Post Diagnosis Follow Up

[SweetHeart]

This morning we went to the doctor for my husband's post diagnosis follow up appointment, and we are more confused that ever about the information you get from health professionals.

Firstly, the doctor was very pleased with MH's BG levels; down from diagnosis 14.9mmol to 7.1 (this morning's fasting test) so she doesn't want him to increase his Metformin. He's only taking 500mg daily. She has put him on Slimvatatin one 40mg tablet per night.

She asked about his diet, and was pleased with what he told he had done. She freaked out when he said he'd been to the online forums; "You don't vant to be fillink your head with invormasion. Eet ees too much for you to be understandink, stay avay from dem' We didn't mention low-carbing, or his small evening glass of red, in case she had a coronary. So we asked her about dietry information and she suggested this as a typical daily diet;

Breakfast: Two pieces of toast (any bread) with margarine and jam or marmalade.
Lunch: Jacket potato (up to 225g/8oz) tuna mixed with yoghurt and salad.
Dinner: Any meat, potatoes (oven chips and roast are ok) or rice or pasta, vegetables or salad.
Snack; As much fruit as you like, one or two biscuits, cheese.

I said nothing, but my brain was screaming at all of those starchy things in one day. There was no mention of portion control except for the jacket potato. She didn't even suggest BG testing after any of those meals to see what agreed with MH and what didn't. When we asked about testing levels she advised we just kept his level in single figures, but not below 3.0mmol. I guess 9.9 is still ok then? :crazy:

This has left MH reeling because Nurse Death :evil: wants him 'maxed out on Metformin and taking two Statins a day'. It's going to be great fun seeing her on Monday.....

Julia

 

[viviennem]

Hi Julia (love your avatar!)

You're beginning to see why some of us are slightly wary of HCPs! I'm lucky with mine - the two I trust (1 GP and the practice nurse) know what I'm doing with low-carbing and let me get on with it. With the others I just nod, smile sweetly - and get on with what I'm doing.

Well done on your husband's drop in BG levels - you're obviously doing something right. As far as your doctor's dietary advice goes - well, if I ate like that, my BGs would always be in double figures. Next time you see her, ask why she is advising your husband to eat food that turns directly into glucose, and see what she says. I personally think that they learn a bit about Type 1 at med school, and nothing else. They seem to recommend regular carbs to keep the blood glucose stable - which you would need if on insulin. Not the GPs fault - I don't think the training is good enough, and they can't be specialists in everything.

NICE guidelines for Type 2 - 4 - 7 before meals/fasting; less than 8.5, 2 hours after eating. So much for single figures!

Is your husband's cholesterol very high, that they've put him on Simvastatin? It works very well for many people, but I can't tolerate the side effects. Metformin gives some protection against CVD and stroke - I take 3 x 500mg per day, hoping it helps me with weight loss, which it does for some people. Not fast enough for my liking :lol: .

I think the best thing you and your husband can do is read around, get well informed, and make your own minds up. They can't make you take anything you don't want to. Just don't tell them about the glass of red wine :lol:

Viv 8)

 

[ladybird64]

Julia, you did give me a giggle with your post. :lol:

Glad to see you back here and glad hubs is with us, brilliant news about his bg's coming down so well.

What you have mentioned regarding the docs reaction to the forum..this seems to be a common reaction. It is similar with the self monitoring issue, of course there may be some that take it to extremes but on the whole, it's an important part of our diabetes care. I would love to know why there is this assumption that those with diabetes know nothing about their condition, are incapable of learning anything about their condition and are all of such a nervous disposition that we will go to pieces and suffer terrible anxieties if we take an active role in our diabetes management!

I just don't get it.. :think:

 

[LittleGreyCat]

<snip>

Oh, can we have a 'smiley' of someone screaming? Looked but couldn't find.

Breakfast: Two pieces of toast (any bread) with margarine and jam or marmalade.

:twisted: So carbs plus concentrated sugar with a hint of fruit. :crazy:

Lunch: Jacket potato (up to 225g/8oz) tuna mixed with yoghurt and salad.

:think: Not too bad - reasonable way to take in carbs slowly, and good other stuff.

Dinner: Any meat, potatoes (oven chips and roast are ok) or rice or pasta, vegetables or salad.

:? Really far too many carbs, and the biggest meal at the end of the day

Snack; As much fruit as you like, one or two biscuits, cheese.

:crazy: Only saved by the cheese!

<snip>

Julia

This looks to me to be a weight loss diet for a non-diabetic.
Presumably aimed at a working person who doesn't have much time to eat in the morning.
Also traditional heavy evening meal.
Lunch looks O.K. if you can tolerate a reasonable amount of carbs.

Whatever happened to
"Breakfast like a King, lunch like a Prince, and dine like a pauper"?

Depending on how well you get on with your current practice, you could perhaps look round for one that is more diabetic aware?

Stick with the forum - you know it makes sense

Cheers

LGC

 

[SweetHeart]

I was going to say 'we' but actually, I was well aware of what the doctor's reaction would be, so MH was well prepped. She's a very pleasant lady, if a little patronising. I'm fully prepared to stick to my guns - the way I see it the BG readings are what counts here because this is such a personal thing, everyone's endo system is different. To a certain extent I've had a similar fight with my hypothyroidism - at least they are willing to diagnose Diabetes....

Thanks to the countless pages of good sense on this forum, I think I'm getting the hang of things low-carbwise. I really wish that MH would read the low carb thread too. Otherwise he is dependent on me to advise him what to eat, but then won't believe me when I say he can have cream, cheese, bacon - because, of course, if you were calorie counting those things would be out and we are programmed to believe that animal fats are bad for you, dairy is bad for you yada yada yada.....! By not finding things out for himself, it still feels to me like a one horse race.

This afternoon he's had Swedish Crispbreads from Ikea, two with pate, a little cheese and a pear for his lunch, with no effect on his levels. Then supper a wee while ago was a pork chop in a cream sauce and a green salad followed by individual egg custard (made by Moi with our own eggs) and rhubarb compote. Only thing I'm worried about is the cornflour I used habitually to thicken the sauce for the pork. He hasn't had his red wine, so I'm thinking he might maybe 1.0 mmol higher....but he'll still be in single figures.... :roll:

MH's cholesterol was 6.0 at diagnosis, which isn't bad for a non-diabetic but should be lower for him now. Tomorrow's dinner time reading I'm expecting to be a wee bit higher still because he will have taken his first statin by then, and because we have a day trip to Hull Uni tomorrow for #2 Son and bread will be on the agenda for sammiches.

LGC; I think we're going to end up doing mostly low carb, but factoring in a slice or two of wholegrain multi-seed bread (two slices toasted with butter & half sugar marmalade = no effect on BGs so far), some porridge and possibly Shredded Wheat (yeah, I know, alarm bells) but we'll test after he's eaten the porridge and the Shredded Wheat respectively. I can do the whole low-carb thing as I won't miss bread, cereals, pasta etc. Just remembered, egg noodles in stir fry don't change his levels either.

Vivienne...that's Cleo, sunbathing under my lamp. We have ten cats but she is my cat.

Can we have an evil nurse smiley too, please? :clap:

Jules