huge conflict with dietician

[kendod666]

First clinic appt and I'm on very low carbs.

Reduced insulin use by 2/3 since going this way.

Glucose between 5-6.

She was insistent that I needed/ to eat loads more carbs/pizza/chocolate/ice Cream!!!!!!! Just take more insulin!!

When I questioned back she had no explanation at all to back her advice up!

I asked what kind of illness/deficiency would I get from low carbs(40g less)Again no answer!

I have since emailed over studies backing up my approach although not expecting a positive response.

They are apparently very concerned over this!!!!

Madenning!!!!!

 

[joaker]

I suppose the worry is that you are missing out on some nutrients.
Do you get you carbohydrate from veg & berries ?
Also how do you make up your calorific intake. Nuts are likely to be better than say high saturated fat foods. Too little carbohydrate and it's the Atkins diet, about but I'd be nervous doing in the long term.

 

[hornplayer]

Kendod666,

I'd be very interested to hear if they ever back up their advice with anything. I'm doing less than 40g carbs a day too. Haven't had my first meeting with DN yet, but the advice from the doctor on diagnosis was to eat as few carbs as possible. - I think I was lucky. Just ran into a friend who's with the same surgery, who was diagnosed two weeks after me. She has been given no advice on diet at all. She feels terrible, can hardly stand, slurring speech. - needless to say, she was just about to go in to see the doc again.

There seems to be so much conflicting advice out there, and so much inconsistency in approach from the medical profession, it seems that it really is up to us to fix ourselves. Depressing in some ways, empowering in others.


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[Hellbunny]

She probably did because low carbing goes against typical NHS guidelines, I've always been told to eat 250g of carbs but i do things my own way and keep my numbers down by having less than 80g a day.

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[joaker]

So where are you getting your calories from ? It's hard to get as low as 80g/day.
You either have to eat a lot of protein or a lot of fat, or both.

 

[SamJB]

Most health professionals panic when you mention low carbing, despite the fact that 94% of T1s aren't hitting the 6.5% HbA1c target* no thanks to the NHS's carb dogma. They worry that because you will be necessarily consuming more fat, you will have cardiovascular disease. Having a high HbA1c is WORSE - much worse - as a risk factor of CVD than consuming fats.

So yes, stop low carbing immediately, you'll be better off with worse diabetes control!

* From the National Diabetes Audit

 

[Robinredbreast]

First clinic appt and I'm on very low carbs.

Reduced insulin use by 2/3 since going this way.

Glucose between 5-6.

She was insistent that I needed/ to eat loads more carbs/pizza/chocolate/ice Cream!!!!!!! Just take more insulin!!

When I questioned back she had no explanation at all to back her advice up!

I asked what kind of illness/deficiency would I get from low carbs(40g less)Again no answer!

I have since emailed over studies backing up my approach although not expecting a positive response.

They are apparently very concerned over this!!!!

Madenning!!!!!

Well done on your results, 5-6 brilliant :thumbup: The NHS should hang their heads in shame, if they cannot, or will not give an proper medical explanation as to why you should stuff your face with lots of high carbs.

I like carbs, especially in fruit and veg, its not all in cakes, bread, potatoes, rice and pasta, as long as you are eating the right amount for you, we are not the same, we are all so different and not clones or robotic eating/injecting machines. One size does not fit all :x

I wish you all the best and good luck RRB

 

[noblehead]

She was insistent that I needed/ to eat loads more carbs/pizza/chocolate/ice Cream!!!!!!! Just take more insulin!!

Might be worth having a word with the Dietitians superiors, if she wanted you to up your carbs from 40g a day recommending pizza, chocolate and ice-cream in doing so is bad advice, very very surprised a Dietitian would say this to you :?

 

[chris lowe]

Funnily enough, when I mention to my DN and my GP that I had lost weight by low carbing they didn't really react at all. No lectures about what I should or shouldn't be eating. Maybe they just though I was another low carb nutter! :lol:

 

[izzzi]

Hi, kendod666

There should be no problems with a Dietitian that is using their well trained good communication skills to be able to convey complex things in a simple way to you (the Patient) needing specialist nutritional advice.

This is part of their "contract of employment"and Job Description

This has not happened in your case.

Thank goodness your sensible and will find a solution.

hope it all works well for you.

Roy.

 

[kendod666]

Hi carbs are from loads of veg broccoli, carrots, cauilflower, tomatoes, apples and the odd bannana.

protein from lean meat, oily fish etc. healthy fats from evoo and the fish and a variety of nuts.

Right up until they asked about diet they were full of praise over my blood work, glucose control, lowering my insulin use etc.

As soon as i ran through my diet it was like id killed a member of their family!!!!


If I'm honest the ice cream/pizza, chocolate was more of a broader statement she was making in relation to eating what I wanted....even though I said i didnt want to eat that kind of thing.

