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Oh My Word! Feedback Received From My Dn

I always heard you had to be very clever to do medicine and its a long road so what a waste of those fine young brains if thats the case. I just hope some of them are thinkers.
Unfortunately a lot of those I have met disprove what you were told - with some notable exceptions of course.
 
Hi @Debandez what a truly shocking response! We all know that the advice given at time of diagnosis seems to be the “standard” guideline text. My DN was genuinely pleased and surprised at my results when I went for my first check up, the second appt wasn’t met quite so enthusiastically, but, it was her first appt of the day and she was having major IT issues and was a bit flustered. I am not making excuses for her and in hindsight I wish I had pressed her for more feedback and thoughts on what I had achieved. It may have been complete shock and surprise as a remission is very unique, rare, unheard of...........or maybe she was worried that if all her patients do the same she will be out of a job!

Please excuse my ignorance but what is the difference between remission and controlled? I hear things on tv etc say thing they “are no longer diabetic” or I’m in remission etc. Am I correct in thinking if they ate a standard western diet again their blood sugar would rise again and they’d be back in diabetic range? If so then surely it’s under control? I’m so confused. Can someone in remission eat normally? Can you ever not be diabetic? Thanks
 
Please excuse my ignorance but what is the difference between remission and controlled? I hear things on tv etc say thing they “are no longer diabetic” or I’m in remission etc. Am I correct in thinking if they ate a standard western diet again their blood sugar would rise again and they’d be back in diabetic range? If so then surely it’s under control? I’m so confused. Can someone in remission eat normally? Can you ever not be diabetic? Thanks
There seems to be a level at which those doing studies say that people are in remission or have reversed their Type 2.
This is usually looked at as consistent HbA1c's of lower than 48mmol/m. Personally I think this is wrong but both Prof Taylor in his Newcastle Diet studies and Virta Health use it as a measure. I would agree that this means very well controlled but feel that level should be lower than 42 mmol/m i.e. not pre -diabetic. Obviously if you go back to the away of eating that helped create the condition in the first place (and who would want to be that crazy) then your high blood sugars would be highly likely to come back.
 
At the moment I could probably eat far more 'normally' and not see diabetic blood glucose levels - but I have never been able to do that all my adult life and maintain my weight and energy levels.
I reaches 264lb eating what was supposed to lower cholesterol and be a really healthy low fat diet, and that was just before being diagnosed diabetic.
For me diabetes is negated by my diet, I am still diabetic but it is of no great importance. It might be viewed as someone who's body doesn't float in water going to live in a desert. The danger of drowning is much reduced, but they would still be unwise to jump into a swimming pool, no matter how tempting the water looked.
 
I always heard you had to be very clever to do medicine and its a long road so what a waste of those fine young brains if thats the case. I just hope some of them are thinkers.

I think the requirements for getting to medical school are very rigorous. But being 'clever' is such a loose term that I am not sure it applies. Good memory, good learning capacity, good at assimilating information, good at regurgitating information... all of those, yes. They must be part of the selection process.

But some of the doctors I have seen have lacked basic compassion, patience and listening skills, also interest in their patients and a willingness to empathise with their suffering and concerns. So I think that whatever selection and examination process is being used is lacking some pretty basic requirements.

I suppose that is the downfall of a selection process that prioritises exam prowess over bedside manner.
I can't help thinking about the tv series House when typing this! lol
 
They do have loads of Medical student Viva type exams with simulated or actual patients. You can see a sample on YouTube, some are funny.
 
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You might wish to mention Dr David Cavan, he developed the BERTIE courses which have spread throughput the U.K. He is very well known Diabetologist and is advocating low carb for type 1 and 2s. (And other types I should think) Chevk out his name on Amazon UK to read boom reviews, his books have Diabetes.co.uk on them.
 
Also, search for new video of Dr David Cavan on this website. I couldn’t post a link because this forum suspected it was a spam message.
 
Also, search for new video of Dr David Cavan on this website. I couldn’t post a link because this forum suspected it was a spam message.
It does that for a while when you are new.. once you have posted a few more times you will be able to post links. Dr Cavan has had links to DCUK in the past and recently released a new book about Low Carb and Type 1.
 
Please excuse my ignorance but what is the difference between remission and controlled? I hear things on tv etc say thing they “are no longer diabetic” or I’m in remission etc. Am I correct in thinking if they ate a standard western diet again their blood sugar would rise again and they’d be back in diabetic range? If so then surely it’s under control? I’m so confused. Can someone in remission eat normally? Can you ever not be diabetic? Thanks
Hi @Flora123 my understanding is that so long as I maintain an eating regime that keeps by blood sugars in check and at the levels of a normal/non diabetic person then I can say I’m in remission.

others choose to say reversed I think it’s a matter of personal preference.

I also understand it to be that if I eat as I did before my diagnosis then my blood sugars will most likely rise and therefore I will no longer be in remission, therefore the choice of remission makes sense to me based on the fact that there is no cure and on this definition

a temporary diminution of the severity of disease or pain.
I hope this helps you?
 
