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Letter to Desmond

Listlad

BANNED
Messages
3,971
Type of diabetes
Prediabetes
Treatment type
Diet only
I wrote:

Good Afternoon,
I am a patient with the NHS in Lancashire and a member of my local PPG group. I used to fall into the lower end of the T2 range and also in the Prediabetes range of diabetic symptoms. I never have attended a DESMOND course but understand that the message delivered on the various DESMOND courses is to deal with T2 diabetes with an Eatwell diet incorporating carbohydrates. However this appears to be at odds with the NHS backing of the Low Carb Program and my own personal findings as I achieved symptom reversal on a low carb higher fat approach. How do you reconcile these differences?

Low Carb Program :
https://www.nhs.uk/apps-library/low-carb-program/

Thankyou
Regards
 
The reply:

Dear Mr Listlad


Many thanks for your email regarding the DESMOND Programme. DESMOND has been delivered locally for over 12 years and is primarily a structured education programme promoting long-term behavioural change. It encourages people to self-manage and individualise their management strategies by encompassing an understanding of the condition and associated risks. The programme looks at different ways of diabetes management including food choices, activity and weight loss which all contribute to successful and sustainable diabetes control. The ‘Eatwell plate’ does not feature in the programme and the learning outcomes are to support people understanding the impact of frequency, amount and type of carbohydrate, quality of fat and benefits of weight loss in order to support glycaemic control along with the role of vegetables, fruit and salt in cardiovascular disease risk.


Whilst there are a number of options for people to treat their diabetes, including dietary approaches, DESMOND considers that there is no ‘one-size-fits-all’ approach and accepts that remission may not be attainable for everyone with Type 2 Diabetes. With this in mind, DESMOND offers a structured, evidence-based programme to enable all participants to manage their diabetes, encouraging participants to recognise what is appropriate, safe and sustainable for them to change. All people with a diagnosis of Type 2 Diabetes are welcome to attend, we do not have their medical history and therefore it would be unsafe to give specific advice about treatments and cannot advocate specific treatment approaches during the course. It does not dismiss these approaches but recommends that participants seek individualised advice from their own health care professional to ensure that they are choosing an appropriate method of management and to ensure that they receive ongoing monitoring and support.


The 6 month post-course feedback that we receive shows that people take on board positive lifestyle changes as a result of attending, this may include recognition and change in the amount of carbohydrate in their diet but may also be other positive approaches, for example through activity and/or weight loss, which all can support the management of glycaemic control. The DESMOND curriculum is adapted to take account of new knowledge and treatment approaches, a new curriculum is about to be launched in recognition of changing evidence.


Many thanks again for your email. Please do not hesitate to contact me if you require any further information,


Kind regards,
 
Honestly that reply just sounds like a load of verbose waffle to me. It doesn't appear to say much besides falling back on weight loss again, like it's a separate thing from carbohydrate management.

Top marks for asking, though. I guess it's promising that they mention changes coming through, but they could have just said that in the first sentence and be done with it
 
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Yes, I presume the new evidence they refer to is LCHF evidence?
 
@Listlad - Have you attended a DESMOND course, orr similar NHS programme?
 
DCUKMod said:
@Listlad - Have you attended a DESMOND course, orr similar NHS programme?
Click to expand...
No as my specific circumstances meant that I did not qualify, in the same way as I did not qualify for a whole raft of other supporting services / checks.

I have however spoken at length to a DESMOND representative whose Eatwell thinking was very much along the lines already reported by many forum members. I saw no change there when I checked at the end of July.

I do hope they change their stance on LCHF soon.
 
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I think their hands are tied so that they have to follow the "official" advice, whatever that is. You have to work on changing that official advice, and that sort of change appears to be slow.
 

DESMOND is a programme delivered via purchased licenses, from the providers of DESMOND, so they deliver whichever version they have purchased. Some versions are more up to date than others.
 
Here in Australia, you just phone up and put your name down for the next available Desmond course which is also free of charge,


I have not been to any of the various diabetic courses available from Diabetes Queensland so cannot comment if they force feed you the gubberment food wheel.
 
Dear Mr Listlad.

Desmond's has been an unqualified success
Over many years as ALL the statistics prove.

Obviously there are many anomalies to that statement, but overall, taking out the increases in those requiring more insulin and the vast majority not reaching normal levels of HBA1c ever, we still stand by our statement, as that to us IS the success level we strive for.

We have of course noted the many cases of those who do and have reached remission over many years on certain diets, but if we continue on with our novel approach to type 2 treatment and advice, we should be able to maintain OUR high numbers of type 2's who don't.... This will ensure us of sufficient funding due to ever growing patient numbers in the coming years.

We appreciate your input, but it's clear to me you know nothing of our business model, and if I might add are endangering yourself with far too much knowledge of what is beneficial for you as a type 2.

You seen to be the anomaly, as most type 2's are, in our eyes, too feeble minded to understand such notions.

