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NHS Diabetes Prevention Programme; letter from my GP surgery

Discussion in 'Prediabetes' started by Gardengnome, Jan 15, 2020.

  1. Gardengnome

    Gardengnome Don't have diabetes · Well-Known Member

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    I have received a letter from my surgery telling me that I am at 'High risk of developing type 2 diabetes and they are now in a position to offer me a place on the Diabetes Prevention Programme; A free personalised healthy lifestyle programme delivered by Reed Wellbeing'. They apparently aim to 'Help you reduce your future risk of developing T2D by enabling you to make positive changes to your lifestyle.. You are invited to an introductory phone call with one of the the health and wellbeing advisors to find out more.'
    Does anyone have the slightest idea what this is and whether it's worth following up? Or is it more of the NHS nannying 'one size fits all' approach? And how much kick back do the surgeries receive for this?
    I was diagnosed with prediabetes 7 years ago shortly after a diagnosis of hypertension which is well controlled with medication. I discovered my HbA1c was 41 shortly after having a health check and was told that was normal and not to worry. However I have a blood test annually each September and that figure has been rising or stayed the same ever since, it's now 44. I also get called in afterwards to see the nurse regarding the HbA1c and given a little lecture on what I should be doing, most of which I already do. I've followed advice and read plenty on this site [many thanks] and frankly am not too impressed with the advice I get from the NHS nurse such as the Eatwell Plate and eating low fat everything. I do try to keep reasonably low carb but things slipped recently after my husband died and probably I don't eat as healthily as I once did. However I'm 77 now and feel life is too short to be in denial. My HbA1c has taken 7 years to get where it is but my fasting finger blood tests are mostly 6.8 - 7.5 mmol which I know isn't good. I'm not at all overweight incidentally.
    I have always been very active but recently arthritis in my knee is getting worse and is preventing me doing the things I once did. My grandmother had arthritis in her knees and was unable to get about properly and then developed T2 which I suspect must have been aggravated by the arthritis. She developed dreadful ulcers on her leg and her final years were not good. I don't want that to happen to me. With that in mind I've made an appointment to see the GP regarding the possibility of a knee replacement.
     
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  2. KernowKeith

    KernowKeith Prediabetes · Active Member

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    Don't talk to me about the NHS-recommended courses, notably the ones run locally by WW (that's 'Weight Watchers Reimagined'...).

    Virtually all the emphasis in supplied literature is on weight loss (no surprise considering the Weight Watchers association…). Not everyone who suffers T2 diabetes or who is pre-diabetic is overweight – my BMI is 22, for example. The people running the local course are not healthcare professionals and never once mentioned diabetes in the meeting I attended. ALL the emphasis was on congratulating attendees for losing weight, or on selling you WW products. When it came down to a chat at the end of the evening, it was clear that I did not need to lose weight (I weigh under 10st) 'but take away these books' which are simply lists of food that already form part of our regular diet. I now get regular e-mails trying to sell me Weight Watchers food programmes.

    By way of contrast, a little over three years ago, I needed to have an angioplasty carried out – a single stent. The follow up course was held at the local health centre and run by healthcare professionals trained in coronary matters. Each session included discussions about coronary health, diet, exercise and lifestyle, with informed talks from people who clearly knew what they were talking about. No badges for being good, no 'buy our products' – just pure information.

    The NHS Diabetes Prevention Programme needs to be run on similar lines – not have us all dumped in with the local Weight Watchers group.
     
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  3. jjraak

    jjraak Type 2 · Well-Known Member

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    Hi @Gardengnome .

    Sorry to hear of your loss.

    The advice is pretty standard it seems, with little deviation allowed on the whole, but things are moving, if at a glacial speed.

    Your efforts so far have kept T2 at bay, so you're doing much of the right things already.

    IF you were to increase your adherence to whichever diet you currently follow (lower portions or carbs) I'd suggest you'd further improve your BG compared to the eatwell plate advice most HCP offer.

    Just as an aside..l used to suffer with joint pains, swelling etc on a regular basis, just put it down to getting older, but since I went LCHF.. And that for me is around 50/60 carbs a day,
    (2 meals a day) the fat is just fats on meat, nuts olives avocado plus double cream for desserts.(Real fruits.. Yum) that's all tailed right off.

