Something MUST be done!!!!

[borofergie]

What about the issue I raised earlier? Is there data anywhere that shows how those people are achieving getting sub 7.5% hBA1c's (meds etc.) and how long survival rates are etc?.

These show the influence of HbA1c vs mortality and cardiovascular "events" for 55 and overs:
http://eurheartj.oxfordjournals.org/con ... hn567.full
http://eurheartj.oxfordjournals.org/con ... .large.jpg
http://eurheartj.oxfordjournals.org/con ... nsion.html

All other things being equal, a 1% increase in HbA1c costs you about 6months off your life. But as others have noted before, these figures don't take into account "quality of life". Some diabetics complications might not kill you, but they could make your last years of life pretty miserable.

Remember, if you live longer, you end up costing the Government more in pension. So there is often a financial incentive to get us to "kick the bucket" early.

 

[phoenix]

Remember, if you live longer, you end up costing the Government more in pension. So there is often a financial incentive to get us to "kick the bucket" early

Only if you die early and directly from a stroke or heart attack. Consider the amount of money spent on stents, heart bypasses and valve replacement . No stats here but as I mentioned some time ago I was shocked when I actually saw how many of the patients in the cardiac wards at a major NHS hospital were people with diabetes.

 

[Sid Bonkers]

Surely Sid this is why a statement like ...

The diet consists of meat, fish, shellfish, eggs, vegetables, legumes and vegetable proteins and fats from olive oil and butter. The diet includes less sugar, bread, cereals, potatoes, root vegetables and rice than a traditional diabetes diet.

...is so powerful as it allows YOU to quite happily interpret...

We're not far apart on this xyzzy the only part I would drop is the less and the than a traditional diabetes diet as I believe that the NHS diet as it was advised to me is fine, but as I've said here numerous times that information is open to interpretation despite what borofergie will say when he quotes his facts and figures about % of this and that, that seem compelling when read but bear no relation to the amounts an obese person should be eating in order to lose weight.

@ Phoenix, thanks for those figures, so 60% of T2's are achieving the NICE recommendations thats a lot more than I was assuming and a pretty good statistic although we shouldnt forget the 40% who aren't but you can lead a horse to water and all that.

So back to portion control, I read here that vlc'ers can eat as much and as many calories as they want and they wont become fat, strange then the the much quoted Dr Bernstein talks in depth about only eating one or two cups :shock: of salad per meal, so who am I to believe? Dr Bernstein or those who say eat as much as you want as long as you dont eat too many carbs? Could this be the reason for numerous threads that start "weight loss stalled" or "LCing but still putting on weight". Just maybe the fat is good mantra sung by many LCers is not as true as some would have us believe, just a thought.

The main thing for any overweight diabetic is to lose that weight, that will then reduce the insulin resistance to a level were a more normal diet can be eaten and by more normal I dont mean the diet that made the person overweight in the first place I mean sustainable portions of every food group including carbs.

Once weight has been lost and insulin resistance is reduced the only thing left to affect bg levels is pancreatic function, some will have most of it in tact whilst others will have suffered considerable damage whilst their levels were high either prior to diagnosis or due to lack of motivation on their part and you dont have to read many threads on any diabetes forum to know that "I've been in denial" is a very common theme, I will add here misinterpretation of NHS diet recomendations either by the person or their HCP.

Now it is insulin resistance and pancreatic function (or lack of it) that will limit the amount of carbs someone can eat and stay at or below a given level, age, sex and some other health issues will play a part but it is mainly IR and PF. This is why I am against the statement "eat x number of carbs to start with" , I often read advice given to newly diagnosed here to "now say start with x amount and then adjust" yet now the mantra is eat to your meter. If I eat to my meter why would I want to start at a particular level of carbs, OK under 50g would probably be safe for everyone but only a very few can sustain that level for life but by eating to your meter and only eating the amounts of carbs you can safely eat many diabetics will find that their 'safe carb levels' will increase as weight loss is achieved.

So how to lose weight? Well if I could answer that I would be as rich as Dr Atkins estate or richer still if I could answer it for everyone, changing eating habits is probably the single hardest thing any overweight person will ever undertake, I know what worked for me, it was fear when I was told I was diabetic but we are all different (boring) and we all have to find our own way as with all things in life, one can be pointed in the right direction but leading a horse to water and making it drink are two different things, although just a single cliché :lol: Which brings me nicely back to should obesity be classified as an eating disorder?

