Newly diagnosed and student nurse

Try with the NHS advice on carbohydrates combined with the lower-carb recommendations that for instance Sweden is known for and what the benefits and possible side effects are, along with what scientific basis there is for one or the other and what it would take to change the recommendations and what the long term effects might be in minimizing the complications.

Would be an interesting project to see and a topic many of us are interested in - some are very strongly pro, and a few not so much - it does however seem that there is something to it.

'In a care situation, how can I as a Nurse best take care of my patients' health and help them to discover the link between carbohydrates and blood sugar, and how can I encourage them to use this knowledge - and why should I?'

'Why testing blood glucose in Type 2 patients should be encouraged and why an accurate measurement of post-meal levels is educational and motivating. How can I support and teach my patients to achieve better control?'

'How much does a post-prandial level rise to 8 increase the likelihood of developing late complications in Diabetes M2 compared to a minimal rise - a comparative analysis. Based on this knowledge, what would be a good diet plan for a diabetic in my unit?'

Blimey Diane you've come to the right place. 10'000 words will be easy, mind you question the low carb route and they might fail you for disagreeing with NICE and the NHS, however you will soon find out that eating what the NHS prescribe will help you to lose your sight and feet.
Good luck. Seriously, loads of evidence out there about low carbing, BS, and eating more fat and protein, and eating less processed foods which is contributing to obesity and diabetes.

If you need some good books Dr Richard Bernstein is a good start, hes an american doc with T1 diabetes. The thing is as you know is to put good evidence in your dissertation both for and against. Loads of info for low carb only it seems the NHS slow to change as you will find out persist in the starchy carbs with every meal. However its just sugar all carbs turn to glucose and thats no good for diabetics.

This is the reading list you should have (not my list by recommended by someone else on here, which are his/her comments)..

Richard K Berstein - Dr Bernstein's Diabetes Solution - I agree that it's not the clearest book, but it was the one that I got first and the one that changed my life.
(Jenny Ruhl - Blood Sugar 101 - much more accessible and less hardline than Bernstein, Ruhl makes sense of the research and the numbers.
Gary Taubes - What If It's All Been a Big Fat Lie - not a book, but an extensive NYT article. Shook my world. (http://www.nytimes.com/2002/07/07/magaz ... all&src=pm)
Gary Taubes - Why We Get Fat - I don't believe all of it, but woah the boy can write.
Gary Taubes - Good Calories Bad Calorie - Heavy going in places, but covers much more ground than WWGF.
Phinney & Volek - The Art and Science of Low Carbohydrate Living - The science behind the low-carb diet, I love this book and back to it all the time.
Lyle McDonald - The Ketogenic Diet - an in depth study of ketosis and exercise. Answered almost every question I wanted answered.
Nestle & Nesheim - Why Calories Count - what I expected was a debunking of the Taubes stuff, but in the end I got a great review of the science and politics of calories.

S

dianecooper said:

Hi I am new to the forum only joined this afternoon, I have type 2 diabetes and have only been diagnosed for about 4 months or so. I am also a student nurse just about to go into my 3rd year and have to write a dissertation and my chosen topic is diabetes (being newly diagnosed) I was wondering if anyone could give me some advice on what sort of questions i could ask/write about as I have to think of a question then write a 10,000 word dissertation on it. I am stuck and would like if possible some ideas.

I'm not sure if I have posted in the correct part of the forum and if I haven't then I am sorry

Regards
Diane :thumbup:

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Hi diane and welcome.

I am sure many of us would be interested to know what advice/education you have been given and if you have been given a tester and meter.

I think most Type2's on here would agree that eating to your meter is the best way forward and yet so many of us are denied this basic tool. You could ask why the discrepancy in who gets them and who does not and the reasoning behind it.

catherinecherub said:

dianecooper said:

Hi I am new to the forum only joined this afternoon, I have type 2 diabetes and have only been diagnosed for about 4 months or so. I am also a student nurse just about to go into my 3rd year and have to write a dissertation and my chosen topic is diabetes (being newly diagnosed) I was wondering if anyone could give me some advice on what sort of questions i could ask/write about as I have to think of a question then write a 10,000 word dissertation on it. I am stuck and would like if possible some ideas.