    Many others report less inflammation eating the LCHF way... May or may not help your circumstances personally, but worth a little investigation, perhaps ?

    I did read that exercise is good, but it is weights and resistance training that offers the best reductions of BG levels.
    Kind of makes sense.. Food is fuel, we turn it to glucose and store what we don't need for later.
    (But T2 do that badly) and rush glucose to the muscles when needed for energy.

    For those times I can't lift weights..I use the wife's resistance band to work my muscles, so they make that call for the excess glucose and help bring down my BG... Might be an alternative if moving or your usual exercise routine is now too difficult?

    As for the fasting finger tests.
    It's quite possibly your body giving you the help to start the day by dumping glucose into you at dawn.. Aka dawn phenomenon.

    Have to agree, advice is poor, and in comparison to @KernowKeith experience, the heart follow up was just way more professional and relevant.

    We do still have a long way to go before we really get to grips with this modern day epidemic.

    Best of luck going forward, which ever way you choose.
     
    #3 jjraak, Jan 15, 2020 at 11:43 PM
    Last edited: Jan 15, 2020
  4. Resurgam

    Resurgam Type 2 (in remission!) · Expert

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    I also advise eating low carb.
    It might help you to keep mobile if you use walking poles. The Nordic walking poles effectively turn you into a quadruped, keep you well balanced and upright too, taking the strain off knee joints in particular.
    After a car reversed into me !! I was unable to get about and my recovery was going very slowly - the pavements around here are very bad, uneven and potholed so was not going very far, and going very slowly too. Once I tried the poles I found I was striding along far more confidently and going further and faster every day.
     
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  5. Squire Fulwood

    Squire Fulwood Type 2 · Expert

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    My new DN (DN2) asked me questions about the food I eat which is a first. She didn't seem as pleased as she might have since I described a fairly low carb menu. She handed me a document entitled "10 Ways to Eat Well with Diabetes". A couple of paras. are "Choose Healthier Carbohydrates" and "Eat less red and processed Meat".

    Things you can look up (it says) is the Fixing Dad web site and the other place which I cannot mention on this site.

    The point I am trying to make is that if you get invited to a course don't expect anything except the same old same old especially if it is sponsored by a weight loss firm or the other place.
     
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  6. Mike D

    Mike D Type 2 · Expert

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    Same issue here Squire. The information from some quarters is staggering, dangerous and downright stupid.

    I wouldn't give nutritionists the time of day. When it comes down to the education, management and treatment of diabetes, it's abysmally ignorant.
     
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  7. Redshank

    Redshank Prediabetes · Well-Known Member

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    Reed well-being has websites that give some idea of their approaches, it may be worth checking these.
    If you have the initial phone call you can ask questions and if you don’t like what is offered then you can refuse it. All you have lost is 20 minutes. If you do like what is said, you can go ahead with it. If at any time you don’t like it you can drop out.
    I would write down what questions I wanted answers to before the phone call and base my decision on that.
    Some people clearly have negative experiences, but if you find out how this operates you can make your own decisions.
     
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  8. Daphne917

    Daphne917 Type 2 (in remission!) · Well-Known Member

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    Mine has never asked me what I eat - she’d probably wouldn’t appreciate my diet anyway!!
     
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  9. Fruitella

    Fruitella Type 2 · Well-Known Member

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    Would be interesting to know if the health and wellbeing advisor is from your gp surgery or whether they will hand your contact details to an outside agency.
     
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  10. Rose22

    Rose22 Type 1 · Well-Known Member

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    I too was told to attend this course in my local area from my gp surgery, when I was told I was prediabetic in 2016.
    I’m wondering have you got on the course? Only as I tried and tried and had no luck! They told me that there weren’t enough participants in my area yet (a large town in Hampshire) and that they would put me on a waiting list and contact me. I tried for six months to no avail. My gp quizzed me as to why I hadn’t chosen to do the prevention class and I complained I had tried but it is near on impossible. Including the telepohone number, it rings and rings, it was a huge call centre somewhere. A year later I was now diabetic as my blood sugars had gone upwards despite my efforts to bring them down, and can you believe it...I got a call from them great news I could join a class, I explained was diabetic and was told now wasn’t able to do the class as only for prevention. So for me personally the whole thing was a waste of time.
    Hopefully they have ironed out the problems (and stopped wasting time and money) and it is running smoothly and helping people that need it and being delivered effectively.
     
