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No NHS support for prediabetics who are not overweight

Discussion in 'Prediabetes' started by snametab, Jan 9, 2022.

  1. snametab

    snametab Prediabetes · Member

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    This is my first post based on my experience.

    October 2020 I found out by accident from the nurse giving me my annual flu jab that I was prediabetic and I had been for at least a year. I am white, female, 68 years old, on medication for high blood pressure and in October weighed 10st 10lbs with a BMI of 24.9. therefore was not obese. Test result in August - Haemoglobin A1c level - IFCC standardised (XaPbt) 42 mmol/mol which was taken as part of a series of tests for a UTI.

    I was totally shocked because I am not overweight and don’t eat sweet food, I don’t even like cakes, biscuits, puddings, chocolate, fruit juice, icecream, jam, fizzy drinks etc and I am very active for my age. I do like and was eating a variety of meales to include pulses, wholewheat bread, masses of veg/salads, diary, fruit, brown rice, oats, barley, nuts, seeds, fish/shellfish, poultry, game, lamb, pork etc infact all my friends considered my diet to be exceptionally healthy as did I. I drink 1.5 bottles of wine spread over a week, plus water, coffee and tea.

    The nurse on realising I hadn’t been previously told immediately offered me support and said someone would contact me.

    The support came from Diabetes UK charity (Chris Askew is the CEO and the NHS use them to help diabetic patients) and their recommendation was to basically eat healthily, exercise and loose weight. As I already did two of those things and apparently was a healthy weight I was shocked again as I couldn’t see how continuing with my current lifestyle would reverse my prediabetic situation, they wouldn't take on board that I was not overweight and didn't eat sugar or processed food. My parents who died at the ages of 82 and 92 had not been diabetic, overweight or sedentary. It just didn’t make sense so I started my research and found that low carb diets can reverse type 2 diabetes and assumed the same would be true for prediabetics. I asked for support to do that but was told they couldn’t support me on a low carb diet.
    Since the beginning of October I have been following a low carb diet (below 50 carbs per day) and learning a lot on the way, it is complex and not easy and many websites worldwide say you should do this with supervision from your doctor, but I know that is not possible with the NHS. I am still not sure if I am eating the right amount of fat, protein and carbs each day, but I am detemined to reverse my situation as my husband died from cancer and diabetes - he didn’t heal from the cancer operation. I believe I have visceral fat and this may have developed over 12 years of severe stress.

    I currently weigh 10st 8lbs and have a BMI of 24.6. Weather permittiing I walk on average 15 miles per week up and down the side of Bishopdale in the YDNP where I am lucky enough to live. Weather being bad currently I am cycling on my exercise bike (42 kilometers per week).

    I have scientific/medical friends in California and they have just advised me to look up Dr Jason Fung and I have ordered his book “The Diabetes Code” which I understand advocates fasting to help.

    My observations regarding diabetes is that the consensus in tackling this disease/condition in the UK is to follow a low calorie/low fat diet but there is growing scientific evidence world wide that low carb diets work much better (Dr David Unwin recommends this) and are more sustainable (I have looked at world wide studies and what people are saying, particulary on this website. The scientific and medical profession in the main appear to be against the low carb diet because there is no long term data to reference. Due to the growing UK population with obesity and diabetes the scientific/medical fraternity are only offering weight reduction as a solution but people like myself don’t fall within that category and if my predisposition to diabetes is not generic then further research is required to understand what causes diabetes and what can remedy a reversal/control through diet for those not overweight and presumably will help everyone in the long run.

    I have written to Amanda Pritchard, NHS CEO, Professor Ron Taylor who advocates calorie controlled dieting for a short period and Chris Askew CEO of Diabetes UK, who's organisation said they couldn't support me and copied my MP Rishi Sunak. I have asked them why they are not acknowledging world wide studies and the work of Dr David Unwin regarding low carb diets.

    Since writing I see there is a website commissioned by the NHS called "low carb program" and there is a page where NHS patients who have been referred by their healthcare team can register with a referral code and so presumably they don't pay everyone else has to pay. My question is what is the NHS criteria for patients to be referred, clearly I wasn't I was just lucky to find out that I was prediabetic when I did. Does anyone in the UK have a sympathetic GP who helps them reverse diabetes/prediabetes on a low carb diet? Is Dr David Unwin the only one? Has anyone been referred to the low carb program by their healthcare team?

    I currently weigh 10st 8lbs and have a BMI of 24.6 so have only lost 2lbs in 2 months and I only deviated from my diet on Christmas day and boxing day. I don't have problems keeping to the low carb diet - I quite like it just miss boiled potatoes and sourdough bread.

