hanadr
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This is a the text of a letter which I have sent to NICe. So far their Autoreply has said it will be about 3 weeks before I get my reply. Comments please!
have read the new guidelines and I'm pleased that there's at least a
nodding reference to improved dietary information in that the guidelines
mention low GI .
I am one of a growing number of type 2 diabetics who follow a low
carbohydrate eating plan to control our condition and to help avoid as many
complications as possible. I don't believe they are inevitable or that type
2 diabetes is invariably progressive.
The guidelines also say somewhere( I should have noted paragraph number,
but didn't) that patients should be involved in planning their own care.
this is severely limited by the decision to stop type 2s testing their own
blood sugars to save money on strips. If , as my GP suspects, the intention
is to get all type 2s onto insulin, then all will need to test and the
strips costs will skyrocket. That is unless there's a plan to take type 1s
off home testing too. The consequence of such action would be to increase
the number of people with serious complications and I cannot guess what all
those blinded by retinopathy, and on dialysis or transplant lists for kidney
failure, or requiring prosthesis after amputations would cost.
I am well aware that type 2 diabetes is still largely a condition of older
people and that many who are diagnosed are set in their ways and don't care
to take control of their own health and welfare. and as elderly people don't
see complications as an immediate threat.
In addition many elderly diabetics don't understand the condition or the
need to eat correctly and the education available to them is not good,
either from healthcare professionals or Diabetes UK. It probably exists, but
isn't offered.
Many therefore decide to pretty much ignore their condition. they take their
medication and that's as far as it goes.
However, there is a growing body of diabetics of all types, who would like
to take full control of the condition. We are the ones who are particularly
badly served by the system at present. We have read the work of Richard
Bernstein, Lois Jovanovic, Katharine Morrison and others and know that what
they advocate and what has been tested by their patients for decades is the
way forward for us. We know that we can comply with a low carbohydrate
eating plan indefinitely and that we only develop depression if we are not
allowed to be in control. We know that there is a wobbly tightrope to
balance on between the weight gain caused by anabolic treatments and blood
sugar control. We have developed tricks to adjust our BGs if they go higher
than our personal target( we have LOW targets) We want tight control
without killing ourselves with huge doses of medication ( ref; the ACCORD
trials)
We worked and paid our dues and now we're being denied the simple way to
monitor our health. 6 monthly HbA1cs are too infrequent. By the time you
get the results, you could have been doing damage for 7 months. In any case
an average of 6.5% HbA1c can represent huge swings of levels in short
periods of time. It's the range that matters NOT the average.
Would any member of the team that wrote the guidelines like to have their
own healthcare taken so much out of their hands?
I have written to my own PCT many times and I have been offered help with
my BG control. I am already doing better than their targets, so what help
could I possibly need other than Home blood glucose monitoring?
have read the new guidelines and I'm pleased that there's at least a
nodding reference to improved dietary information in that the guidelines
mention low GI .
I am one of a growing number of type 2 diabetics who follow a low
carbohydrate eating plan to control our condition and to help avoid as many
complications as possible. I don't believe they are inevitable or that type
2 diabetes is invariably progressive.
The guidelines also say somewhere( I should have noted paragraph number,
but didn't) that patients should be involved in planning their own care.
this is severely limited by the decision to stop type 2s testing their own
blood sugars to save money on strips. If , as my GP suspects, the intention
is to get all type 2s onto insulin, then all will need to test and the
strips costs will skyrocket. That is unless there's a plan to take type 1s
off home testing too. The consequence of such action would be to increase
the number of people with serious complications and I cannot guess what all
those blinded by retinopathy, and on dialysis or transplant lists for kidney
failure, or requiring prosthesis after amputations would cost.
I am well aware that type 2 diabetes is still largely a condition of older
people and that many who are diagnosed are set in their ways and don't care
to take control of their own health and welfare. and as elderly people don't
see complications as an immediate threat.
In addition many elderly diabetics don't understand the condition or the
need to eat correctly and the education available to them is not good,
either from healthcare professionals or Diabetes UK. It probably exists, but
isn't offered.
Many therefore decide to pretty much ignore their condition. they take their
medication and that's as far as it goes.
However, there is a growing body of diabetics of all types, who would like
to take full control of the condition. We are the ones who are particularly
badly served by the system at present. We have read the work of Richard
Bernstein, Lois Jovanovic, Katharine Morrison and others and know that what
they advocate and what has been tested by their patients for decades is the
way forward for us. We know that we can comply with a low carbohydrate
eating plan indefinitely and that we only develop depression if we are not
allowed to be in control. We know that there is a wobbly tightrope to
balance on between the weight gain caused by anabolic treatments and blood
sugar control. We have developed tricks to adjust our BGs if they go higher
than our personal target( we have LOW targets) We want tight control
without killing ourselves with huge doses of medication ( ref; the ACCORD
trials)
We worked and paid our dues and now we're being denied the simple way to
monitor our health. 6 monthly HbA1cs are too infrequent. By the time you
get the results, you could have been doing damage for 7 months. In any case
an average of 6.5% HbA1c can represent huge swings of levels in short
periods of time. It's the range that matters NOT the average.
Would any member of the team that wrote the guidelines like to have their
own healthcare taken so much out of their hands?
I have written to my own PCT many times and I have been offered help with
my BG control. I am already doing better than their targets, so what help
could I possibly need other than Home blood glucose monitoring?
