I Don’t Usually Buy a Newspaper......

[Rachox]

...... but this headline caught my eye today. All the usual rhetoric .....

 

[Jaylee]

I heard this on the radio today at work too... (A potted short attention span version of news..)

 

[Deleted Account]

Diabetes UK's recent has been about the seriousness of diabetes which I guess is why they are pushing this message, today.

But, I'm intrigued by Jones "a former punk rocker from Chatham, Kent" (top of page 2) and wonder what he was involved in trying.

 

[Goonergal]

Notice they don’t define what ‘proper care’ is.

 

[Rachox]

Diabetes UK's recent has been about the seriousness of diabetes which I guess is why they are pushing this message, today.

But, I'm intrigued by Jones "a former punk rocker from Chatham, Kent" (top of page 2) and wonder what he was involved in trying.

Just for you @helensaramay!

 

[Energize]

@Rachox
Thanks for posting. I think this is the same article, on line https://www.express.co.uk/news/uk/1037654/diabetes-news-500-deaths-preventable-diet-management

I think it's scandelous the NHS HCP don't give the correct advice, ie to cut/reduce carbs. It would save so much money for the NHS!!!

 

[Grumpy ole thing]

Hi @Rachox , thank you for the info, there's more on here:- https://www.diabetes.co.uk/news/201...-diabetes-related-complications-96273152.html

We so informed them thusly (for Sheldon fans); its like whistling in the wind.

 

[DavidGrahamJones]

I didn't manage to avoid the headlines today, wish I had. It raises more questions than answers.

1. If you experience a cardio vascular event, fatal or otherwise and you happen to have diabetes, are these considered to be CVEs caused by having diabetes.

2. Is diabetes the actual cause of complications like amputations or is it poorly controlled blood glucose.

3. I see they state yet again that type II diabetes is related to obesity, is obesity the cause or the symptom? Only asking.

4. Will the NHS ever change it's recommendation for everyone that 1/3 of our calories should come from carbohydrate? Should we be looking at insulin resistance in young healthy individuals (I remember those days) before they show any signs of BG problems?

5. It's very nice that they have invested £80 million on reducing the complications of diabetes, but how about investing some money in discovering why it is becoming a bigger problem as we continue to have the NHS guidelines that we have.

6. Have I been mistaken in thinking that the problems are obvious and that the NHS refuses to believe that their guidelines could be wrong?

 

[Bluetit1802]

So sad. The number of deaths from heart issues, amputations and strokes is really alarming. Sad because so many of those people could be saved with correct dietary advice and less reliance on unsuitable medications (for T2s)

 

[NicoleC1971]

I am glad that they (Diabetes UK) are shouting out about the shame of preventable deaths however discouraged to see something in The Express this weekend amidst the carbs fest that is the work canteen, which rang the alarm bells but only promoted the Newcastle Diet as the only way to reverse diabetes. Surely the media can invesitgate a bit more and not just follow the party line on this?

 

[Flora123]

Oh I so wish I hadn’t read the comments on that article. . Those know it alls who say just stop eating junk food and it can be reversed. Like we all eat junk food and that it will disappear forever Sigh....

 

[JAT1]

In my unimportant opinion it's fairly obvious that top dogs in the mainstream diabetes community in all our countries, want these results and want the situation to worsen so that more funding can be justified and procured for exactly whom and what being more buried secrets. It comes down to money. Big farming and big pharma would lose trillions if more diabetics cut carbs. The corporate world can not care about those who die as it has no heart.

 

[PolarBear81]

I didn't manage to avoid the headlines today, wish I had. It raises more questions than answers.

1. If you experience a cardio vascular event, fatal or otherwise and you happen to have diabetes, are these considered to be CVEs caused by having diabetes.

2. Is diabetes the actual cause of complications like amputations or is it poorly controlled blood glucose.

3. I see they state yet again that type II diabetes is related to obesity, is obesity the cause or the symptom? Only asking.

4. Will the NHS ever change it's recommendation for everyone that 1/3 of our calories should come from carbohydrate? Should we be looking at insulin resistance in young healthy individuals (I remember those days) before they show any signs of BG problems?

