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Low Carbs versus NHS recommended diet.

Discussion in 'Ask A Question' started by Inchindown, Dec 12, 2016.

  1. walnut_face

    walnut_face Type 2 · Well-Known Member

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    You don't!
    Buy yourself a meter and eat to it, is the best advice that comes from this website.

    2 Cliches

    a) If it aint measured it aint managed
    b) A failure to plan is a plan to fail
     
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  2. JohnEGreen

    JohnEGreen Other · Master

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    You don't.

    As walnut_face says get a meter it won't cost you an arm or a leg not getting one may.
     
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  3. serenity648

    serenity648 · Guest

    3 months? I have 6 months between HbA1c tests. I am getting my results tomorrow (gulp)
     
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  4. noblehead

    noblehead Type 1 · Guru
    Retired Moderator

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    Like others have said the above doesn't make any sense, the RDA for carbs is 300g for a man so why would a diabetes consultant suggest 250g a meal? On a 1 unit to 10g of carbs ratio that would be 75u of insulin just for his meals plus any correction doses, that's not taking into account his basal dose which could be anything from 20-40u, so his TDD (Total Daily Dose of insulin delivered) would be 100+units, as the reservoir on pumps typically hold between 200-300u that advice doesn't seem plausible at all.

    I've been diagnosed 35 years and never been told to bolus according to calories consumed and its always been carbs, however there are algorithm's available now where you can use bolus calculations according to calories but this has only been a recent development if I'm not mistaken, as its only in recent years that the experts are realising that its not only carbs that raise bg levels in type 1's but fat & protein too.

    If your friend has been told all this then he is being poorly advised and the consultant/clinic needs reported, you should take up @tim2000s offer where he said he'll report them if your friend passes on their details.
     
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  5. Oldvatr

    Oldvatr Type 2 · Expert

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    There used to be a team who provided dietary and pump clinic support, but they were disbanded due to cuts and only support the local hospital We have one Consultant, and two DCN in the county, but most local GP surgerues have trained healthcare workers who support the GP clinics.

    I don't think my friend wants to count anything. I think he works like a bang - bang servo system in that he makes rough estimate when he sets up his basal in the pump, then he tests later and either eats biscuits or adds a correction dose on the pump based on his readings. He often says when I meet him for rehearsal or gig that he has just eaten high calorie meal and has given himself 20 units so he should last the gig. Sometimes he only gives himself 10 units, so it is very rough and ready. I have never heard him use the term bolus, but he does use basal. He understands how to deal with low bgl in his own way and only uses insulin correction when it is high. His target level seems to be 7 mmol/l since he is shocked when I get a 5 and don'r eat a biscuit immediately. I think high calorie in his eyes equates to high fat, so it is his way of compensating for the effect that has on him. I did copy him the report on T1 IR due to high fat intake, and he did read it, coz he mentioned that now he delays his readings and it helps stop him from over correcting/

    I agree that his control is nothing like what it should be (as currently taught) but he is an obstinate old codger, and must do things his way. Its the same with his music, so learning a new song is a challenge. Having experienced disagreements with him, I can see why a Consultant has told him to revert to his old ways, rather than insisting that he do it correctly. When he was LC with me, he liked it since he did not have to count carbs, just avoid high carbs, and he did report needing less insulin, so he was clear that that was what would probably happen. So it was no more dangerous that his current bang-bang regime, where someone would regularly pick him up off the floor. I taught him my more relaxed way of using LC, and it suited him, And he was beginning to report finding LC meals at Asda that I could use, with glee. I hope I can get him back on the wagon,
     
  6. kokhongw

    kokhongw I reversed my Type 2 · Well-Known Member

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    As a rough guide, statistics from US ADA shows that it would be rare...very rare...
    http://www.diabetesforecast.org/2015/jan-feb/remission-rare-possible-type-2-diabetes.html
    http://care.diabetesjournals.org/content/early/2014/09/12/dc14-0874.abstract
     
  7. pleinster

    pleinster Type 2 · Well-Known Member

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    It wasn't intended to single out women...that's why I included the "gibbering circus clowns" (ie. men).
     
  8. serenity648

    serenity648 · Guest

    you know clowns can be female too, right? ; )))))
     
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  9. azure

    azure Type 1 · Expert

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    But what did he do on MDI? Surely he bolused then? If he can't or won't bolus correctly, and is 'misusing' his insulin, then LC is a dangerous suggestion which could,lead to severe hypoglycaemia or worse...

    Rather than get him back on your wagon (LC for a Type 2) I strongly advise you try to gently persuade him to seek out help from a Pump Nurse, even if that means travelling a little further for his appointments or simply speaking to one on the phone, which would be less hassle. He would then, hopefully, be on the appropriate 'wagon' for a Type 1 who is using an insulin pump.

    You don't estimate your food and adjust your basal. I find it hard to,believe he's doing that. However stubborn he is, if he's been a Type 1 that long he'd know how to bolus. And if he's correcting highs then why isn't he simply using the bolus system for his food?

    As I and others have said - it makes no sense at all, and is very hard to understand and believe.

    I know you don't use a pump,and aren't Type 1, but to me it sounds like the equivalent of taking Metformin by balancing it on your head, with the number of tablets corresponding to the number of degrees centigrade the temperature is that day.

    I can't really think of any other adequate comparison. It simply doesn't make sense.
     
