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How it used to be

EricD said:
Like me there must be a lot of people who shy away from asking questions because they are afraid of starting yet another argument that has nothing whatsoever relating to their original question.

What we "newbies" need are proper answers and not "heated debates".
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Hi EricD.

Don't ever 'shy away' from asking questions. The original thread does get derailed sometimes, I know. If your or anybody elses question hasn't been answered because of this, ask again !!

I firmly believe that debate whether heated, measured or whatever can inform us all. You don't have to go along with everything that's said - there are many times I have disagreed with somebody. I may respond or just ignore it. I'm sorry you find it boring - I don't agree with that at all.

It's all opinion - some valid, some not so.
Please make YOUR contribution EricD, I think it is the former.
Regards.
Ken.
:D
 
hanadr said:
Is there anyone out there, who has been diagnosed a Long time ( say over 30 years) who can remember what advice they were given and who would be willing to share? T1 or T2
I got a PM from a comparative newbie, which hurt my feelings and was obvious that the pm'er only knows modern advice.
Click to expand...


This is the original question that was asked - perhaps we can now get back to it.

:|

Edited. 1653hrs. 13/04/09
Looks like that was a forlorn hope !!
 
So anyway, I was diagnosed as a type 1 diabetic in 1980 (with a father as a GP who in the classic doctors and their own family cliché missed all the signs until it was coma and ambulance time) what I remember roughly goes like this:

* Initially a glass syringe with changeable needles.

* 2 insulin injections a day, with pork or bovine insulin in non decimal strengths which required a bit of complex mathematics to alter the dosage.

* Eating to match your insulin, not the other way around.

* Urine testing with a test tube and exciting fizzing and popping until you got an orange or blue liquid to denote sugar content.

* The constant fear of hypos (and nuclear attack, this being the 80's, but I could do more about the hypos).

* The excitement of getting blood testing strips. They were like the ketone test strips you get now and had to be visually compared to a chart on the side of the container. You also would cut them in half in a good 'make do and mend' way. This did away with the slight old world charm of the mad professor chemistry lab for the urine tests.

* No dietary advice initially, although I do remember having to eat digestive biscuits instead of pudding at school. Then came the nice but dim dieticians with their silly charts and insistence on vegetables fruit and pasta.

* As a teenager I was put on a 210 carbohydrate a day diet (50 for each meal with 10 or 20 gram 'snack's in between) and being told to 'eat normally'.

* Wondering how lions got by in Africa on what I assumed was no carbohydrate but not having the gumption to follow this train of thought through to its conclusion and become Dr. Atkins before Dr. Atkins.

* No ancillary medicine (i.e. aspirin, lisinopril, statins etc.,).

* Er, and that's it.

Although I must end by saying; EricD - CUT THE CARBS! Sorry, couldn't resist.
 
I have split this post into two parts, this section remains so that Hana's original question can be answered, the second section called How it used to be - The Cradle can be used for all references to Sesame Street, Jim Henson's puppetry, the miracles of Jesus, Robert Atkins, whatever.

Regards, Tubs.
 
To expand on my husbands experience further at the time, he was serving in the RAF when he was diagnosed the Easter of 1979…

His diagnoses and start of his treatment was within his local civilian hospital, where he stayed for the best part of the month under the consultant… When he left hospital the best they had achieved was a urine test of orange (2%) the highest on the scale...

He then had to report to Nocton Hall RAF hospital with another month stay which he reckons this is where he got the best information and advise...

The Dr there not only changed his insulin’s, he also gave him a hypo so that he would know what a hypo felt like… The doctor also showed him how to calculate his insulin so that he could adjust it to his food intake and gave him the best bit of advice concerning his diabetes, and that was he had to be his own doctor where his diabetes was concerned, to maintain control of it!! He left Nocton Hall with constant Blue urine tests.

Mind you this lead to my husband first disagreement with his consultant, who wasn’t amused at all that some-one from the RAF had dared interfere with his patients medication, with a how dare they and hubby would be put back on the insulin that he himself had prescribed him..

Hubby reply not a chance in hell was that happening, the insulin he was using was doing a far better job of controlling his diabetes, as he hadn’t had a hint of orange (2%) and had no intentions of going back to them etc… Stood his ground and got his way…

As for the relationship with his consultant well that didn’t last too long either, as after a couple of frustrating years, he gave up with the consultant, after being keep waiting all morning for his 9.30am appointment, hitting dinner time and needing something to eat, he informed reception he was going! When they said they would make another appointment for him, he replied don’t bother I’m not coming a back!!

Which he’s never have … He didn’t receive any diabetic medical supervision until they brought in the Diabetic nurse into our surgery around 10 years ago now, who we both have a brilliant relationship with....
 
I'm racking my memory about what my mother told me. In the 30s she had a job cooking for a diabetic, so knew what was needed then.

Fast forward to the 50s. A teacher colleague of my father was diagnosed. He came in to us for lunch, & Mum always cooked for him with diabetes in mind. Plenty of home-grown veg, protein but no carbs. He took the school football team, so needed plenty of energy. When he moved on to insulin, he could eat more & felt better, but his eyes were failing & he had to retire.

