I may be wrong since I am guessing on this, but I think the values the consultant recommended werw actually MIN values, and because it was a correction dose approach on the pump, then it was actually probably a per meal value, not per day as I originally said. In practice he makes a guess on x units insulin per y calories, and this may be why he has been getting problems. He then corrects later when his post prandial shows low bgl by adding a fixed amount normally 8 or 10 units. There seems to be no calculation in this correction dose, and is based on previous experience.I suggest he gets Think Like A Pancreas and Pumping Insulin. They're both fantastic books for a Type 1 pumper
I'm surprised he was told to,eat a set amount of carbs. Also, I'm very confused that you say he was told to stop carb counting. Do you mean in the general,way that people refer to carb counting here (ie watching how many they eat per day)? Because carb counting in relation to Type 1 means assessing carbs and adjusting bolus insulin. One of the things you have to do before going on a pump is show that you can do that.
As for the NHS diet, I've never had a problem with it or dieticians. I've always been told to adjust it according to my needs and have never been told I have to eat a certain amount of carbs, protein or fat. Type 1s usually have more leeway than many Type 2s due to insulin and the lack of insulin resistance (usually).
Calories.
I may be wrong since I am guessing on this, but I think the values the consultant recommended werw actually MIN values, and because it was a correction dose approach on the pump, then it was actually probably a per meal value, not per day as I originally said. In practice he makes a guess on x units insulin per y calories, and this may be why he has been getting problems. He then corrects later when his post prandial shows low bgl by adding a fixed amount normally 8 or 10 units. There seems to be no calculation in this correction dose, and is based on previous experience.
As I am a T2D not using insulin, I cannot advise him. He is set in his ways, and even his DCN has tried to change his control method, but only his Consultant can do that. Rock and a hard place.
Or Chicken and Egg ! It seems he is being taught to adjust his carb intake to feed his insulin habit, rather than doing things properly. With LC you can reduce the need for insulin, so need fewer carbs, but the NHS does not want to take that concept on board at all. Presume it is not a good idea to take insulin without giving it glucose to work on. I think that is called an overdose So make sure there are loads of carbs to tame the insulin - NUTS!
My health coach is the same, telling me that I must cut down on fat and only slightly limit my carbohydrate intake. Although much modern research shows a link between insulin use and dietary fat. So lowering your blood sugar, by reducing your carbohydrate intake will significantly lower your cholesterol level.
I cannot answer your questions myself. However, I suspect that my friend who is vey stubborm, was originally taught to control his condition (some 40 years ago) and has refused to learn new tricks. I suspect either his Consultant is of similar vintage, or is taking the line of least resistance. All I know is that my colleague had difficulty understanding LC, and kept wanting to go back to calorific value. The concept of sugar being a carb was new to my colleague, and also the concept that protein becomes glucose. Likewise he is still not able to counteract the effects of high fat intake.Sorry but none of that makes sense. Why's he correcting a low blood sugar with insulin?? No wonder he's having hypos! How does he use the pump if he's unable to count carbs? And how did he get it in the first place? And surely he knew calories were nothing to do with it when he was on MDI?
You don't use correction doses like that, which surely he'd know from MDI.
And if, as you say, the consultant told him to bolus by calorie value, then something is seriously wrong and he/she should be reported.
I cannot answer your questions myself. However, I suspect that my friend who is vey stubborm, was originally taught to control his condition (some 40 years ago) and has refused to learn new tricks. I suspect either his Consultant is of similar vintage, or is taking the line of least resistance. All I know is that my colleague had difficulty understanding LC, and kept wanting to go back to calorific value. The concept of sugar being a carb was new to my colleague, and also the concept that protein becomes glucose. Likewise he is still not able to counteract the effects of high fat intake.
I will not see my friend until the gig, and then we will not have much time to discuss this. It will have to wait till our next 'scheduled' rehearsal in about 3 weeks time.
This isn't strictly true. I had a very long conversation with Anna Brackenridge at Guys who runs the Diabetes clinic there. We were discussing my CGM output and she asked me whether I ate reduced carbs, as "in her experience, those with the lowest Hba1Cs tended to".Yes, but this is part of the problem... consultants never ask how good people get good results... they are too wrapped up in giving more uncontrolled people more bad advice...
We must all bear in mind that there is a very clear reason why the general NHS "healthy food" diet is not as effective for us; it's simply because it is pure nonsense put together by three dozen non-diabetic,well-meaning, badly educated, old women, a few retired and gibbering circus clowns, a very overweight, blind cat and a cute, three-legged Labrador puppy which writes its views on toilet paper with its ****. Seen in this light, we should not really be surprised.
We must all bear in mind that there is a very clear reason why the general NHS "healthy food" diet is not as effective for us; it's simply because it is pure nonsense put together by three dozen non-diabetic,well-meaning, badly educated, old women, a few retired and gibbering circus clowns, a very overweight, blind cat and a cute, three-legged Labrador puppy which writes its views on toilet paper with its ****. Seen in this light, we should not really be surprised.[/QUOTE
Not completely sure why you would lump us "Old women" into that particular diatribebadly educated or not. The one thing that comes shining through on the research is that its easy to find woman researching the benefits of the low carb way of life and apart from the much vaunted benefits of the Mediterranean diet - whether substantiated or not, in general MEN (possibly old) appear to be the prime cause of much of this dietary muddle.
Shocking!until I found low carbing I was accused of all sorts by medical professionals who gave me diet sheets and then blamed me for putting on weight on high carb regimes. I have been shouted at called a liar, lazy, greedy - and for a long time I thought it was my fault I was fat. Then I found that I could lose weight on a low carb diet and was instantly berated and told that my thinking was wrong and the diet was dangerous. A few years later I found Dr Atkins New Diet Revolution, and found that he was treated in just the same way, but that he had got lots of patients who were alive when standard medical treatments would most likely have killed them. The medical establishment really needs a good shake up.
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