I hope this reply eases your worries.
Perhaps now you could let go of this silly notion of getting better and just let us be your food guide in the future.

Remember a course is ALWAYS available, if required.

Kindest regards.
 
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@Tipetoo. I have and I must say that for me it was a complete disaster. Because I hadn’t had much luck with getting my HBA1c down, I figured that I must have been doing something wrong and was keen to see what it was. Part way through we were directed to a couple of tables that had sample foods on them and serving sizes.

At the end, we were given sheets to take home with menu plans and lists of food to have on stand by in pantry, fridge and freezer.....so, I went shopping in the way home.

I followed it faithfully and at the end of one week, I was bloated (couldn’t get my jeans done up), constipated, fatigued, and felt so sick I couldn’t believe it. My vision was also blurred , I was suffering from brain fog my blood sugars were for the first time up in double figures and I had put on a couple of kilos.
 

I never actually attended DESMOND, but from what I've heard and read, here and elsewhere, it's hard to shake the suspicion that the majority probably come away eating more of everything that put them there in the first place.
 
As some of you may know, I have a fair amount of involvement in with the NIHR, and in particular with our part of it in the nearby city. I have attended many, many meetings about T2 education; ranging from trying to increase uptake, to styles of delivery, and so on.

From there, I am confident to say that we are very much different from the majority of T2s. Many of the lay T2 attendees at those meetings say they got a lot from Desmond and they felt better empowered as a result of attending. Many also talk about improving their understanding of the condition.

Don't get me wrong, I'm not saying DESMOND is the bees-knees, but it does differ in terms of versions delivered and locations. I feel positive each course will vary somewhat, depending on the attendees, and where they are in their journey.

Personally, DESMOND wouldn't be for me, but I am also reconciled that once size or approach doesn't fit all.
 
One issue with Desmond is that the CCG control who leads the courses not Desmond, and often it is just nurces who think they "know it all" as they learned that fat was bad at college. Hence DESMOND has little control other than what they put in the handouts.
 
I didn't bother to attend the DESMOND course I was invited to in 2015, so I do not feel qualified to comment as I am not a fan of anecdotal evidence.

However, criticising something you have no first hand experience of is a little strange.
 
i attended, but it took so long to get an appointment i was already dabbling in LCHF.
so i was more aware then many and found it nice to be with fellow suferers, but the info conflicted with so much i had read.

i seemed to be one of few making points and asking for clarification,
which at first seemed welcomed, but as the day progressed it seemed easier to not disrupt the script.
it was an otherwise willing audience, all discussing how much carbs they eat and love and how they MIGHT cut down... IF they had to.

Me ...i was already out the door mentally, dismissing most of what was said.
i'd tried the eatwell for 6 weeks and it failed me, as i got worse., LCHF was my new hope.

i did stay at end of second session, thanked the two educators, who were much more relaxed about talking of other methods.
i had mentioned about DCUK, and had desperately tried to engage the others to simply take a look at forum.
i don't think any did, as i left my user name ..and none have posted me yet. (nov 2018)

The educators listened but seem pretty dismissive and i think the quote was :"they are obsessed with low carbs."
i didn't have the confidence or knowledge i have now, to engage and defend the forum or LCHF.

the point isn't that they educate to a low standard...lowest common denominator.
( i'd say the script is pre determined form above, they seem to have little leeway or input into the course structural format )
it was the lack of acknowledgement that their MIGHT be another way.

i still find it incredible that a way of eating, proven by ONE medical practise, extolled by so many on here, not just today but over many years, to return most to prediabetic if not normal BG levels, isn't take in hand,
examined and rolled out as an alternative choice at least.

yet the ND IS...

I find that infuriating and sad.

in my mind that's almost Neglect, no matter how others like to dress it up.

Can anyone think of another disease that has an alternative treatment, that outperforms the standard by such a magnitude, does it over many years, yet the main treatment is STILL the Failed one, proven over decades, and the alternative seems almost forbidden to talk about ?

No, me neither.

Neglect, i rest my case..
Your witness.my learned friends
 
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@jjraak - What I find incredible about dietary advice, isn't so much the ignorance towards LC or Keto, but the sheer level of opposition to it. There are obviously a number of reasons for this, profit margins, bias, lack of knowledge etc, but the lies being told and fear used to put people off even trying it. That and the detrimental advice and being told off about glucose testing.

@Listlad - credit due for the effort. I didn't expect to see such a long winded response, but at lest you got a response.
 

Well, if one subscribes to the notion that metabolic syndrome is the underlying problem causing a great many of the modern degenerative ailments (obesity, hypertension, diabetes, depression, any number of autoimmune reactions etc. etc. etc.) then yeah, pretty much all of them fit your criteria. They are all seen as separate diseases and treated with pharmaceuticals instead of tackling the root causes of metabolic syndrome. But I appreciate this is probably drifting off topic somewhat so won’t labour the point too much
 
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Could be the ignorance fuels the opposition?
 
Wilful ignorance more likely. Certainly in science circles.
 
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