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  11. xfieldok

    xfieldok Type 2 · Well-Known Member

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    @Rose22 this forum is likely to be far more help than any course. Are you testing before and after eating?
     
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  12. Resurgam

    Resurgam Type 2 (in remission!) · Expert

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    I reported it as it was all over the forum - seems to have been dealt with.
     
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  13. Sweet_Sophie

    Sweet_Sophie Prediabetes · Well-Known Member

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    Have been on such a programme in 2019 in hertfordshire. These were very interesting and food wise they advised low carb but it was very pious sessions explaining very well how insulin works/ blood etc... also the effect of stress and exercise. The range of people were half half senior / middle aged. I was put on the programme because I was close to pre-diabetic (42). I was explained that these days pre-diabetic are put on these programme because prevention is key. I found both the course and this forum to be of great help.
     
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  14. Gardengnome

    Gardengnome Don't have diabetes · Well-Known Member

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    I have often wondered why people use ski poles for walking so it's interesting to hear you say that they turn you into a quadruped, I'd never thought of it like that. I should give them a try or perhaps cut myself 2 hazel poles to see the effect.
     
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  15. Gardengnome

    Gardengnome Don't have diabetes · Well-Known Member

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    To be fair Reed well being doesn't appear to be a part of WW. I gather that it depends on the area in which one lives as to which firm the NHS allocates the job of 'educating' us! As suggested by Mike D I gave them a call and surprise surprise I was spoken to by someone with a modicum of sense! She began by asking me what my daily diet consisted of and various other questions then went on to say that I was wasting my time and I didn't need their course. how honest. I told her my opinion of Weight Watchers and how in the past I'd lost £ and lbs following their programmes when all they seemed interested in was selling packets of crisps and biscuits which were fine to eat as long as they were WW brand. I lost weight for good once I came off their programme.
     
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  16. Gardengnome

    Gardengnome Don't have diabetes · Well-Known Member

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    I do agree Rose22. But as suggested here I gave them a call to see what their courses consist of. When the girl I spoke to said I really didn't need their course which was my way of thinking anyway. Far more information here.
     
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  17. Gardengnome

    Gardengnome Don't have diabetes · Well-Known Member

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    Clearly the GP surgery had passed my details to this firm as the letter said not to contact the surgery.
     
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  18. Gardengnome

    Gardengnome Don't have diabetes · Well-Known Member

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    I'm interested that yourself and others have found it beneficial for joint pain to follow the LCHF diet. I think perhaps I should persevere more with that and see if it helps. The knee pain isn't so bad but the stiffness, swelling and immobility is getting worse and I think I should ask the GP for a referral so as to at least get on the waiting list for a replacement. it could be a long time!
     
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  19. Gardengnome

    Gardengnome Don't have diabetes · Well-Known Member

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    It always amazes me that diabetic nurses promote the Eatwell plate and similar. You'd think they would know that carbohydrate turns to sugar in the bloodstream. But the Fixing Dad website?? and what is the one you call 'The other place I cannot mention'?
     
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  20. jjraak

    jjraak Type 2 · Well-Known Member

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    A nice story, two sons fix their dads increasing T2.
    And the other place is DUK Website.
    It promotes the Eatwell plate mainly, though does have a part with the direct route the two sons take.

    https://www.diabetes.org.uk/Researc...ht/Research-spotlight-low-calorie-liquid-diet

    It all sounds good, until you see the stats.
    A starvation diet, then a low carb diet.. But the success rate is only 30% are in remission after year two.. While others on here with LCHF are in remission for years.. (Check people's signatures)
    So why not just go LCHF from day one and skip the misery of direct.

    I do realise others have had some success with it, and will praise it, so do have a look yourself.
    It's just not for me.

    A surprise note to me from the info I was looking for re fixing dad, was that the life expectancy after any diabetic amputation is two years..:wideyed:
     
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    #20 jjraak, Jan 18, 2020 at 3:40 AM
    Last edited: Jan 18, 2020
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