Anyway I am boring myself now so ttfn

 

[smidge]

Hey all!

I have read through this thread with interest. Xyzzy wondered about Type 1 reactions to carb-reduction and eat to your meter messages. Somebody else (can't remember who - sorry) thought Type 1s were getting good care.

As an LADA, I'd like to make a couple of observations:

1. In my opinion, Type 1s are not given good care across the board. There is an awful lot of misdiagnosis and conditions like LADA (and other Type 1ish conditions) are not even known about by many HCPs who claim to specialise in diabetes. Unless your pancreas gives up suddently, you are generally allowed to become very ill before any chance of a proper diagnosis and treatment. Also, many Type 1s seem to be left on insulin regimes for many years without review to see whether it is still an appropriate regime for them - again, not great care in my view.

2. Again, my opinion, the dietary advice to Type 1s is poor. 'Eat what you like and cover it with insulin' is a recipe for disaster, and yet it is the message that comes out again and again. Presumably because it's what newly-diagnosed diabetics want to hear, but it is a flawed philosophy. Most diabetics of whatever 'Type' will struggle with control if they eat high carb diets. It is true that the occasional high carb meal can be accommodated for many Type 1s, but as a regular occurence it is likely to lead to poor control, high insulin use and weight gain. Type 1s need educating on how our bodies react to carb, protein and insulin. We need to be told that reducing carb intake makes control easier and more stable. We also need to be told that keeping insulin use to the minimum is essential for weight control and that controling BG with smaller amounts of insulin requires carb reduction - drastic carb reduction for some of us. Then it is our choice, but in my view, it is unacceptable to pretend we can eat 'normally', cover with insulin and remain healthy. We might have more options than Type 2s, but they are not all good options, and we certainly don't have the choice to eat as if we don't have diabetes and remain healthy long-term.

3. Many Type 1.5s are not taught to carb-count and have no idea how to match their insulin needs to their carb intake. I don't consider this 'good care'. The message for Type 1/1.5s just needs slight adjustment to emphasise carb/insulin balance, but 'eating to your meter' is still an essential component.

Smidge

 

[borofergie]

The diet consists of meat, fish, shellfish, eggs, vegetables, legumes and vegetable proteins and fats from olive oil and butter. The diet includes less sugar, bread, cereals, potatoes, root vegetables and rice than a traditional diabetes diet.

...is so powerful as it allows YOU to quite happily interpret...

We're not far apart on this xyzzy the only part I would drop is the less and the than a traditional diabetes diet as I believe that the NHS diet as it was advised to me is fine, but as I've said here numerous times that information is open to interpretation despite what borofergie will say when he quotes his facts and figures about % of this and that, that seem compelling when read but bear no relation to the amounts an obese person should be eating in order to lose weight.

Not sure how I came into it (although I do like a nice percentage or two). I agree that we should remove the reference to "the traditional diabetes diet", mainly because there is no "traditional diabetes diet".

I'm not actually sure where weight loss comes into it. Obviously it would be nice if some of the obeses diabetics lost weight (and it would help with their control), but many diabetics don't need to lose any weight. This is a diet to help them get control, weight loss is incidental.

So back to portion control, I read here that vlc'ers can eat as much and as many calories as they want and they wont become fat, strange then the the much quoted Dr Bernstein talks in depth about only eating one or two cups :shock: of salad per meal, so who am I to believe? Dr Bernstein or those who say eat as much as you want as long as you dont eat too many carbs? Could this be the reason for numerous threads that start "weight loss stalled" or "LCing but still putting on weight". Just maybe the fat is good mantra sung by many LCers is not as true as some would have us believe, just a thought.

"Eat as many calories as they want" is exactly right. Eating more protein and fat increases saitety meaning that you eat until you are full and you don't need eat any more. It's about listening to your body's satiety signals instead of being influenced by blood sugar swings/ I can eat plenty of raw spinach on my Bernstein 30g a day of carbs - 850g to be precise - which is far more than I could stomach. I've lost over 60lbs on VLC so far and I'm still going strong...

