell him I'm adopting a mild version of LCHF (130g) and that it is recommended that I tell him about it. He frankly admits that he doesn't have enough knowledge of this style of eating and asks me to see the dietician. Met with the dietician yesterday ( another generally helpful person ) who tells me she's never heard of LCHF, that I shouldn't trust anything I read on the web unless it's from an NHS source and that I should be eating starchy carbohydrate with every meal.

For me, this means that I have to have the courage to follow a regime that my health professionals don't support. I am now committed to do this but it must deter very many diabetics.

Are we as a community trying to change this situation? If so, how are we going about it? It would be good to build an information pack, citing NHS approved or internationally accepted mainstream papers supporting the LCHF case to point them to. There would need to be a mix of easily digestible and serious papers to try to convince them, but the most important issue would be the source which would have to be one they'd trust.

As mine are relatively open minded, I've sent them some representative material but it's likely they won't have time to read it and we are such a long way from their knowledge base that it's like trying to move a mountain.
 
My GP laughed, shook his head and said "that sounds ridiculous" when I told him on diagnosis that I was intending to follow a LCHF diet.

When I went back 3 months later, he was only slightly less dismissive of the idea, but did say "keep on doing what you are doing, as it seems to work"

He probably still thinks I am some freakish accident, and the NHS Eatwell nonsense is the way to go.
 
Hi dougie I love your energy!! I think in many ways professionals have gaps in knowledge, not all and of course varies. When I was diagnosed the team were awesome in support, however in terms of diet or insulin they were not great. I got my hbca awesome with another team and they turned around and said," right, now your a fat cow and need to loose weight" (nurse and dietain). I was 20 at the time but I basically demanded to go to another nhs after that. Anyway what I'm trying to say is that those professionals mentioned gave me support from their knowledge and empathy in different ways. However like the fat cow one they were not acknowledging that I had been On a strict diet for 5 years, and when I got to the pump the bakery opposite where I worked was too tempting!!!! However instead of calling me names a structured diet would have helped. I wonder sometimes if professionals when they are taken out of their knowledge zone thy react from fear! I feel it's about them being able to direct people to the correct knowledge rather than guessing . Sorry major rant there but I really relate to what your saying
 
I find the situation extremely frustrating. If you follow NHS advice and get bad results then you are blamed for not following the advice properly. If you follow LCHF and get great results, then they don't want to listen to how you got those results.
 
Nothing I have done over the last 3 months ND and then LCHF was generated from any of my health professionals and I didn't seek there support. My GP was shocked when I turned up after 8 weeks and had lost 16kg, decided to stop taking my 1000 daily Metformin and showed him a record of my BG tests. To his credit he endorsed all of this after the event and was blown away when the HbA1c came back. I lent him my copy of 8 week (though I pointed out that I actually used the ND). he had no idea but was impressed and interested. Last week I spoke with a Diabetes organisation to see if I could find out that from July the Australian government were no longer subsidising self testing for type 2's (it looks like this is correct) During the conversation I mentioned the Newcastle Diet and there was no recognition but I was advised it doesn't really matter because all type 2's will be on insulin within 10 years of DX.

It would now appear in Australia we are now cut and pasting the NHS guidlines.
 
Saw my DCN a day ago. She had no real knowlege of LCHF, but had studied Atkins. She was well inpressed with my results, and made notes about this website, so she may be lurking here one day. We need to talk to our HCP's whenever we can, and show by our example what can be achieved. Then we need to show show it is a real lifestyle change that is sutainable, and not a flash in the pan. This diet has dropped my HbA1c from 99 to 44, and its still dropping,: I have already dropped one tablet a day, and am considering dropping both of my evening meds..
 
Instead of making this about a low-carb diet, why not make it about why you don't need a diet high in carbs? That makes the conversation about something the doctor/dietician SHOULD know something about.

The biggest misconception that seems to caused all of these issues is that our brains need 130g of carbs to function.

The fact of the matter is, our brains need about 100g of GLUCOSE to function regularly.

First, 130g is the "safe" number since some of our brains need more than others.
Second, those figures assume that your only source of energy is glucose and it completely ignores the fact that energy can come from other sources (although the brain does still need SOME glucose).
Third, and most importantly CARBOHYDRATES and GLUCOSE are NOT synonymous. Glucose can be created through other sources (particularly excess protein) though the process of gluconeogenesis.

