Hi Tony
Yes, I'm pretty sure the "doom and gloom" approach was scare tactics, but it was a classic example of "one-size-fits-all" rather than choosing the appropriate approach for each patient. In fairness, the DM specialist GP hardly ever sees me, so doesn't know me well. Rather than seeing the specialist at diabetes review time I see the GP I normally go to, who is very used to me and has even been known to tell me to "go away and look it up on the internet" :lol: That was lumbar spinal stenosis.
Our practice nurse, who does the practical side of the annual review, is very clued up on Type 2 despite not being called a DSN. I've never seen the DSN who covers our area - I think our nurse daredn't let me at him! :lol: I did see a dietitian, in a group counselling session when I had to bite my tongue several times because of all the other people in the room - I didn't want to confuse them by arguing with her, and she was of course toeing the party line. I get excellent care in my practice - many others do not.
If I'd followed the dietitian's advice I'd never have lost 60lbs (60 more to go!), and my HbA1c would probably still be in the 6s or even higher.
I think that a matter-of-fact, reassuring approach in the leaflet is essential; I don't consider Type 2 a disease, it's more a metabolic condition. It is not the end of the world, and I fully intend to enjoy my allotted life span, even if I've had to tweak my lifestyle to accommodate Type 2. I don't metabolize carbohydrates well, so I don't eat them in any quantity.
A note about how insulin resistance can make you fat would help avoid a lot of the self-blame and self-disgust that the newly-diagnosed often feel. Overweight/obese Type 2s are often made to feel like pariahs. I don't know how the thin ones feel - about 20% of us are skinny at diagnosis.
In my experience reading "Newbie" posts on this site, many of the newly-diagnosed don't seem to know what a carbohydrate is; I'm not sure they cover that in schools any more. Many people are told to "avoid sugars" but are told nothing about avoiding fast-acting carbs and certain fruits and veg. So a bit of education in the food groups, and in the Glycaemic Index, and how they relate to one's blood glucose, would be a good idea.
A friend's husband was diagnosed at the same time as me, and we often compare notes. The other day he had breakfasted on rice crispies and a banana, as recommended by the dietitian (though in fairness I don't know whether she said "together"). That combination would have put my BGs into the lower teens, even 2 hours later. Then again he only does random tests, twice weekly. So how would he know?
Oh dear, I could write a book on this subject! I'll stop rambling on - but do PM me if you want to ask about anything. It's very good to have an HCP interested in what we think.
Viv 8)
PS I agree with Sid, especially about the self-motivation.
. In fact I slipped under the diabetes care radar for several months after diagnosis, but that as they say is another story :lol: There does seem to be large differences in the care and number and types of courses offered by different areas/Trusts.