But all this is besides the point. The "eat-to-your" meter mantra is about control and not about weight loss. No-one is prescribing any level of low-carb. Everyone needs to work out the level (and quality) of carbohydrate intake by iterative "eating to the meter". If you do that, I bet no-one ends up below 50g a day.

You can still be overweight and still have good blood control. Some people here have recently demonstrated that you can get your BG under control in a couple of weeks. Losing weight will make it easier, but it isn't absolutely necessary. If we had the solution to weight loss, then we'd be rich enough to buy meters for everyone.

 

[Defren]

I'm not actually sure where weight loss comes into it. Obviously it would be nice if some of the obeses diabetics lost weight (and it would help with their control), but many diabetics don't need to lose any weight. This is a diet to help them get control, weight loss is incidental.

"Eat as many calories as they want" is exactly right. Eating more protein and fat increases saitety meaning that you eat until you are full and you don't need eat any more. It's about listening to your body's satiety signals instead of being influenced by blood sugar swings/ I can eat plenty of raw spinach on my Bernstein 30g a day of carbs - 850g to be precise - which is far more than I could stomach. I've lost over 60lbs on VLC so far and I'm still going strong...

But all this is besides the point. The "eat-to-your" meter mantra is about control and not about weight loss. No-one is prescribing any level of low-carb. Everyone needs to work out the level (and quality) of carbohydrate intake by iterative "eating to the meter". If you do that, I bet no-one ends up below 50g a day.

I saw a video on Youtube a couple of weeks ago, trying to establish how the Atkins diet works. The conclusion drawn was that eating more protein and lower carbs was the answer. As you mention above, the extra protein does make you satiated longer, so hence you eat less. They got to this conclusion using two control groups, one on a traditional low calorie diet, and another on the Atkins diet. The study took a year to complete, and all grocery's were monitored via a special supermarket, set up purely for the use of those in the study. So the conclusion you make above was infact shown to be correct in a scientific study!

 

[xyzzy]

We're not far apart on this xyzzy the only part I would drop is the less and the than a traditional diabetes diet

:lol: :lol: :lol:

No seriously, then we do have differences because I don't accept the concept that good dietary guidelines for non diabetics are necessarily good dietary guidelines for diabetics. Which is why in that quote I like "less" and "than a traditional diabetes diet" words. Removing those key words implies the same diet is applicable for all.

as I believe that the NHS diet as it was advised to me is fine

I've underlined the key bit imo in what you said.

Same here my NHS doc says "keep eating 60g / day its working for you and has put your T2 into remission" yours seems to say the same as mine which is essentially "do what works". The problem is while probably all docs would recommend what yours recommended to you not a lot seem to say what mine said about 60g / day. If you were my doc would you have said "keep at 60g as its made your levels safe"? That's the key question I have for you Sid. If your answer is yes then we are very close in agreeing. Will await your reply...

@ Phoenix, thanks for those figures, so 60% of T2's are achieving the NICE recommendations thats a lot more than I was assuming and a pretty good statistic although we shouldnt forget the 40% who aren't but you can lead a horse to water and all that.

Yes on the surface I agree and like I said I was surprised. However if you take the 13 years of research done on the Steno study then getting a less than 7.5% hBA1c is just one aspect of all of this. How you got that 7.5% has a lot to do with it. So if you get a 5% hBA1c but are still say very obese then you may have limited your chance of a diabetic complication but you haven't reduced your chances of CVD. Likewise if getting that sub 7.5% meant you went through the range of drugs and are now insulin dependent maybe that's not the best way either.

So back to portion control, I read here that vlc'ers can eat as much and as many calories as they want and they wont become fat, strange then the the much quoted Dr Bernstein talks in depth about only eating one or two cups :shock: of salad per meal, so who am I to believe? Dr Bernstein or those who say eat as much as you want as long as you dont eat too many carbs? Could this be the reason for numerous threads that start "weight loss stalled" or "LCing but still putting on weight". Just maybe the fat is good mantra sung by many LCers is not as true as some would have us believe, just a thought.