She was very reassuring when I was diagnosed. My very helpful Dr told me ALL the complications I could expect ... :evil:
 
Been reading this thread with interest. Apart from Mr Keyes etc and the fact that you couldnt eat bread, pots etc exept in restriction.

Was there actually ever any adverse medical effect observed / recorded with the diet for the time that it was used. ? If the answer is yes got any reference to it please??

Dave P
 
The adverse effect was of course progression, particularly of T1. Was T2 significant before 1950? Or was it not diagnosed?

I suspect that "they" have got the "DAFNE" syndrome. Inject the insulin, take the medicine & eat a normal diet, carbs & all. And, of course, diabetes is progressive, so expect complications, but don't worry - we're skilled at amputation & laser surgery.
 
Ian

I take it that you haven't been on a DAFNE course by your remarks?

It isn't just about encouraging diabetics to stuff there face with carbs at all...

It actually teaches the diabetic about there condition, how different factors can effect how you may react to carbs and insulin ect...

It teaches you how to adjust your doses to suit you on going needs, be it eating exercising, feeling unwell, or fine tuning... The carb content/amount isn't decided by the diabetic team, but by you as a indivudual so that if you want to low carb or high carb you have the tool kit and knowledge to do it safely...

And the best thing about the course it actually treats you has a individual person who is different from the next diabetic that is sat next to you...

which sadly isn't the case with some regimes that I could mention...

Strange thing is that I eat carbs of verying amounts and types, I have good control of my diabetes with as good and better results than those that avoid them like the plegue...

So when it seems that I've learn't my trade so well, why should I stop eating my carbs?
 
Well I haven't as yet been on a DAFNE course so here's my view on all this.............

As some might know, I became type 1 in 1965 when I was 10 years old. I went into hospital for about a week and was lucky to be stabilised on one injection per day of Allen & Hanbury's Lente (beef) insulin. It was explained to myself and my mum that I would need to keep to eating a set amount of carb at specific times of the day in order to balance out the effect of the insulin. I was shown how to inject, how to test my urine, what a hypo would feel like..... :( The nursing staff made a real big fuss of me.

While in hospital I wrote down in a diary all the meals that I eat and noted the portion sizes of potatoes etc. For about a month after I came home my mum just carried on cooking exactly the same portions of food as I eat in hospital. It was only when contact was made with the British Diabetic Association (now DUK) that my mum found out loads of info about the carb value of food, and using the 10gram exchange system so that I could eat more or less anything as long as it equalled the amount of carb that I was due to eat for each meal. The BDA were brilliant. I was however only eating 100 grams per day of carb and after two years looked like a stick insect as the carb allowance was not really high enough to enable me to put on any weight. It was only when my mum sought advice from the BDA that we had a row with a junior doctor at the diabetic clinic about the restriction on carb and he agreed that I was too thin for my age so increased my insulin dose and my carb intake upto 130 grams per day. From then on I always knew what effect carb would have on weight so just did my own thing as I got older.

It is now 44 years on lol and although I have gone from one injection, then to two, and now MDI, I still eat the same way more or less as I did years ago. However, I have of course altered the amount of carb that I eat so as to keep my weight ok but still balance myself with insulin and carb by eating little and often. It's been fairly easy peasy really, I'm not one for making life too hard for myself.

I have learned through trial and error how to calculate my insulin bolus and can just eyeball food to roughley work out how much insulin I need to use and do bg tests about 5-6 times a day so that I can alter if need be, the amount of carb that I eat as a snack. No one has ever suggested to me to look at insulin to carb ratios.

Since moving address two years ago, I have only seen a consultant once. He congratulated me on the number of bg tests I did and said that he had a job in getting people to do any at all. I asked if there was anything he could offer in advice to me and he said that only I could look after myself with diabetes and that if I carried on the same way I should remain complication free.

My hba1c ranges between 6.4 to 6.7 since testing 5-6 times a day and touch wood :wink: , I haven't as yet come unstuck so am fairly happy.
 
My initial diagnosis was followed by a 5 day stay in the local childrens hospital where I was given a crash course in everything diabetes, including the induced hypo! My consultant was really good and laid some excellent foundations some of which I still rely on to this day (exchanges became carb counting). Started on long + short acting insulin twice a day with disposable syringes, and thought the little chemistry set to test urine was great fun.

But there have been some muppets along the way too. In the mid 90s my consultant retired and the new guy was more interested in form filling, ticking boxes etc rather than engaging with his patient and managing the condition. No discernible "bedside" manner at all. So I just changed hospitals and got the best ever guy as a result. I do have a practice nurse who is diabetic herself, but my care is almost exclusively handled by the hospital, and always has been.

When I think back to the early 80s, so much of what we take for granted now in technology terms was literally science fiction back then. Insulin pumps, blood meters with 3 second results, and lancing devices that didn't come straight from the Spanish Inquisition!
 
Cugila

When I was diagnosed 20 years ago, there was little consideration of you as an individual…. I was basically told that I had to start eating breakfast, which is a meal that I avoided from childhood… I was told that I would have 3 main meals in a day, and 3 snacks a day… And that each would consist of xxx amount of carbs!