    I have found an envaluable website called diet doctor and I am currently studying 15 reasons why (less than 50 carbs per day) I appear to have plateaued. For anyone embarking on a low carb diet I recommend getting "Carb & Calorie Counter" by Chris Cheyette & Yellow Balolia this allows you to count all your carbs I am now also counting protein. I have a spreadsheet and know exactly what I eat each day and am building up a list of recipes that I use regularly. I have found that having a Thermomix (it is expensive) and Instant pot duo air fryer helps as they are all I need for my low carb diet. I am only cooking for one. I also have a spreadsheet to log my exercise and weight I either walk or use my exercise bike, from March to October I garden nearly everyday for most of the day.

    To summarise I am unhappy that the NHS is not embracing low carb diets and that they bracket all prediabetics/diabetics together under the same heading obese/must lead unhealthy lives/need to loose weight therefore low calorie/low fat diet recommended with exercise. I am very happy with what I have discovered re low carb eating and will be continuing this and hope that my next HA1c test result will be lower. Does anyone know if I can ask for test at 6 months after last one?
     
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  2. bulkbiker

    bulkbiker Type 2 · Oracle

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    Welcome to the wacky world of NHS T2 diabetes non treatment.

    You make several very valid points but unfortunately few if any will lead to change.

    Agree good advice he, alongside forum members here, started me off on my low carb journey.

    Not the only one but one of a small but hopefully growing band of low carbers slowly getting the message out.

    I'd be very interested to hear if your communications get any further traction but unfortunately until you are diagnosed with "full-on" T2 you'll get little to no help from the NHS.

    As some of us have found even once diagnosed they are still relatively useless.

    You seem to have had some good info already so hopefully by joining up here too you'll get even more.

    That's what we spend our time here trying to achieve.
     
  3. Outlier

    Outlier · Well-Known Member

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    I commend you on your approach to this issue.

    I can offer no help with NHS/GP attitudes and lack of help, as this is happening for me as well, so all down to ourselves unless we are lucky enough to have enlighted medics - they do exist but are rare birds.

    What I hope will help is the observation, for me at least (and we all respond differently here and there) is that I have had a series of plateaus rather than a steady improvement. So, given your healthy lifestyle, maybe your improvements will be small and spaced out as well.

    Are you using a blood glucose meter? Most of us find them really helpful.
     
  4. snametab

    snametab Prediabetes · Member

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    I think that is my next step and I am now investigating. I tried to search for a recommended one on this site but couldn't find any posts. Thinking of buying the Betacheck C50 cassette system as I understand it is made in the UK. What do you think?
     
  5. ZoeinKent

    ZoeinKent · Active Member

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    Hi @snametab, welcome to the forum!

    Firstly, I'm so impressed by all the research you've done and how proactive you've been in writing to all those people!

    I was borderline prediabetic (HbA1c of 41) several months after a gestational diabetes pregnancy. I'm also a normal to low BMI. Although it was I who suggested a low-carb diet to my GP, she was largely supportive and offered me a second HbA1c after three months to see how the changes had impacted my levels. Thankfully the result came back at 31 - low carb plus running three times a week had worked for me. I think the level of GP support is very much a postcode lottery. However, she actively encouraged me not to use a home glucose meter - I disobeyed this advice and have found a meter invaluable in showing what foods I can and can't tolerate. I use an Accucheck Performa, but the strips are expensive - others on this forum have some good knowledge of cheaper brands.

    Best of luck to you!
     
  6. Lakeslover

    Lakeslover · Well-Known Member

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    I think it’s @Rachox who has some good info on meters.

    I’m afraid I have had little help from the NHS as a type 2. For years I was told to eat “healthy” carbs, and every time I discussed my diet with the diabetic nurses or doctor they said my diet was good and no changes needed. About 5 years ago I decided to try low carb but after a month on it I had a routine appointment where I was soundly told off by the nurses. So I went back to following their advice, with the resultant ever increasingHbA1c.

    fast forward to March last year and I decided to get a libre to monitor blood sugars, joined this forum and went low carb. Latest HbA1c is 44 (in sept last year it was 71). I have told the doctor I’ve adjusted my diet…but not yet how. I will do though when I can see her face to face.
     
  7. Dave Russell

    Dave Russell Type 2 · Active Member

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    I was diagnosed type 2 at the beginning of December and told then that I was prediabetic in 2015. I don't remember being told I was prediabetic although it was a phone call and my hearing isn't great.