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    #69 azure, Dec 13, 2016 at 3:44 PM
    Last edited: Dec 13, 2016
  10. CherryAA

    CherryAA Type 2 · Well-Known Member

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    I KNOW - I was teasing :)
     
  11. JGLondon

    JGLondon Type 2 · Member

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    Actually I think it is very easy to ignore your Doctor's advice, I have been ignoring mine for a decade and maintain good control. I won't say that I am on Atkins, but I certainly avoid Carbs as much as is possible. Fortunately I am also on Insulin and can dial up whatever units I need to cover the carbs I am eating, but Insulin increases the risk of weight gain, so I try to keep the units down. Best of luck!
     
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  12. Moosepig

    Moosepig Type 2 · Well-Known Member

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    I couldn't agree more Mark, if I just stuck with my gp and DN advice I would be out on a limb! Before I found this forum and the low carb lifestyle I felt isolated and confused. Sadly with the nhs cuts our surgery is reduced to a practice nurse covering everything - cardiac, COPD, diabetes, stroke, hrt, family planning etc so no time to support and advise on my diabetic nutrition and blood glucose levels. The low carb lifestyle has proved itself already, its a win win lifestyle and provided people get the confidence to tweak it to their particular needs (I cant cope with much fat) and get support and ideas from the great bunch on this forum it really is the way forward!
     
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  13. donnellysdogs

    donnellysdogs Type 1 · Master

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    Please note that a GP in charge of diabetes care in a Practice does NOT mean he has any extra knowledge than other GPs in that Practice.
    In my old Practice the GPs were just allotted their "speciality" by the core Partners. He had no extra knowledge than the day before he was allotted the diabetics to oversee.
    The GPs are a business. They effectively get paid by results, qty patients, flu jbs given and the targets they hit for example the qty of hba1cs in range etc.
    So, Practices are allocating "specialisms" to GPs. Ie baby clinics will go to x, diabetics to y, heart persons to z. Those GPs will look at targets and news, but do not even know sometimes about new treatments... ie tresiba as a new basal insulin a few years back.
    Now, nurses- come of our nurses specialused and actually had two degrees!
    My new Practice is taking on an uktra qualified nurse in preference to a GP, as she can prescribe.
    Even a diabetes manager from my last hospital did not have any knowledge on diabetes at all when she visited me at home in July. She had been a nurse and a mental nurse. Not an ounce of diabetes training or speciality at all.

    Yes. GPs do have to undertake some courses but the courses can be taught from watching a video and training for 90mins online in various different subjects that they can choose to select.

    Nurses ysed to have to keep registered and pay to keep their qualifications. Not sure how this runs now..

    Please dont expect GPs to know the ins and outs of everything.. even if they have been allocated "diabetics"... generally they have in my past 4 GP practices referred me to a nurse... or even recently for trseiba insulin referred my request from hospital to the in practice pharmacist who is sorting out the prescribing nowadays...
     
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  14. Japes

    Japes LADA · Well-Known Member

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    I had a very depressing conversation with a student nurse recently who was earnestly encouraging me to follow the NHS advice (after a 2 day training course) "As you NEED some carbs" and "There's no need to completely give up foods you like.". This was after seeing me refuse cake, biscuits, and chocolate. Also after telling me her mum was Type 2, with complications, and she herself was expecting to follow in her mum's footsteps in about 15 years time given her blood pressure, weight and BMI all of which, along with hereditary factors, put her as high risk.

    I pointed out I preferred to keep my limbs and eyesight, if at all possible, and frankly, after years of eating a "healthy diet" of the current kind of recommendations, cutting carbs to an absolute minimum was working for me and I seemed to have lost my taste for sweet things along the way... She was still having none of it, so I terminated the conversation and will be making sure I do my lunch time checks out of her sight from now on.
     
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  15. fene48

    fene48 · Well-Known Member

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    I am a fan of the good Professor too and almost a year down the track things are still working. At the end of the day it is your weight, condition, medication, research, experimenting, measuring etc etc that will do the trick for YOU. Roy Taylor is a good place to start, you seem to have an open mind and a positive attitude - great assets. The only piece of advice I have is do your own research and don't get locked into a particular mantra. Best of luck and success.
     
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  16. Trebor2516

    Trebor2516 Type 2 · Member

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    I have been following the '8week Blood Sugar' diet by Dr. Michael Moseley, which gives a good low carb diet and the recipes to go with it. He also explains the science and tests that were done by himself and Prof Rod Taylor. I was so appaled by the NHS advice when I saw it online I wrote to my MP to complain and ask him to take it to the Health Minister, which he has done. I think it is scandalous that the advice they are giving is at worst killing people, at best losing limbs. I suggest anyone who has been on a lowcarb diet also write to their MP.
     
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  17. Trebor2516

    Trebor2516 Type 2 · Member

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    I would advise him to carry on his low carb diet and find another consultant. It's his life and limbs after all.
     
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  18. Monty19

    Monty19 Type 2 · Member

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    Hi I have been type 2 since May and am now at normal levels on low carb diet with metformin. My GP has been really impressed by my scores . I have a blood test every 2-3 months .to keep on track. Low carb and exercise works. Read Dr Michael Mosley for more sensible info. NHS behind the times I think,
     
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  19. azure

    azure Type 1 · Expert

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    If he's not using/understanding his pump properly it may be dangerous to go LC as explained above.

    The needs of a Type 1 pumper are different to a Type 2 :)
     
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  20. donnellysdogs

    donnellysdogs Type 1 · Master

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    Totally agree with @azure..

    Making any changes to diet and carbs on a pump needs a full
    Understanding of how the pump etc works.
    To me it is such a shame that this "friend" cannot really be bothered to change lifestyle or thinking when there are a lot of people that have to jump through hoops to get a pump....


    I am absolutely shocked at reading details to be honest of this "friend".
    I absolutely fear what could happen to him...
     
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