Im currently working out my next move @Rachox....still reeling to be honest. When my DN saw me in May and gave me the HbA1c results she did say 'nobody has done what you are doing EVER. Not one person has walked through that door and done it' but I thought she was meaning keeping BS records, bringing in books I had read, newspaper cut outs, weight loss stats. I know now that she actually meant putting diabetes into remission!

My GP said the same too - he was absolutely stunned. He's been working with diabetics for over 30 years, and had never seen results like mine - I went from an HBA1c of 51 to one of 40 in 3 months. Currently MySugr is predicting an HBA1c of 33. I love low carbing!
 
It interesting to see the criteria Kraft, Ivor Cummings and others used/use.
Hyperinsulinemia is diabetes in situ, even if our hba1c is within what is considered to be ok in UK. Hba1c with many T2D's is the last parameter to go out of limits when the pancreas has been flogged to its last legs. That is, unless we have genuine low insulin T2D.

D.
 
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Hi @Flora123 my understanding is that so long as I maintain an eating regime that keeps by blood sugars in check and at the levels of a normal/non diabetic person then I can say I’m in remission.

others choose to say reversed I think it’s a matter of personal preference.

I also understand it to be that if I eat as I did before my diagnosis then my blood sugars will most likely rise and therefore I will no longer be in remission, therefore the choice of remission makes sense to me based on the fact that there is no cure and on this definition

a temporary diminution of the severity of disease or pain.
I hope this helps you?
For my condition, I mostly like to use the term reversal as was described by Dr. Taylor since I have reach the point that my pancreas started to work normal again even with high carb diets I take sometimes. My HBA1C was 79 at diagnosis and becomes 33 6 months later after following very low carb diet and lost almost 14KG. For the time being, I am on moderate carb diet and I have changed my diet routine in order to keep weight on normal range.
For me, I think remission is different from reversal from my own experience. But, I totally agree with others that going back to bad diets will lead to high readings again and high HBA1C.
 
I sometimes wonder if medical students are allowed to think. Are they taught Diabetes in a progressive disease and you will be lucky if it doesnt get you in the end? End of. Or are they encouraged, even allowed, to think maybe there are ways of living which will allow long term control of diabetes. I do wonder.
Yes, the mind is like a parachute. It only works when open. I fear that new discoveries or innovations may be filtered trough the conservative filters of their teachers. The adoption rate of new ideas is well demonstrated by the 20 years it took for a bug called Helicobacter to be recognised as a cause of stomach ulcers.
 
I'm starting a letter (signed as a new member of the PPG) to my GP practices (2) today (for attention of all drs (@8) and DNs (4 that 'specialise') and paramedic practitioner (2) practice manager and her deputy. It feels like a criminal case to catch a murderer kind of letter! My story, updated to include the Birmingham event confirming it was very successful and why. It would appear from the feedback I received from the surgery via the practice manager that I'm the only patient EVER to have put my diabetes into remission apart from the post bariatric surgery patients (We are entitled to ask for stats if anyone else is thinking of doing this as it doesn't breach patient confidentiality, the results could be incredibly interesting). I was shocked to the core but I'm not surprised nobody else has to be honest as they are all obviously following the progressive disease guidelines and nobody has questioned anything or looked to Google as I did. I'm going to include the Inspirational Stories booklet (this is so powerful and if anyone else would like their own journey included it's an ongoing thing, I will just keep sending them to DCUK who are redesigning our booklet), 100 stone lost and kicked diabetes' butt leaflet (the reductions in weight and HbA1c levels are astounding) and the blood sugar leaflet (as they obviously don't know how important testing is to diabetics!). I'm also printing off Dr David Unwins paper and confirmation of his last award. No 9 on the list of 50 most influential gp's. As a low carb advocate he has saved his practice 57k in just one year, and helped so many patients lower their HbA1c levels. I will see what their response is. It will also be interesting to see what comes out of our event from the PR perspective. I have lots of ideas on who to send our story to but just need to wait to see how DCUK get on first. One of them is fellow diabetic Teresa May although i think she has quite enough on her plate at the moment (but is it low carb!?). Ideas in the pot welcomed. My ultimate plan is for us to be sitting next to Holly Willoughby on that sofa ' move up Holly there's a few of us!'!!! Shoot for the moon and all that.

Yesterday along with doing a TripAdvisor review of Jamie's Italian I wrote a long email to Hannah our amazing waitress on the night. I'm going to write to Jamie himself (although I did ask Hannah to forward hers to him as it was not only thanking them for meeting our dietary needs so well but it made suggestions re including low carb desserts into his menus.

Sun's out here on the north west coast. I'm taking my dear old friend for lunch. 89 years young. Lovely day for it.

Have a good day folks.
 