    I have a healthy lifestyle but have a higher BMI than it should be, but wouldn't see myself as overweight. Always been slightly stocky though, despite running and cycling. Though I always liked a drink with crisp or cup of tea with a packet of buscuits.

    I'm on a mission to reverse it, but if I'd known what I know now. Luckily I think I'm in a good place regarding my levels.

    It's great what you are doing. I commend you.
     
  8. sunspots

    sunspots Type 2 · Well-Known Member

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    I've been lucky since moving house as my diabetic nurse is at least into the Newcastle diet which differs from the regular carb heavy advice. I have had several operations before moving, was on a keto diet, and given toast to eat before I could leave (after day surgery). It seemed to me that there is an even bigger problem in secondary care when it comes to understanding the inappropriateness of the NHS obsession with carbs in a healthy diet.

    I have just returned to eating low carb, but not keto this time. Nothing else in my experience has worked as well at normalising blood glucose values.

    I think the take home message I received over time was that the NHS expects type 2 diabetics to manage themselves with minimal input from them. Don't get me started on my experience of diagnosis and after!!!
     
  9. Rachox

    Rachox Type 2 (in remission!) · Moderator
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    Welcome to the forum @snametab and thanks @Lakeslover for the tag.

    Here’s some info on UK meters, and to be clear I have no commercial connections with any of the companies mentioned.


    HOME HEALTH have the Gluco Navii, which is a fairly new model and seems to be getting good reviews, links to the strips and the meter:

    https://homehealth-uk.com/all-produ...ose-meter-test-strips-choose-mmol-l-or-mg-dl/

    There are also discount codes for when you come to buy more strips - "navii5" and "navii10" will give you 20% off purchases of 5 packs of strips and 25% off 10 packs of strips respectively.


    Then they sell the older SD Code Free, details to be found here:

    https://homehealth-uk.com/all-products/codefree-blood-glucose-monitoring-system-mmoll-or-mgdl/

    Discount codes for the Code Free strips

    5 packs 264086

    10 packs 975833



    SPIRIT HEALTHCARE have a meter called the Tee2 + found here:



    https://shop.spirit-health.co.uk/co...e2-blood-glucose-meter?variant=19264017268793

    with the strips found here:



    https://shop.spirit-health.co.uk/co...py-of-tee2-test-strips?variant=19264017367097

    Some members have got a free Tee2+ by phoning up to order, with a large order of strips they often throw the meter in for free:

    Phone number 0800 8815423


    With more expensive strips is their Caresens Dual, this one has the advantage of glucose and ketone testing in one machine, it’s to be found here:

    https://shop.spirit-health.co.uk/collections/caresens-dual



    If there is a choice of units of measurement then ‘mmol/L’ are the standard units in the UK, ‘mg/dl’ in the US, other countries may vary.


    Don’t forget to check the box if you have pre diabetes or diabetes so you can buy VAT free. (for all meters and strips)
     
    • Informative Informative x 1
  10. snametab

    snametab Prediabetes · Member

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    Thanks for your reply I am appalled that they told you off, how dare they. You need to write to your MP and explain this. If the NHS carries on promoting high carb diets they are pushing more and more people towards being diabetic. Thank goodness for the internet where we can see the scientific studies that disprove what the NHS are promoting. What I am puzzled about is this low carb program website commissioned by the NHS that appears to be for a select few - I need to get to the bottom of that. I am sure low carb is the right way to go but do make sure you are eating enough protein and fat? Diet Doctor and healthline websites are good on advising on that. Good luck.
     
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  11. snametab

    snametab Prediabetes · Member

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  12. snametab

    snametab Prediabetes · Member

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    thank you much appreciated
     
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  13. NicoleC1971

    NicoleC1971 Type 1 · Well-Known Member

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    Well done on the fact tht you have realised early on that the NHS is stuck in a paradigm where obesity is believed to cause type 2. Jason Fung (his book is a great explanation of diabetes and how the drugs don't work but a low carb or fasting approach does) and many others believe obesity is merely a symptom and that a little visceral fat in otherwise normal bmi people can cause diabetes. Meanwhile there are very fat people who churn out massive amounts of insulin or don't store fat around their organs and so don't become diabetic.