You and Stephen (if he wants to) should take that debate elsewhere as it takes this thread nowhere in my opinion. You and others are free to disagree if you think I've misinterpreted the OP or perhaps the OP would like to comment? The idea of "Eat to your meter" is to be inclusive. My style, your style, Stephens style all work at getting levels safe and are just options to be presented to the newly diagnosed.

The main thing for any overweight diabetic is to lose that weight, that will then reduce the insulin resistance to a level were a more normal diet can be eaten and by more normal I dont mean the diet that made the person overweight in the first place I mean sustainable portions of every food group including carbs.

Once weight has been lost and insulin resistance is reduced the only thing left to affect bg levels is pancreatic function, some will have most of it in tact whilst others will have suffered considerable damage whilst their levels were high either prior to diagnosis or due to lack of motivation on their part and you dont have to read many threads on any diabetes forum to know that "I've been in denial" is a very common theme, I will add here misinterpretation of NHS diet recomendations either by the person or their HCP.

Now it is insulin resistance and pancreatic function (or lack of it) that will limit the amount of carbs someone can eat and stay at or below a given level, age, sex and some other health issues will play a part but it is mainly IR and PF. This is why I am against the statement "eat x number of carbs to start with" , I often read advice given to newly diagnosed here to "now say start with x amount and then adjust" yet now the mantra is eat to your meter. If I eat to my meter why would I want to start at a particular level of carbs, OK under 50g would probably be safe for everyone but only a very few can sustain that level for life but by eating to your meter and only eating the amounts of carbs you can safely eat many diabetics will find that their 'safe carb levels' will increase as weight loss is achieved.

Not much to disagree with there as it applies to me. I am now of "normal" weight, have lost insulin resistance and can do a few more grams per day but certainly not anything much over 80g / day.

In my new member posts I don't say "now say start with x amount and then adjust" do I? I say halve and then point out that based on meter readings you should go down if you're not safe but you're fine to go UP if you are safe. I say halve as that is what the up to date research states. Half is around 130g which is the ADA 2011 & 2012 RDA and the UK 2012 position statement, as Phoenix pointed out to me in another thread, references that ADA document throughout to make very similar sounding statements about glycemic control and the importance of carbohydrate intake in achieving that control. Have you read the UK 2012 position doc Sid? Grazer will have to speak for himself but I think he does say 120-150g which again as far as I interpret is to imply halving RDA.

we are all different (boring)

Intrigued why you think "we are all different" is boring, just because its a statement of the bleeding obvious perhaps? Bleeding obvious to you and me perhaps but not to many HCP's who do a one size fits all kind of approach. Hopefully that joint American / European 2012 self management position doc will improve things.

Which brings me nicely back to should obesity be classified as an eating disorder?

I would say it depends on the circumstances and has to be looked at on a case by case basis. Regardless of if it is or isn't you should advise the person based on what they need to do in the future and not make value judgements based on a past you haven't been closely associated with or fully understand don't you think?

 

[jopar]

Xzyyz..

T1 diabetics are about 5% of the total diabetics!

Well I'm a T1 whose got a 5.8% HbA1c... I achieve this with a moderate carb diet with a moderate amount of fat, (no dietician has ever managed to convince me to swap my full fat milk, cheese, or roasting my Taddies in beef dripping, or my occasional fry up!) My husband also achieve's this with his HbA1c of 6.5%. I've haven't got any complication but hubby did have problems with his eyes around 14 years ago but that was mainly due to trying to work night shifts on 2 jabs a day!

I have a pump because I suffer from Dawn P, and a large fluctuation of basal profile which is impossible with injecting background insulin to flatten out into a workable profile to work any calculations from only a pump is at the present moment able to do this for me...

As to the dismal statistics, some is based in lack of education/knowledge, some is based lack of access to equipment like pumps and a reasonable amount is purely based the 'I can't be bothered' part denial attitude! Believe me I have seen T1's given pumps that really don't deserve them, because they fall into the latter group and a pump isn't going to change anything!

I've met some very long term T1 diabetics, one lady I cared for was in her early 90's, been a diabetic since early teens, no complications but sadly had cancer... My ex-husbands uncle is in his early 80's diagnosed at 20 (I think) some eye issues but otherwise doing fine..