When I paid a visit to clinic, they would look at my bloods, my dairy and see how this was working… I as a individual wasn’t considered in the equation…only my diabetes and that was it full stop…

I lived my life around my diabetic medical condition…

I changed that many years ago, even before it was common practice to do so, but adjusting my insulin to match a larger or smaller meal….

Several years ago I looked into Bernstiens method, and decided that I didn’t like being told what type of foods I could and couldn’t eat, nor did I like the notion of going back to the old days of having to follow a regime of 6-12-12 carbs per each meal…

He sees the diabetic medical condition and not the individual behind it, he suggests by doing as he tells you that you will gain perfect control and avoid all the complications that can be faced by a diabetic! But check his forum it’s not the bed of roses he suggests, as even following his text book, his members and followers all face control issues just as any other diabetic that follow the normal protocols of control…
 
Thank You for that Jopar.

Just wanted clarification of what you meant. If it is working well for you then why change anything. I don't subscribe to the books written by all these different people,
I prefer to do my own research and make my own decisions. Rightly or wrongly I stick with that. It works for me.

Ken. :D
 
I have sat and observed this debate and thought that most of you havent a clue about what was happening 20 years ago. And that is not a criticism by the way!

Carb counting was the norm for all - and they were known as NIDDMS and IDDMS . I hate these labels by the way.
Now dafne courses et al are def the way forward for type 1.

Some people were good at it and others couldnt grasp it - so nothing changes!

But somewhere in the late 80 it went out of fashion - havent a clue why , altho tbh maybe people didnt have the food knowledge we have now .

But we didnt have meters and people came back 2 weeks later for a useless blood result.

So I think that actually alot is better as we have meters and we have more knowlege of food and carbs. the trouble is that maybe some need to accept that there is not just one way of controlling it and that early help from a dietitian is important. There are plenty on here who do not low carb so give them a break please. You know my own pts do not need to either . And people like tubs, Jo and cathereine are real role models for a low gi approach .
 
Before this is provoked into yet another low carb v the rest of the world thread please can we stick to the OP as in how it was years ago.
 
It applies to every diabetic going…

Having good control is one thing, but to continual to maintain that control as everything around you changes is the nightmare…

20 years experience has taught me one thing, which is diabetes changes as different factors and advents happen as you travel through life…

Not only does your body change with age, but you face changes in your personal or working lives that all can have an impact… I am a lot different person than I was 20 years ago, my life both home and working life are very different indeed than it was then, and yes at every major turning point I’ve had to reassess and change the way I handle my control…

Cugila

I done the same, I follow no set regime but follow what works for me, I expect others to do as I do… Learn about our condition and see what works for us as individuals… What ever that is..

I happy to say what works for me, and you can decide to try if you want and if it works then great, if not perhaps I've given a idea to a solution that might..
 
sixfoot
Was there actually ever any adverse medical effect observed / recorded with the diet for the time that it was used. ? If the answer is yes got any reference to it please??
Click to expand...

A very sensible question, though I expect evidence is thin on the ground.

However, there has been a surprisingly recent (pub Feb 2009) analysis of data on diet and subsequent control in the intensively controlled group of the DCCT . This research took place in the late eighties , the diet advocated reflecting that recommended at the time . The DCCT showed that for each percentage reduction of HbA1c there was a decreased risk of complications and that tight control for type 1s was preferable.
The subjects received advice about dietary goals, with a target nutrient profile of 10–25% protein, 30–35% fat, 45–55% carbohydrate, they used various methods some carb counting otheres exchange systems
'Once participants established a framework for diet consistency, they were instructed on how to analyze the blood glucose response to food, insulin, and activity; to adjust insulin doses for expected changes in food intake or activity; and to respond to high blood glucose concentrations in a timely manner'
[ie the type of ideas that are now taught by courses such as DAFNE.]

Diet histories were collected at baseline, and intervals through the study.

Results:
Higher insulin dose, lower carbohydrate intake, and higher saturated, monounsaturated, and total fat intakes were associated with higher Hb A1c concentrations at year 5. In age- and sex-adjusted multivariate macronutrient models, substitution of fat for carbohydrate was associated with higher Hb A1c concentrations (P = 0.01); this relation remained significant after adjustment for exercise level, serum triglycerides, and BMI (P = 0.02) but was no longer significant (P = 0.1) after adjustment for baseline Hb A1c and concurrent insulin dose.*
Conclusion
Among intensively treated patients with type 1 diabetes, diets higher in fat and saturated fat and lower in carbohydrate are associated with worse glycemic control, independent of exercise and BMI.
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*the paper discuses reasons for this ' First, in the DCCT, participants in the intensive-treatment group who had more residual C-peptide had lower Hb A1c.....it is possible that any degree of endogenous insulin secretion allows improved metabolism in a range of diets.In addition, subjects with better glycemic control at baseline may have been more motivated or had more advanced diabetes self-management skills throughout the study, which also would have obscured the association of dietary variation with glycemia.'
http://www.ajcn.org/cgi/content/abstract/89/2/518
 
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