Outrageous advice! IMO

MissMuffett said:

Rant alert!
I’ve just had a phone call from the GP to review my diabetes medication - Metformin 2000mg and Forxiga 10mg. We were discussing if I should take Sitagliptin as well. I said I was taking FBG readings and ideally want them in the 5s. Mine range between 7s (on a bad day) and 5s on a great day.
AND THIS IS THE OUTRAGEOUS PART. He said anything between 6 and 11 is fine! No it bloomin well isn’t! Yet again I shall ignore the GPs advice. Roll on the operation then I can add exercise to getting my BG down, lose weight and get off all the medication.

Sorry for the rant. Have a lovely Tuesday evertone.

Click to expand...

Hi - your DR said FBG between 6-11 is fine? Is that true? The advice is so conflicting I dont knwo what to believe. I fi am good and on point mine is always in the 5s and early 6s. If I eat bad or go to my previosu diet (carbs, chocs, crisps etc) it can go to 7.5s

I have been aware for some time that insulin users in my area have also been told to aim for the higher targets (in this area its 7 to 12) and I suffered this treatment when I was in hospital for a non diabetic condition. They even removed my diabetic meds, and I assumed that this higher range was what they expected me to be getting while on hospital food. But no, my GP is also giving out the same message and also threatening to remove my sdiabetic meds if I do not get my next HbA1c above 55.

The NG 28 limits have also been changed to reflect higher target ranges for patients based on age and use of glucose lowering medication. If I drop my meds, then the range for me also drops to the standard levels we have all been asuming to be our control range, and as reflected by the advice on this website (DCUK)

I wonder if it is an attempt to match Eatwell advice to the target ranges that most non lowcarbers will probably experience. I suspect that those on Eatwell are also not advised to test, and so it is more natural for them to get higher levels due to the diteary advice, and so HCP's will no longer need to chide and chivvy patients to get lower since they know that will not happen on the standard diet. So eat your starche, fruits and grains and live a guilt free life.( IMO that is not the way it should be)

MissMuffett said:

He did allude to the Eatwell guide, he did say ’stick to the healthy eating guidelines’ which I assume means the same thing!

Click to expand...

Paradoxically the NHS diet guideline strategy is called Eat Well, Live Well. It is what we here recognise as Eatwell and it used to be the Food Pyramid as laid down by Ancel Keys (I believe) The USA uses Standard American Diet or SAD, which is the same thing, and has a more compatible anacronym don't you think?

I stand corrected. It was not Ancel Keyes who introduced the Food Pyramid.

It is worrying that NICE are changing their advice and guidelines to match Eatwell and are not supporting Low Carb dietary principles. I can understand that the platter is probaly not an issue for insulin users, but it severely and adversly impacts T2D on orals or lifestyle changes.

NICE gudelines are controlled and updated by a committee called SACN, as is Parliament. It is interesting to see who belongs to SACN and what their interests and ties are. The AGM for SACN issues a helpful document that gives this data, which I give a link to below. an interesting side study that I did was to take each member, and google if they had either vegetarian or vegan leanings, and the results I got filled a spreadsheet and was quite enlightening. It explains much of th apparent bias behind SACN, and the funding by the likes of Nestle and Barilla and Cargill show why grains and fruit and nuts play such a prominent role in the guidelines.

PS some of the entries look innocuous, in that some may be researching per ex. Vitamin D. What their research actually is looking for is a vegan source for D3 and EPA which are generally animal sourced only.

So there is bias in the type of research and lectures that they give, not just who pays them. In 2020 I found that over half the commitee was involved in promoting or researching vegan works. I have not checked this latest issue of the Members Interests report. for instance, in the 2020 work I did I found some members were employees of Tesco - ok, thats one hit, but then I found out they were on the Tesco management team that was about to introduce the new Vegan range to the supermarket, and they were up to their elbows in it. No wonder milk and dairy and meat products all but disappeared in the 2020 version of Eatwell.

MissMuffett said:

Yes that’s what he said! I didn’t reply to his comment. I’ve decided to keep shtum now as it’s easier than arguing and stops me getting stressed

Click to expand...

I tied my DN and gp in knots with the wealth of information I found out regarding my type 2. But yes, it is easier and more satisfying to say nothing, easier on our minds and I know exactly what you mean xx

If I had followed that diet, I am certain that I would not be here!
Why do they try to put everyone under one dietary regime? It just doesn't make sense and illogical!I
Most T2s are intolerant to many of the recommendations and the spikes are very dangerous!
Could the pharma be raising their ugly head again?

Lamont D said:

If I had followed that diet, I am certain that I would not be here!
Why do they try to put everyone under one dietary regime? It just doesn't make sense and illogical!I
Most T2s are intolerant to many of the recommendations and the spikes are very dangerous!
Could the pharma be raising their ugly heaid again?

Click to expand...

First look at the SACN commitee list 2023 I saw some being funded by GSK and Novo Nordisk. But this list is not as obvious as the 2020 one, and there seems to be less commercial funding involved. I also noted that two members from 2020 that I found to be veggie are correctly shown as working on the Plant Based soft drinks sub commitee. I have some reservations on a couple of members who are funded by DUK (The Other Lot),

There seems to be a study that several are involved with which is comparing Vitamin D2 against D3, and also looking to limit access to D3 for " reasons of toxicity" which could be a witchhunt.