Sid

Bernstein's 2 cups of salad is based on, bulk creating Carbs! if you stretch the stomach with more than 2 cups of salad this creates carbs If I remember correctly it's something like doubles it! so 6g's turns into 12g's! Similar with protein he restricts this as well, so that the possible amount of carbs produced after the body has fulfilled it's protein needs...

xzyyz picked up on a good point about the newly diagnosed, they generally are eating more carbs than the RDA so having to reduce down the RDA comes as not only a shock but a struggle, yet a high percentage will be eating an 'healthy; diet! So how come!

Some of cause will be based in portion size, but a lot of it will be based around the promotion, of fat, sugar, salt are bad! And manufacturers will help guide us concerning the 'healthiness' of their product, by informing us that 'it's low fat' or 'reduced sugar' even give us the amount of Fat sugar,salt and calories in the product with the percentage of the RDA! Problem is the only mention of 'carbs' is in the often or not, tiny writing on the back of the pack, with no mention to what percentage of the RDA is!

So they've spent their time, looking at 'sugar' perceiving this to be the 'white' stuff concentrated on low fat etc, given up on the calorie count, too much of a large number to calculate all the time... Only to find out that sadly they did what they could and still ended up with T2 diabetes... And somebody just told them all the preconceived ideas about their diet, nobody warned them of the dangers of the carb... Let alone told them that Sugar is the Same as a Carb and all the information they've seen on packaging is working on the assumption you'll 'Joe average' requiring 2000 calories a day! Wonder how many people truly fit the bill!

So perhaps, we should be asking the HCP's to bring Carbs to forefront and in the same league with fat etc and drop the calories side of things... Then perhaps when T2 or even T1 is diagnosed, finding your carb tolerance might not come as such a shock or the struggle that it's currently is!

 

[viviennem]

Lots of really interesting stuff posted on here since I did my last post, and I haven't really had time to absorb it all!

I've looked at and taken on board all of what has been said directly about my last post . . . I'll incorporate what I can. BUT - if we want to get anything before the upcoming Public Accounts Committee meeting, which is in about 2 weeks' time, it's going to have to be very quickly - and it will need to be short, sharp and to the point.

Don't forget, the agenda will probably have been drawn up by now; the members will have all the relevant papers, and their secretaries will have read them and have given their bosses a relevant precis keyed in to the main document. We need to get something in front of those secretaries that will make them bring it to the attention of the boss. Short, sharp and to the point. The one person we don't want to bore to death is that secretary.

Not that any of us is boring! :lol:

The real message I want to get across is:

"please, talk to us - real diabetics - before you make any decisions that will affect our lives"

I'm so afraid that they will simply listen to the party line and cut funding across the board. We need their attention first; the more detailed stuff can come later.

If I can make a list of the committee members' contact details over the weekend, I will - I'm a bit busy and I want to be outside, not chained to this computer. And I've got 100 slides to scan and a lecture to put together :thumbdown: but they are paying me :thumbup: :clap:

Viv 8)

 

[xyzzy]

Jopar thanks for the info on T1. I know from my son how much effort and stress it takes for a T1 to get good control and can see that makes it difficult to achieve the sub 7.5% target. Talking to my son and talking to other T1's in my family it seems to me a large part is down to gaining a good knowledge of the condition and a willingness to put that knowledge into practice. The same thing applies to T2's.

Likewise I read your reply to Sid and agree a lot of T2's (me included) have been caught out by the low fat healthy message. It is why I get "touchy" when its implied I somehow brought this on myself. I do agree I SHOULD have noticed my not vastly overly excessive weight gain and I've said on many occasions I wish my gp had very loudly pointed out the dangers given the history of db in my family. However like you say when you ate a low fat, 5 a day, cook from fresh BUT high carb diet that is recommended by the state you somewhat blindly assume its not doing you too much damage.

Again as a middle of the road T2 in terms of the carb debate (some would call me a sit on the fence T2 :lol: ) I do agree that calories made a large contribution to my weight gain and that now if I if I were to just restrict carbs without keeping an eye on calories I may get a brilliant HbA1c but still keel over from a heart attack. I try to tell that to MW but given she's just lost 6lbs in two weeks on VLC its falling on deaf ears at the moment!