5. It's very nice that they have invested £80 million on reducing the complications of diabetes, but how about investing some money in discovering why it is becoming a bigger problem as we continue to have the NHS guidelines that we have.

6. Have I been mistaken in thinking that the problems are obvious and that the NHS refuses to believe that their guidelines could be wrong?

I'm always getting upset by these ludicrous claims that the blame for t2 is pushed back on to the patient. I'm just inside the normal BMI just above the underweight range and we all know how BMI is the diagnosis gold standard in the GP surgery (at least from my experience).
I've worked in pathology for 15 years diagnosing patients just on blood tests which then obviously get 'interpreted' by GPs. I went for my postnatal check up to see if my GDM had resolved. My A1C and fasting came back just within the non diabetic range. Let's not forget i was breastfeeding and eating generally healthier than the usual diet because of this and so it wasn't a complete surprise to me to be normal. I explained to the gp that I had been fingerpricking and was getting prediabetic readings with the occasional one in the diabetic range. She fobbed me off saying it was user error or dodgy strips and told me to come back in a year for my yearly review. I argued I know how to test I'm not a complete idiot but just got ignored and told I don't fit the diabetic picture. I guess she meant obese. Clearly my professional abilities didn't matter.
Anyway 1 year later I went back, no longer breastfeeding, making sure to carb load weeks before the test and low and behold: prediabetic.
Saw a half amazing diabetes nurse who advised me that because of my size and strong family history of t2 then there is up to a 90% chance I will get it, it's just a case of when. She advised me to only have 10% carbs on a plate and to do some more exercise but did say that it may make no difference as it's likely I have very little or no insulin resistance its just lack of insulin thats the problem, it's just a waiting game to see when it happens and to come back in a year for my next annual review.
I'd explained about still having high fingerprick readings and she said there's nothing they can do with that knowledge as it's not how the local area diagnoses people. I just have to wait for my A1C or my FBG to be high.
The good thing is she didn't refer me to 'fat camp' to help me learn how to cook. I really wanted to go to show how ludicrous the system was but she said it's not going to help me as I clearly know how to eat properly.
So that's why she's only half amazing. She knows her stuff but isn't allowed to fully use it for the benefit of the patient as the bigwigs say no and I guess she doesn't want to push. It's only for the benefit of the system. It's a one size fits all approach when it comes to treatment or lack thereof and for those of us that sit outside of the 'classic' types as determined by the press we get forgotten leading to more serious complications at a later stage.

 

[JohnEGreen]

I never buy newspapers any more they don't even make good toilet paper even though they come pre-filled with ****. Dung, excreta, feculence.

 

[Bluetit1802]

then there is up to a 90% chance I will get it, it's just a case of when.

but did say that it may make no difference as it's likely I have very little or no insulin resistance its just lack of insulin thats the problem

She is not that amazing! Yes, there is a chance you will get diabetes, but only if you eat too many carbs. It should be easy enough for you to get back down to non-diabetic levels and maintain this.

The fact you are thin/slim does not mean you have no or very little insulin resistance. The visceral fat particularly round the liver is unseen. Plus she can't possibly know if you have too little insulin unless you have had the appropriate tests for this. The vast majority of us T2s have too much insulin. That is the major problem, and resolved only by eating many less carbs and high insulinogenic foods. She certainly can't tell just by your weight.

 

[PolarBear81]

She is not that amazing! Yes, there is a chance you will get diabetes, but only if you eat too many carbs. It should be easy enough for you to get back down to non-diabetic levels and maintain this.

The fact you are thin/slim does not mean you have no or very little insulin resistance. The visceral fat particularly round the liver is unseen. Plus she can't possibly know if you have too little insulin unless you have had the appropriate tests for this. The vast majority of us T2s have too much insulin. That is the major problem, and resolved only by eating many less carbs and high insulinogenic foods. She certainly can't tell just by your weight.