 

[noblehead]

If I'm honest the ice cream/pizza, chocolate was more of a broader statement she was making in relation to eating what I wanted

That figures, I did think that she wouldn't be a Dietitian worthy of her qualifications if she suggested you upped your carbs using the above three :lol:

 

[kendod666]

still should she really be telling me i can eat whatever i want and then list some of the worst **** out there?

There was no mention of any healthy alternatives at all!

 

[noblehead]

still should she really be telling me i can eat whatever i want and then list some of the worst **** out there?

There was no mention of any healthy alternatives at all!

I'm a bit lost as you said it was more of a broader statement of what she said, obviously if your going to eat carbs then you should look for healthy options and only consume pizza, chocolate and ice-cream as an occasional treat.

 

[kendod666]

still should she really be telling me i can eat whatever i want and then list some of the worst **** out there?

There was no mention of any healthy alternatives at all!

I'm a bit lost as you said it was more of a broader statement of what she said, obviously if your going to eat carbs then you should look for healthy options and only consume pizza, chocolate and ice-cream as an occasional treat.

"You can basically eat whatever you want with diabeties nothing is restricted at all. So if you like ice cream or pizza or chocolate that is fine to eat, you just count the carbs and take an appropriate amount of insulin to cover"

That is pretty much all she said before I responded with my diet as I wanted to get across how different I ate.

Then no further advice or options just " more carbs "

Are you a dietician? Did I see you today? ;-)

 

[kendod666]

Most health professionals panic when you mention low carbing, despite the fact that 94% of T1s aren't hitting the 6.5% HbA1c target* no thanks to the NHS's carb dogma. They worry that because you will be necessarily consuming more fat, you will have cardiovascular disease. Having a high HbA1c is WORSE - much worse - as a risk factor of CVD than consuming fats.

So yes, stop low carbing immediately, you'll be better off with worse diabetes control!

* From the National Diabetes Audit

Sam where did you get this figure of 94%?

Is there anything you can link me to? Just after more ammuntion!

 

[noblehead]

Are you a dietician? Did I see you today? ;-)

I like it :lol:


I read your opening post as if the dietitian was advising you to up your carbs from 40g by eating pizza/chocolate/ice Cream:

''She was insistent that I needed to eat loads more carbs/pizza/chocolate/ice Cream!!!!!!! Just take more insulin!!''

As you can see the above was misleading and perhaps she didn't say to eat loads more carbs by consuming pizza, chocolate and ice cream.

I agree and disagree with the dietitian if she said you can basically eat anything whatever you want and take the appropriate insulin, a healthy balanced diet is one that should be low in fast/processed foods and sugary treats, OK as an occasional treat like I said but not something that one should eat every day.... or week for that matter.

 

[kendod666]

Guess I was just typing in the heat of the moment.

 

[EllisB]

NHS /NICE guidelines are predicated with the assumption that most diabetics:

• Do not have the resolve to lose weight (if they need to)
• Will not get enough exercise, whether due to laziness or other medical issues
• Will be unable to successfully manage their BG in the long term.
• Are not able to understand the complex mechanisms going on in their own bodies
• Will not follow the advice anyway

I know that is patronising but, unfortunately, the truth is that there is a large body of evidence that this is the case and that those of us who can take control and keep our BG at close to normal levels are in the minority.

There is a much smaller body of evidence that the secret of successful management of DM is for the patient to be empowered and supported in learning how different foods and treatments affect their BG.

So your Dr and other HCPs are used to dealing with people who are not in control and getting them to improve bit by bit.

So trust in your evidence : energy, general well being, HbA1c, Blood Lipids, BMI and, if you are self monitoring, your BG measurements. If it is working for you brilliant! If not, then it is time to listen to the HCPs.

 

[kendod666]

NHS /NICE guidelines are predicated with the assumption that most diabetics:

• Do not have the resolve to lose weight (if they need to)
• Will not get enough exercise, whether due to laziness or other medical issues
• Will be unable to successfully manage their BG in the long term.
• Are not able to understand the complex mechanisms going on in their own bodies
• Will not follow the advice anyway

I know that is patronising but, unfortunately, the truth is that there is a large body of evidence that this is the case and that those of us who can take control and keep our BG at close to normal levels are in the minority.

There is a much smaller body of evidence that the secret of successful management of DM is for the patient to be empowered and supported in learning how different foods and treatments affect their BG.

So your Dr and other HCPs are used to dealing with people who are not in control and getting them to improve bit by bit.

So trust in your evidence : energy, general well being, HbA1c, Blood Lipids, BMI and, if you are self monitoring, your BG measurements. If it is working for you brilliant! If not, then it is time to listen to the HCPs.

That is An excellent post, thank you.