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Interaction with the NHS

Peter_Clark

Newbie
Messages
2
Hi everyone,
I just joined, hello to you all. I have been pre-diabetic for about 4 years and following a low carb diet for that time.
My main problem, I believe it is a trap for low-carbers, is letting sweets creep in, because they are addictive, then I am eating fat and sugar - the worst! But mostly I manage all right.
I have a question for anyone who is interested; how do you manage with your GP and practice nurse, the NHS generally? I kept my mouth shut about low carbing for years because I sensed there was no space for that in their minds. But on one occasion I mentioned, mildly I thought, that the recommended diet was high in carbs and must surely be pushing up my blood sugar - the nurse refused to continue the session, to offer me diet advice, and asked me to leave.
Is there a way to deal with this?
Perhaps someone knows a suitable form of words?
Or a general strategy?
Or a way to find a sympathetic practice?
Any thoughts welcome,
Peter
 
WHAT???? That is unbelievable! The DN asked you to leave just for discussing diet? Oh my days. Find a new doctors IMMEDIATELY and put in a complaint suggesting that the nurse attends an X-PERT course! :eek:

I know lots of people do find their GP have some lack of knowledge etc but to ask you to leave? I am obviously lucky, my doctor, nurse and dietician have all been saying low carb.

Am sure @daisy1 will be in touch shortly with lots of useful information that you can show your nurse!

Welcome to the forum by the way, you have come to the right place! ;)
 
The nurse asked you to leave just because you mentioned carbs? That does sound strange. If you're sure that was the reason and you don't want to speak to that nurse again to clarify, you could phone and ask to speak to the Practice Manager.

Is it at all possible that she was just running out of time or something and failed to communicate properly with you?
 
@Peter_Clark,
i am not on a low carb diet, I am on a controlled carbohydrate diet:rolleyes:.
I was lucky in that I was on insulin, and hence on strips, so I had proof that certain foods raised my BG 9 and could be vocal that the carbs in the food were a problemand the advioce conflicted with O level, Higher Grade, CSYS, A level & University Biology & Chemistry, Physiology, and Biochemistry! at this point the nurse usually backed down:)
 
@Peter_Clark

Hello Peter and welcome to the forum :) I agree that you have been badly treated. Here is the information we give to new members and I hope you will find it useful, especially with regard to diet and carbs which you are right to have cut down on. Ask as many questions you like and someone will be able to help.

BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find over 150,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to bloodglucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.
 
@Peter_Clark,
i am not on a low carb diet, I am on a controlled carbohydrate diet:rolleyes:.
I was lucky in that I was on insulin, and hence on strips, so I had proof that certain foods raised my BG 9 and could be vocal that the carbs in the food were a problemand the advioce conflicted with O level, Higher Grade, CSYS, A level & University Biology & Chemistry, Physiology, and Biochemistry! at this point the nurse usually backed down:)

Thanks for the replies everyone, very helpful.
I had very similar discussion to CollieBoy, I did not just mention carbs, I mentioned basic biology and that it seemed inescapable that starches would affect blood sugar. I also mentioned blood sugar monitoring that I undertake myself, and that wholemeal bread for example was just as bad as mars bars. At that point the nurse did not back down - I was asked to leave.
But this was a year or more ago, perhaps I should have taken it further at the time. What I do is try is not to consult these people any more than I need to, and not mention low carb when I do.
Of course I have thought of moving doctor, but how can I know the attitude of the new lot is not worse? By asking I suppose, but then would they agree to take me?

Peter
 
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