You say there is a chance I will get diabetes if I eat too many carbs. You are using the information that is thrown about in the media. This is not the case in my family it is due to lack of insulin as has been shown in other members. It is a gradual thing that takes time and I can only presume this will be classed as a subtype of t2 in years to come if it hasn't already.
In my nhs trust I have to be diabetic before I have the tests. It's a cost thing. I'm still only classed as prediabetic.
Just to note I am on a low carb diet, have been for over a year, do lots more exercise and the results are the same.
Also you mention the vast majority of T2 have high insulin, meaning there are some that don't. You're forgetting the minority, just like the media, and labeling everyone the same.
I was trying to put across the point I was actually listened to by my nurse, my family history was taken into account and a not at risk diagnosis wasn't based just on BMI.
The downfall in care came when the previous year the GP completely disregarded my comments, ignored my professional knowledge and told me to comeback in a year because I wasn't obese so shouldn't worry.
Then the following year the nurse couldn't use her expert knowledge to help me in anyway due to costs and that I don't fit the classic potential for DM referral pathway as I'm not obese. All I have to do is wait until I'm classed as having DM before they'll do anything.
This is where the better care to save all these people from premature deaths needs to start. Start listening to the patients. Start having the ability to treat based on your expert knowledge not on what some suit in an office who never sees a patient says is more cost effective at that moment in time rather than in 20 years when all the complications arise due to poor care earlier on.

 

[JohnEGreen]

"Type 2 diabetes mellitus is a multifactorial disease, due to decreased glucose peripheral uptake, and increased hepatic glucose production, due to reduced both insulin secretion and insulin sensitivity. Multiple insulin secretory defects are present, including absence of pulsatility, loss of early phase of insulin secretion after glucose, decreased basal and stimulated plasma insulin concentrations, excess in prohormone secretion, and progressive decrease in insulin secretory capacity with time. beta-cell dysfunction is genetically determined and appears early in the course of the disease. The interplay between insulin secretory defect and insulin resistance is now better understood. In subjects with normal beta-cell function, increase in insulin is compensated by an increase in insulin secretion and plasma glucose levels remain normal. In subjects genetically predisposed to type 2 diabetes, failure of beta-cell to compensate leads to a progressive elevation in plasma glucose levels, then to overt diabetes. When permanent hyperglycaemia is present, progressive severe insulin secretory failure with time ensues, due to glucotoxicity and lipotoxicity, and oxidative stress. A marked reduction in beta-cell mass at post-mortem examination of pancreas of patients with type 2 diabetes has been reported, with an increase in beta-cell apoptosis non-compensated by neogenesis."

This is an abstract cannot access full text.

https://www.ncbi.nlm.nih.gov/pubmed/18640585

 

[SamJB]

I didn't manage to avoid the headlines today, wish I had. It raises more questions than answers.

I worked on the steering committee of the NDA for 3 years and might be able to answer your questions

1. If you experience a cardio vascular event, fatal or otherwise and you happen to have diabetes, are these considered to be CVEs caused by having diabetes.

2. Is diabetes the actual cause of complications like amputations or is it poorly controlled blood glucose.

The NDA compares risk factors by looking at the number of complication events for patients (adjusted for Age, Sex and social deprivation score) without diabetes and then compares that against the number of events experienced by diabetic patients. E.g. Say in the UK that 5% of the population had Angina and that there are 100,000 Type 2s. You would expect 5,000 T2s to have Angina too. If, in fact, there were 10,000 Angina events in then you can say the risk of Angina is 2 compared to non-diabetics.

The NDA doesn't make causal assertions, it just, well, audits and provides information on the data.

Notice they don’t define what ‘proper care’ is.

In the Care Processes & Treatment Target report (not the one discussed here, this is the Complications & Mortality report) "poor diabetes care" is defined as not receiving regular tests of:

1. HbA1c
2. BP
3. Lipids
4. Foot checks
5. BMI checks
6. Retinopathy screening

There are others, including attendences of structured education.

 

[caius2x8]

...... but this headline caught my eye today. All the usual rhetoric .....

View attachment 29236

Was it about cardiac probs for types 2 or hypos for types 1s or just diabetics in general?

 

[Rachox]

Was it about cardiac probs for types 2 or hypos for types 1s or just diabetics in general?

Cardiac problems, amputations and strokes are the only specific conditions they mention.