So Mr. or Mrs. Doctor,
I agree with you that my brain needs glucose to survive. However, I'd prefer to get that glucose from sources other than carbohydrates because carbs raise my blood sugar. Plus, since you said I need to lose a few pounds, I figure it makes sense to get most of my energy from my body fat.
 
I was never given any advise on diet, but found LCHF on this site. Now, I am that weird diabetic who came off medication, but yet have normal numbers.
They are puzzled (GP nurse and GP), but none of them ever asked how I did that, and I never told them, because there simply isn't enough time in a 10 minute consultation.

If they were truly interested, they would have asked, wouldn't they?

I don't think they would even read papers I brought to them, so I will continue keeping my mouth shut and just do my thing.

It is my impression that many doctors are annoyed at patients who have any knowledge of their own desease. I am even having a hard time getting mine to tell me my HbA1c, and always have to ask for it several times, before they reluctantly tell me. I still don't know my numbers from when I was diagnosed 4 years ago.

Since I escaped the playpen, I have always been interested in how things work, but only recently, some sixty plus years later, I have finally come to terms with the fact that not all people are equally curious, not even those who have a degree in science.
 
We can point them to resources hoping they'd read, but the bottom line is, it goes against "official" recommendations, and so as healthcare professionals, it doesn't reflect too good on them to go against "official" prescriptions. This is especially so if they're not exactly experts on diabetes, but merely regurgitating what they've read (again, through "official" channels).
 
Living in Cumbria, I'd always assumed we were a backward county and our medicine was steeped in the dark ages. However, when I mentioned limiting carbs the dietician was most enthusiastic and very supportive. She even gave me some recipes and recommended Asda for a pack of ready-grated cauliflower-rice to microwave for cauli mash (its in the chillers with the Good and Balanced veg).
Well impressed.
Still miss pastry.
 

The frustration is that all the research info for the diet many of us are following, is out there if health professionals could/or would want to promote it. Thing is...we all know that for many, being doctor or nurse is just a job... once out of door, they don't have interest/energy or will left to 'study' different areas any further. You just tell for your patients what you are told to tell and job done! Many 'pro's ' who have true interest to diabetes and follow the latest research often don't really deal day to day patients..many of them are more of academics. It takes to have either very personal reason to start digging info out or have 'nerdy' interest for this subject. I can't see ordinary doctors and even 'diabetic ones' having that much time in their hands.
And then there is that 'follow the money' controversy..somebody always 'have to benefit'...if it is good or bad advice/treatment. There is no money to be made..nor much with the healhy food and definitely not when not able to promote excess medication 'sales'.

How are we going to change the situation?....very slowly I'm afraid.....one diabetic at the time. After yesterday's appointment to see DN...she took great interest how I changed things around with my diabetes...she had a look at my books, list of web sites..yes, I dragged anything and everything with me....and she did wrote some key words down so she can follow them up herself.... She had never even heard LCHF diet...or banting....and admitted not really knowing much about ketone diet neither... Until now.... She did mention about Atkins..
Maybe she is not allowed to recommend this type of diet for her patients...I don't know...but I hope she will advise/direct some of her patients to visit this forum...we had good chat about us and what we get up to too..
Maybe it is just case of making lots of individual noises around to get 'rumours' going around....I have already talked about things for few diabetic friends and neighbours..trying to do my bit. But it almost always comes down to...'but my nurse/doctor/dietician says...'
Funny enough..I seem to have more success promoting LCHF type of eating to non-diabetics! Some very active friends have taken it into their lives with really good results. And I have managed to convert couple 'life time' slimmingworld ladies to try it too!
 
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At diagnosis, by a quirk of circumstance, I was unable to be referred to any of the more niche subsidiary HCPs relating to T2, so I had to get on with things and educate myself.

One thing I will say loud, loud, loud is that I never, ever us the phrase High Fat when I am discussing diet, aside from on this forum, where it is part of the parlance. The use of those two words, in a joined up way, seems to cause a big concern for almost anyone, at the moment. Things are changing, but slowly.