    In the UK I like this GP practice who have also developed an pp:
    https://lowcarbfreshwell.co.uk/

    Dr Joanne McCormack runs courses but you can see her tips on this site
    http://www.fatismyfriend.co.uk/category/how-to-change-your-eating-in-8-weeks/
    I am also just reading a book by Dr David Cavan (fwd by Dr Unwin) called Busting the Diabetes Myth which is written by a diabetes consultant who DID get the memo about eating low carb.
    I am sorry that these are not part of the NICE recommended pathways though their guidance does allow a flexible approach and even DUK concede that a low carb diet is possible (that's big of them!! though they tend to promote their own research (the 800kcal Newcastle diet).
    Things are slowly changing and DUK are doing research into Diabetes remission for TOFIs like you (Thin Outside Fat Inside) via Prof Taylor who established the paradigm that type 2 is reversible. There is hope but don't wait for the NHS to sort you out!!
    https://www.diabetes.org.uk/about_us/news/retune-type-2-remission-study-preview
     
  14. MrsA2

    MrsA2 Type 2 · Well-Known Member

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    @snametab . Excellent research so far. There is much more info out there. I'm currently reading the book Metabolical by Dr Robert Lustig, available on kindle at the moment for a bargain 99p. Although a lot in it is based on the US, much is applicable here and you'll see its not how much we eat but what we eat that causes the problem.

    BTW, I've been totally locked out of any NHS support because I got myself into remission too quickly, and in 2020 found I'd been prediabetic since 2006 but no one told me!
     
  15. Lakeslover

    Lakeslover · Well-Known Member

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    I use an app called nutracheck which allows me to monitor protein, fat, carbs, cals, set a target and also links to my watch to record exercise. I use keto recipes on line, and in cookbooks, and have bought an air fryer too.
     
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  16. snametab

    snametab Prediabetes · Member

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    thanks for all the info
     
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  17. Rocinante

    Rocinante · Well-Known Member

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    What sort of specifically low carb things do you eat?
     
  18. Riva_Roxaban

    Riva_Roxaban Type 2 · Well-Known Member

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    I ask for my blood tests either done three or six months with my GP depending on what tests need checking here in Australia.

    It does not hurt to ask your GP, he can either say yes or no to your query.
     
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  19. snametab

    snametab Prediabetes · Member

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    Hello. So I eat 3 meals per day and have found that those that I list fill me up and I find that I not really hungry by the next meal time. I include veg with every meal.

    SOME BREAKFASTS: 200gms greek yoghurt+1 tbsp seeds +20gms of either walnuts or pecans nuts + 50gms blueberries OR 2 eggs + 100gms tomatoes+whole avocado OR scrambled tofu (half a pack of tofu fried in butter with my special mix to make it taste great*) + 100gms green veg like kale/spinach/brussel sprouts OR 4 slices of Mattesons sliced turkey +100gm of mixed beans *100gms nutritional yeast, 4 tsps kala namak, 3 teaspoons onion powder, 1 teaspoon turmeric and 1 teaspoon garlic powder - place in a jar and shake and then use when frying the crumbled tofu.

    OTHER MEALS: I cook portions of meat or fish with a green veg or fried aubergine. I marinate chicken in yoghurt and tandoori mix or I coat raw chicken with a spice mix/rub and fry. I make mushroom stroganoff. Cauliflower cheese soup. Fried tofu mixed with pesto. I love a good lettuce (Lambs lettuce if you can get it) in french dressing (I make my own). Smoked salmon. Humous. Cheese and nuts. Ratatouie (Delia's roasted ratatouie is delicious). Roasted curried cauliflower.

    I cook in butter to get the fat levels up and is also delicious. If I feel hungry I eat a piece of cheddar cheese and that seems to sort it or 30gms of nuts like brazils or pine nuts. I am using 'Prewetts ground golden flax seed' bought from Morrisons to sprinkle on some meals where I feel I need more fibre.

    I can't cover everything I eat as I have a very varied diet, I am a very keen cook and have always been interested in food so for me it is easy to think of tasty interesting meals. I can't recommend enough the book mentioned in my original text "Carb & Calorie Counter", I use it all the time. I use a spreadsheet to record all my meals and now log both carbs and protein as I believe I was not eating enough protein when I started my low carb journey. I have now read online that for me (my age etc) that I should aim for between 80-100gms per day and I doing that and it has helped me. I also make sure I eat fat which I know to begin with is hard. I have never had a sweet tooth but do miss potato and bread. I have never had to diet in my life so doing all of this is different for me and I would admit that it is time consuming and would not be easy if you have other people to cook for.
    my BMI is 24.4 current weight 10st 7lbs I seem to be stuck at this point but I am still highly motivated because I believe that I maybe reducing my visceral fat and building up muscle with increased exercise - time will tell when I have my next HA1c test.

    I hope this all helps and good luck
     
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  20. snametab

    snametab Prediabetes · Member

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    I should have added that on average I am managing less than 30 carbs a day.
     
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