hi all,
A little while back I wrote to my MP basically spelling out the poor advice being given by NHs and outlining my success by ignoring it. Also, pointing out that I didn't think if they changed their practise of denying test strips to type 2's or advising to monitor and cut carbs EVERYONE would suddenly become compliant, but my point was the individual would have information to help them manage their own condition.
Well true to his word he wrote to the Dept of Health and DUK and forwarded the reply from Paul Burstow (minister of state for care services). He is awaiting a reply from DUK but says he will fwd to me when he gets it.
The jist of the letter is
- we are working hard to ensure diabetics get the support they need via the nine care processes each year.
-the focus for T2 diabetes is lifestyle intervention (weight,exercise,diet). Most people will subsequently need sequential addition of oral glucose lowering drugs
-the mainstay of dietary advice for T2 should be total calorie intake rather than the source of the calories for optimal glycaemic control.
-The website (this one) cited by your constituent is a privately owned community website so doesn't need to ensure its content is evidence based like Diabetes UK,BDA,NHS diabetes
-DUK publised a position statement in 2011 on low carb diets (think this has been mentioned before) it's conclusions is that low carb diets may be effective in facilitating weight loss in people with T2 in the short term but there is no evidence this approach is more successful in the long term than any other approach. More research is needed to assess the effectiveness of varying degress of low-carb diet on weight, BG, BP and lipid profile in people with T2 as well as to investigate the long term effects of these diets.
-losing weight will assist in normalising BG control but low carb diets which are low enough in calories to effect weight loss are often relatively high in protein. This can be detremental to those diabetics who may have associated kidney problems. Also may not be balanced so all neccessary micronutrients may not be provided.
-contribution of fasting and post prandial BG to the HBA1c value and the impact of post prandial glucose excursions on the development of complications remain the subject of debate and without consensus in the literature. For some people home blood glucose monitoring clearly provides vital information to enable them to better manage their diabetes. However, this is not univerally the case. Its expensive and requires commitment we need to be certain the resources are allocated to those people who will get most benefit. As part of its review cycle NICE is about to consider the clinical guidelines for T2 diabetes in adults by updating effectiveness of self- monitoring of BG for BG control. This is expected to be publised in 2014.
Sorry I'm rushing ive paraphrased some bits and put some as word for word . the jist is there.
I will be replying re some parts.
Thanks
Mary x
A little while back I wrote to my MP basically spelling out the poor advice being given by NHs and outlining my success by ignoring it. Also, pointing out that I didn't think if they changed their practise of denying test strips to type 2's or advising to monitor and cut carbs EVERYONE would suddenly become compliant, but my point was the individual would have information to help them manage their own condition.
Well true to his word he wrote to the Dept of Health and DUK and forwarded the reply from Paul Burstow (minister of state for care services). He is awaiting a reply from DUK but says he will fwd to me when he gets it.
The jist of the letter is
- we are working hard to ensure diabetics get the support they need via the nine care processes each year.
-the focus for T2 diabetes is lifestyle intervention (weight,exercise,diet). Most people will subsequently need sequential addition of oral glucose lowering drugs
-the mainstay of dietary advice for T2 should be total calorie intake rather than the source of the calories for optimal glycaemic control.
-The website (this one) cited by your constituent is a privately owned community website so doesn't need to ensure its content is evidence based like Diabetes UK,BDA,NHS diabetes
-DUK publised a position statement in 2011 on low carb diets (think this has been mentioned before) it's conclusions is that low carb diets may be effective in facilitating weight loss in people with T2 in the short term but there is no evidence this approach is more successful in the long term than any other approach. More research is needed to assess the effectiveness of varying degress of low-carb diet on weight, BG, BP and lipid profile in people with T2 as well as to investigate the long term effects of these diets.
-losing weight will assist in normalising BG control but low carb diets which are low enough in calories to effect weight loss are often relatively high in protein. This can be detremental to those diabetics who may have associated kidney problems. Also may not be balanced so all neccessary micronutrients may not be provided.
-contribution of fasting and post prandial BG to the HBA1c value and the impact of post prandial glucose excursions on the development of complications remain the subject of debate and without consensus in the literature. For some people home blood glucose monitoring clearly provides vital information to enable them to better manage their diabetes. However, this is not univerally the case. Its expensive and requires commitment we need to be certain the resources are allocated to those people who will get most benefit. As part of its review cycle NICE is about to consider the clinical guidelines for T2 diabetes in adults by updating effectiveness of self- monitoring of BG for BG control. This is expected to be publised in 2014.
Sorry I'm rushing ive paraphrased some bits and put some as word for word . the jist is there.
I will be replying re some parts.
Thanks
Mary x