I have always described my diet as necessarily reduced in carbs (because of "they don't agree with me too well", if I'm discussing it with a lay person, or "because of my meter feedback from a consistent testing regime" if talking to an HCP who should understand nutritional). I then go on to say that if I find myself losing weight, I top up with additional fats, so would add extra butter to my deliciously buttered cabbage/broccoli or whatever so that I balance out. Using that, I can honestly say the most "worried" feedback I've had is someone commenting upon lipids. But, by now I have lab based evidence that shows a lipid improvement when eating in this way.

I don't talk about quantities, unless specifically asked, and then, of course, I would be truthful. My way of communication is not about lying or misleading, it is about expressing things in a way that is truthful and likely to receive a supportive response. At the end of the day, I am the one who will have to live with any consequences of my actions taken in a, educated, mindful state.

Good luck with it all.
 
A low carb diet is not exactly a novel way of treating diabetes, it was first(?) used in the 1790s, and LCHF was cartainly being used in its treatment in the pre insulin era - see: http://www.ncbi.nlm.nih.gov/pubmed/16489278. So there's existing evidence that it works. It seems to me that it's a matter of "lost" treatment needing to be re-discovered.

And we currently have Trudi Deakin from X-Pert Health batting for us; she wrote Eat Fat which is an introduction guide to low carb, so the message is spreading. I believe she's a member of our forum.

Dr David Unwin who is a forum member, is also an advocate of low carb diets for diabetics, and has published his research in the prestigious BMJ.

My own GP was also enlightened enough to suggest the Atkins diet for weight loss when he diagnosed me at the end of 2013 with type 2. I didn't actually try Atkins but this pointed the way to LCHF to me.

So we do now have some people in the right places who hopefully are being heard and noted.

Robbity
 

I changed my doctor and surgery when they wouldn't give me my results without my persistence and weren't interested in a collaborative approach to T2 management. They even took six weeks to sign my forms for "My Diabetes, My Way" which was not supposed to be optional for them. I've never regretted changing.
 

So how do we get the "official" guidance changed?
 
You are very lucky!
 
My endocrinologist and his dietician, directed me to the forum.
He is very open minded and thinks outside the box.
I met the same dietary advice from my surgery for over a decade and when my endocrinologist wrote to my GP about my diagnosis and how I controlled my blood glucose levels and the results from my weight loss and how all my health issues were alleviated, he had a change of direction in his understanding of how to control bloods.

I still had to show him my food diary and all my blood readings and he was impressed.

When I took my wife to consult about her T2, our GP advised cutting the carbs.

If you have the proof, they can't deny it.

It is because in the last few decades diabetics were able to be look after themselves better with meds and a better healthier diet than they were before.
There is also big business especially pharmaceutical companies that want you to be ill!
A lot of GPs are not good with diabetes and the dsn role within surgeries have become important. It's the training that needs updating and the knowledge of the diabetic community.
There are still some good doctors out there!
 
Just found this paragraph in one of the sheets given to me,( the highlighting is mine) published by the BDA, the Association of UK Dieticians, Food Fact Sheet for Diabetes - Type 2. So maybe there is hope after all. I will point it out to her when I see her next week (for a different reason).
 
Well.....sounds like the 'one diabetic at the time' approach might be working! I've heard
a little rumour...
Hubby just came from work...few days ago he was talking to his boss about my diet and changes to my diabetes etc. His boss is non-diabetic but have been experimenting LCHF himself and found it very good for him AND he of course talked about my success with his wife. His wife is nurse...and she had heard that one hospital here in Midlands have a diabetic patient that have lost 3 stone with LCHF diet...he is doing it under doctors and nurses observation and is been used as trial patient/experiment!!!!!! So, if hospital is willing and interested to 'invest' to lean about this type of diet.....some information must have been trickling through the 'grape vine'!
Even this news have come long way round and it is not published information, just nurse's inside information(gossip)...but it does sound encouraging indeed. Who ever this patient is....I hope he/she is not only happy with the achievement but also with knowledge that his/hers success can be life changing for many other diabetics as well.
Let's hope doctors and nurses are open minded and will forget the old teachings and let the evidence speak for itself...fingers crossed!
 
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