There is also research by some to remove satfat from dairy products and that is funded by the Danish Dairy Foundation so may be hoping to show a different outcome in regards to mortality and heart disease rather than supporting the Low Fat is Good camp.

Other research is being done to see if Vitamin B6 is a substitute for B12 in regards to iron anemia - this may be looking to use plant based B6 rather than animal based B6.

Most of the diabetes related input seems to be from members researching GD / maternal diabetes, or in children finding ways to encourage them to eat more vegetables (yes that is what one researcher is specialising in).

Several members are specialists in novel food items, but no clues as to what way they are novel.

I think that Nestle is shown as funding several grants to the commitee but not specifically linked to any member, although several claim to be overseeing the allocation of grants. Cargill is funding research into carbohydrates and sweeteners.

Lamont D said:

If I had followed that diet, I am certain that I would not be here!
Why do they try to put everyone under one dietary regime? It just doesn't make sense and illogical!I
Most T2s are intolerant to many of the recommendations and the spikes are very dangerous!
Could the pharma be raising their ugly head again?

Click to expand...

Just over 4 weeks ago, when first diagnosed, I did follow the Eat Well diet. My fasting BG reading was in the 15s at this point. Every meal pushed me into high 17s. After 4 weeks on low carb, my fasting BG reading was 6.3 this morning, 5.7 before brunch, and 5.9 two hours after.

I don't understand how the NHS can keep peddling this Eat Well nonsense for diabetes management.

My recent discussion involved lowering the basaglar and a possible lowering of my ratio to 1:10.
My ratio is 1:3 and my a1c is 5.5.
The reductions in insulins are suggested because I'm ONLY getting a 5.5 not a 7!!!!
Or higher.
Not sure why this is better.
I get 0 hypos and am very insulin resistant And i get bs numbers from 11 to 16 daily.

Paul_ said:

>>>>>
I don't understand how the NHS can keep peddling this Eat Well nonsense for diabetes management.

Click to expand...

There are many on this forum who share your disbelief. But we need to remember that the NHS sees a different picture both from GP surgeries and from hospitals. We are a minority in the diabetic world, and the majority of T2D have never heard of or would recognise what a carbohydrate is. In fact they probably don't care either. The doctor says take this magic potion and come back for a blood test in 3 months/ or a year to see how it is going. This disese is progressive, and one day you will be on insulin.

We are lucky that we have had the blinkers removed and have access to alternative methods of control. But generally most of us come up against Eatwell and the No Test philosophy of the NHS. This blinds most T2D who take meds so they can continue eating harmful food in the belief that insulin tomorrow is many years away. I too was on a trip down de Nile before I was presented with the Insulin from now on pathway.

But we are few, so very few compared to T2D-world outside this portal.

I sent a Translation of this to my German Diabetes Dietician. Her words were, "Whoever stated that should be de-licenced. Acceptable is a relative word. The whole idea of good medical management in diabetes is to get the BGL's and HbA1c down as far as possible. Then pursue a program to keep it there. As I live in Germany, these are our guidelines. 4.5 to 5.5 is normal. 5.5 to 6.5 is pre diabetic, 6.5 and above is T2. She said that anyone who is T2 and getting such Information should seriously considered changing Centers. I'm hacked off getting a BGL of 130mg (7.2) after Dawn Phenomenon. 7 to 11 equates to 126mg to 198mg. I'd be screaming. Just got my Center HbA1c back. 5.3. I have to work hard for that. On the other hand I have a sister-in-law who weight 150kg. Eats what she wants then just shots herself up with Insulin. Lazy and stupid. Now she is whining that her left foot is freezing cold and painful. I wonder why.

MissMuffett said:

I agree and the guidelines that you state are the ones we follow here in uk so I don’t know why my GP is quoting those figures. I’m waiting for a spine operation but I will be changing practice once that is over.
My sister who is T2 does just as your sister in law and she’s nearly blind in one eye due to diabetic retinopathy as she just injects more insulin when she eats cake, rice bread etc

Click to expand...

I wish you luck with your journey. PS I also need some Vitamin Sea.

MissMuffett said:

I agree and the guidelines that you state are the ones we follow here in uk so I don’t know why my GP is quoting those figures. I’m waiting for a spine operation but I will be changing practice once that is over.
My sister who is T2 does just as your sister in law and she’s nearly blind in one eye due to diabetic retinopathy as she just injects more insulin when she eats cake, rice bread etc

Click to expand...

Oh my goodness. Crazy. When I was in hospital (only three days of Eatwell) Blood sugar went up to 17 which it hadn't been up to then.

We buried my mother-in-law in February, 20 odd years of near perfect clinical diabetes control. Virtually blind, severely obese, Kidney failure, Heart failure and minus a foot. i'm happy with my low carb and hope to stave off all of the above. I couldn't care less what their recommendations are, i have my own targets.

My average glucose for the last 7 days, according to my Libre 2, is 11.7 mmol/L and for the last 90 days is 11.6 mmol/L. My diabetes specialist says I'm doing brilliantly, considering how much influence my non diabetes medication has on my BG. When we have tried to tighten up these results, I end up with BG going too low (5 and below especially before bed). My specialist says to continue as I am, as I'm jogging along just fine.