Interesting Gp View.

I'm only posting this to give an idea of how a GP's brain might (might not) work. This particular GP just happens to be someone my wife knew from her days at Leeds University, even I've known her for 35 years. She came to visit over the weekend and although she was interested in my Freestyle Libre and my low carb diet one of her parting statements was surprising and probably explains an awful lot about what some GPs think. She actually said that I took my condition far too seriously, something that allowed me to monitor 24/7 was excessive and in fact unnecessary and that I shouldn't be quite so draconian with my low carb diet and "lighten up" and enjoy my food more. She suggested that frequent monitoring causes stress and is counter productive.

Luckily I didn't feel the need to justify my approach because there would have been a major argument. I was somewhat intrigued that someone who is quite clearly intelligent (apart from the fact she does a lot of swimming in rivers and the open sea) should adopt an opinion based on NICE guidelines, almost as if she has stopped thinking.

Even more luckily, she is not my GP, mine is much more open minded especially as my approach quite clearly works.

So, I was thinking, when your GP takes a similar approach, you will know that they are probably towing the party line, almost like parliament where MPs have to tow the party line.

kas16 said:

Mmmmm, at the risk of being shot down, I actually think she has a point.

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I won't be shooting anyone down. Like everything in this world our approach, and our opinions are based on our personal experiences. It's very easy for someone like my friend, skinny as a rake, even before she was swimming in rivers, to say "don't be so draconian about your diet", she has never gained weight, apart from while being pregnant, and then returning to dead skinny.

My wife and friends enjoyed a lot of food over the weekend, that's what it's all about. Had I enjoyed as much food as they had I would be in serious trouble. BG and weight wise. Losing weight is a big enough struggle even when doing all the right things (what are they?), so I can't afford to start gaining weight just for the sake of a "good" weekend.

Personally my weight experiences have been completely different. AT 12 I was underweight and worse still my mother was told I was under nourished. Forced to stay to school dinners I weighed 14 stone at 14 (also 6ft tall), 16 stone at 16 and leaving school helped me gain another 3 stone in the first year. Strangely, I dropped to a "healthy" 12 1/2 stone by the age of 24 by which time I had long left home, but started to gain again in my late 30s, in fact gaining 3 stone in 3 months when I moved in with my wife. Maybe that's the answer, I should live on my own and not let others dictate my diet. LOL

kas16 said:

I sometimes think that for many it becomes an all consuming task, the joy is sucked out of life, every minute of every day is spent thinking about it, agonising about it, watching every mmol point and being thrown into a depression if it so much as rises, weighing every morsel that passes your mouth and on and on.

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I'm lucky to have a Freestyle Libre, it is a game changer and a godsend. I don't watch every mmol and don't get depressed when it rises, mainly because my problems are a little bit out of my control in that I can keep between 5 and 7 all day every day, except for the start of the day. Dawn phenomena is a real pain in the backside and if my reading is correct, losing the fat around the liver will help that situation. My draconian diet has enabled me to have some days with no BG rise first thing but it's surprising how temporary that can be. Personally I only weigh food when I go through a period of monitoring food intake. I don't change my diet too much so I know it stays about the same.

I think my friend's opinions are based on what she'd expect of a diabetic patient taking all the drugs she could prescribe and eating what the NHS consider to be a healthy diet. My weight escalated to 27st while taking Rosiglitazone for BG and Citilapram for the anxiety of gaining weight. Stopping the Rosiglitazone (it messed up my liver function) helped my weight drop like a stone until it was decided I need Gliclazide. Not only did my weight loss stopped immediately, I gained 10 kgs. So, medication isn't an option for me if there's to be any chance of losing more weight.

kas16 said:

I believe we can manage it properly without the hysteria and also take it seriously.

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I had to look the word up because I often think I know what a word means and quite often will only be sort of right.

Hysteria - exaggerated or uncontrollable emotion or excitement.
an old-fashioned term for a psychological disorder characterized by conversion of psychological stress into physical symptoms (somatization) or a change in self-awareness (such as a fugue state or selective amnesia).

So probably not guilty although I do talk about it a lot.

Otherwise, I couldn't agree more, perhaps my talking about it was mistaken for hysteria. I follow a low carb diet by cutting out bread/pasta/rice/potato, I don't eat processed food. I have one "treat" which is toast on Sunday and because it reminds me every week how much my BG rises just on a couple of bits of toast, it helps me keep to the straight and narrow the rest of the week.

britishpub said:

Other than an "interesting exercise" I can't see the need for a T2D to use a CGM, nor can I see the need for frequent testing once you have gained control.

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I thought I had gained control, I cut out bread/pasta/rice/potato, threw away the Gliclazide and Januvia, HbA1c dropped to about 45 and you would have thought that was it, I had gained control. And yes I relaxed my testing regime and became complacent. Then, after 4 years I get an HbA1c of 64. Where does that come from? I'm still not eating bread/pasta/rice/potato or most things processed (I'm counting pickle as processed).

Based on my HbA1c most GPs would have just prescribed Gliclazide again, previously that had halted my weight loss and I gained 10kgs, so not what I want again. Also, because I use the FS Libre, I know that first thing in the morning, when I frequently don't eat and probably would do a finger prick test, my BG was going mental, dawn phenomena! Add to that my low carb diet I would be having hypos all the time, also not what I wanted. So, for me the FS Libre has been essential in knowing exactly what is going on. My GP knows me well and has allowed me to look at my diet more carefully and although my HbA1c came down to 48, it will still rise to 51 sometimes, despite having gained control.

If you don't think I need a CGM then you won't see the need for me to know my level of insulin resistance. I do, I've had it measured three times and it's been different each time, so obviously changes. For some reason mine has been 1.7, 2.4 and then 1.7 again. So I'm tempted to say that one never really has proper control because there's a variable that will change, we can fix diet and eat approximately the same all the time, but when your IR changes, so will your BG and eventual HbA1c.

So, although I may not need a CGM or need to test frequently, I'm happy that knowing what I do because of having a Libre, I can avoid just the basic problem of additional medication and hypos. By the way, eating more carb to prevent the hypos so that I can take something like Gliclazide isn't in my opinion a sensible option.