It interesting to see the criteria Kraft, Ivor Cummings and others used/use.
Hyperinsulinemia is diabetes in situ, even if our hba1c is within what is considered to be ok in UK. Hba1c with many T2D's is the last parameter to go out of limits when the pancreas has been flogged to its last legs. That is, unless we have genuine low insulin T2D.

D.
The confusing thing is that my sister was t2d and had bariatric surgery. Her pancreas kicked straight back in and is now completely non diabetic as in no insulin resistance. Still trying to get my head around that.
 
I'm starting a letter (signed as a new member of the PPG) to my GP practices (2) today (for attention of all drs (@8) and DNs (4 that 'specialise') and paramedic practitioner (2) practice manager and her deputy. It feels like a criminal case to catch a murderer kind of letter! My story, updated to include the Birmingham event confirming it was very successful and why. It would appear from the feedback I received from the surgery via the practice manager that I'm the only patient EVER to have put my diabetes into remission apart from the post bariatric surgery patients (We are entitled to ask for stats if anyone else is thinking of doing this as it doesn't breach patient confidentiality, the results could be incredibly interesting). I was shocked to the core but I'm not surprised nobody else has to be honest as they are all obviously following the progressive disease guidelines and nobody has questioned anything or looked to Google as I did. I'm going to include the Inspirational Stories booklet (this is so powerful and if anyone else would like their own journey included it's an ongoing thing, I will just keep sending them to DCUK who are redesigning our booklet), 100 stone lost and kicked diabetes' butt leaflet (the reductions in weight and HbA1c levels are astounding) and the blood sugar leaflet (as they obviously don't know how important testing is to diabetics!). I'm also printing off Dr David Unwins paper and confirmation of his last award. No 9 on the list of 50 most influential gp's. As a low carb advocate he has saved his practice 57k in just one year, and helped so many patients lower their HbA1c levels. I will see what their response is. It will also be interesting to see what comes out of our event from the PR perspective. I have lots of ideas on who to send our story to but just need to wait to see how DCUK get on first. One of them is fellow diabetic Teresa May although i think she has quite enough on her plate at the moment (but is it low carb!?). Ideas in the pot welcomed. My ultimate plan is for us to be sitting next to Holly Willoughby on that sofa ' move up Holly there's a few of us!'!!! Shoot for the moon and all that.

Yesterday along with doing a TripAdvisor review of Jamie's Italian I wrote a long email to Hannah our amazing waitress on the night. I'm going to write to Jamie himself (although I did ask Hannah to forward hers to him as it was not only thanking them for meeting our dietary needs so well but it made suggestions re including low carb desserts into his menus.

Sun's out here on the north west coast. I'm taking my dear old friend for lunch. 89 years young. Lovely day for it.

Have a good day folks.
Hi,

You are so inspirational Debandez. Thank you for being so proactive !

I have written to Jamie too, but alas, no response so I wish you luck. But I am quite positive he will reply to you.

The Brighton Jamie’s have told me they do not have cream there anymore. Strange as I kept up to date with your Birmingham event and obviously they did. I also did some feedback for Jamie’s requesting some sugar free desserts or even a cheese plate. So let me know how you get on. Thanks again.x
 
Hi Brunneria,
It is not rote learning at medical schools at present, students are taught by doctors with decades of experience in the different fields of medicine.
Many have a teaching certificate similar to school teachers as well as a medical degree and other degrees.

The problem you highlight is obviously caused by system constraints, where unless a double appointment is booked, they have to read notes, consult and write up notes, all in ten minutes.
I doubt many of us can do that in a relaxed manner. I would not want the job, it's too much of an ask. No wonder so many don't work a full week or retire as soon as possible.

The situation is somewhat different if a doctor concentrates in a specific field, like a diabetes specialist, where more time is allocated.
regards
D.

I think the requirements for getting to medical school are very rigorous. But being 'clever' is such a loose term that I am not sure it applies. Good memory, good learning capacity, good at assimilating information, good at regurgitating information... all of those, yes. They must be part of the selection process.

But some of the doctors I have seen have lacked basic compassion, patience and listening skills, also interest in their patients and a willingness to empathise with their suffering and concerns. So I think that whatever selection and examination process is being used is lacking some pretty basic requirements.

I suppose that is the downfall of a selection process that prioritises exam prowess over bedside manner.
I can't help thinking about the tv series House when typing this! lol
 
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'The only patients who have done this to my knowledge at the surgery is post bariatric surgery'

So it would appear that the diet the Dr is encouraging hasn't worked for ANY of his patients. The DN by the way was my mum's DN for about 10 years and my dear mum passed away 11 years ago.

That is the sad reality...but there is rampant cognitive dissonance in T2D care. They choose to attribute the failure to the patients. eg patients unable to stick to lifestyle changes...blah blah blah...rather than recognized the failure of their recommended approach.

https://steemit.com/diabetes/@kokho...diabetes-is-rare-except-via-bariatric-surgery
 
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