I'm not sure if I have posted in the correct part of the forum and if I haven't then I am sorry

Regards
Diane :thumbup:

Click to expand...

Hi diane and welcome.

I am sure many of us would be interested to know what advice/education you have been given and if you have been given a tester and meter.

I think most Type2's on here would agree that eating to your meter is the best way forward and yet so many of us are denied this basic tool. You could ask why the discrepancy in who gets them and who does not and the reasoning behind it.

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I totally agree,A very valid question which will hit a raw nerve although sadly we know the answer all too well even though it's whitewashed with the usual "Testing will make you depressed" and "Testing has no value,you can't do anything about a high reading,blah,blah,blah." BUT we know it's financial,many HCP's have admitted so during a consultation.

Hi Diane

It's good that you are writing about something that affects you, because you are going to have your own experiences to relate to, including being able to evaluate patient care/support.

Wishing you the best of luck

Moya

Hi. I agree with the other's suggestions regarding reducing carbs. The key point that I would raise is the NHS Diabetes professionals' view that low-carbing is not advised '...because the possible risks of a low-carb diet aren't yet identified...' whcih is pretty stupid and illogical when it's 'proven' that todays so-called 'healthy' diet can cause obesity with high risks of heart disease early death, diabetes T2 and so on. Perhaps another avenue is the classification of diabetes types. To many in the profession there are only two types of db i.e. T1 and T2 when in fact there is a complete spectrum including specifically LADA and MODY. With LADA and MODY often being mis-classified as T2 the data for reseach purposes is distorted which is not a good start point for ongoing research. Whilst I also agree with the testing strips issue, the cost constraints within the NHS must be one of the hidden reasons testing isn't encouraged.

Hi agree with all the points made so far. Another question I would ask is related to pre diabetics and early glucose intolerence.
Would better and agressive screening of the populus together with proactive interventions by way of diet and testing, prevent the progression of the current diabetic epidemic ? i.e should we have pre diabetics testing bm's and controling diet to reverse the condition rather than just monitoring the progression.

Another question worth asking is why do PCT's fail to adopt the NICE guidlines in full. But I would suspect that this would not go down very well. For your own interest, try looking at the PCT's nemonics for diabetes for different counties. It's surprising how much they vary from county to county .

Like others I'd be very interested in your findings and responses. Best of luck

Is the current NHS recommended diet for cholesterol relevant for diabetics and in what way should it be changed if it is not? So far I have not been given a diabetic diet sheet at all.

i think you could include all of above but have the overall topic of managing change, working in partnership with the patient, client etc cos that is what nursing is about. good luck x

Diane
It woul help your patients if you worked on the actual effects of diet[ I recommenr Gary Taubes's book" The Diet Deception" , which quotes all the sources of evidence] I'd compare that with the standard advice given by Diabetes Uk and the NHS.
We are currently in a transition period. Some of the medical profession are becoming aware of the failure of their current practice. Also check out the local information the "Think Glucose" initiative in your area. Your tutors may not like this, but if you justify everything you write, they cannot penalise you
Hana
PS use the Swedish stuff too.

dianecooper said:

Wow thank you all very much for all your advice. I am new to this forum and hardly go on my computer hence why I am slow at replying. I have been told I can only ask the one question for my dissertation and would be great if we can relate this to practice. Something that could potentially make a change within the trust. :?

As i am a newly diagnosed type 2 diabetic I don't really know what is to be expected, what if needed etc

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Then how about something along the lines of 'how the 'cost' of diabetes could be reduced by empowering the patient'. The cost of diabetes to the NHS is rising and much of what has been suggested to you above can be brought into focus this way.

[Redacted - I misread that part]

Re OP: There is a reason the NICE guidelines are as they are; the authors have reviewed the relevant research and made their recommendation accordingly. Thus, it might be difficult to find good quality research that conflicts with these recommendations (if there was, the recommendations would be different)