 

[xyzzy]

"please, talk to us - real diabetics - before you make any decisions that will affect our lives"

Yes I would guess in that time frame that's the only message that works. Perhaps one of the media savvy members could advise...

 

[xyzzy]

Remember, if you live longer, you end up costing the Government more in pension. So there is often a financial incentive to get us to "kick the bucket" early

Only if you die early and directly from a stroke or heart attack. Consider the amount of money spent on stents, heart bypasses and valve replacement . No stats here but as I mentioned some time ago I was shocked when I actually saw how many of the patients in the cardiac wards at a major NHS hospital were people with diabetes.

Actually Stephen I tend to agree with Phoenix. The cost per day for having someone in hospital is horrendous.

On a brighter note based on those HbA1c / Cholesterol / BP tables I have extended my expected lifespan by over 10 years over the last 5 months and of course they don't show what additional improvements having a sub 6% hBA1c makes.

 

[lucylocket61]

"please, talk to us - real diabetics - before you make any decisions that will affect our lives"

Why would they talk to us, let alone listen?

We are just stupid patients who got ourselves into this mess through our greed and stupidity and are not medical 'experts' therefore have nothing to say that is considered worth listening to.

(sorry, been with the Mother-in-Law and come back feeling either murderous or despairing, or both. Either way I have had a day of being lectured on my sins and stupidity)

 

[noblehead]

(sorry, been with the Mother-in-Law and come back feeling either murderous or despairing, or both. Either way I have had a day of being lectured on my sins and stupidity)

Sounds like the Mother-in-law from hell :shock:

 

[Unbeliever]

On Yuesday I had laser reatment in both eyes at the hospital. While I was there I have been in various outpatient depts of that and other ospitals and it has often sruck me that just a little more information in the appointmens letter could preventmuch sree and confusion thus benefiting booth staff and patients.
perhaps even a simple notice in some circumstances could help greate a calmer atmoshere.

I have onluy had daycare surgery thus far but he same problems were apparent there .

For a long ime now I have been elling myself that I should pass on my suggestions for improvement . but there is always the danger of a comment being seeen as a complaint against he dept I was visiting which would have beeen oally unfair. if anything I
was complainng about some of the patients who seem o feel hat hey are in their GPs surgery and expect to be seen in the order of arrival.

Anyhow, on this occasion I contaced the hospital by email from their website and have just been informed that my suggestions have been welcomed by the person responsible for admissions and thus the appointment letters ec and shold be implemented asap.

I was etremely surprised at how quickly this was done. But they were simple ideas and would cost very little to implement and will fr
hopefully free =up some of he staff for more productive tasks than answering
reperteive quesions.

This obviously confirms nmy view that simplicity and minimal introducion costs with he possibility of future savings is the way to a least obtain a hearing for our ideas.

I am not comparing my minor success wih he maor task ahead - but- he hospital is a large foundation Tust covering an extensive area in England and Wales. Minor improvements saving ime or money multiplied by the otal number of depts wards , waiting areas can add up an appreciable difference over time.

That is why I supported the OP so wheheartedly in his original idea of a simple handout leafle giving he newly diagnosed some simple but potentially life saving advice. If we go hat idea suggested -even if he leaflet was didtriuted with saer packs giving BAD adice the patients would be given at least an option o take the path which works for so many of ius.
It would not be up o us to arrnge for the printing and disribution. The handout could include nformation about this websie.
If reference to his website and acceptance of our ideas could even be recognised by the NHS -even alongside DUK then a very important barrier would be broken and a great advance made.

I really believe strongly that we have to make the most of what we have asap and ry to achieve recognition in our own right
DUK is a large leading charity and we are not in competiton with them.
This forum is written by diabeics for diabetics and many here have achieved great hings by an altrernative method gradually becoming accepted globally, and with which many HCPs already suppor although it is not official policy.
This method will not lead o added costs and often shows immmediate results. Diabetics willing to take an acive part in the mangement of heir own condition have found his method to be one which works for them and are already saving the NHS
money by needing less medcaion and by prevening complicaions. Many use srlf testig to achieve hese results which are outstanding in some cases and generally resukt in lower HBA!c results.

This approach if adoped immediately upon diagnosis could prevent later complicaions and in many cases could mean a return to non-diabeic levels wihout the need for medication. It can also be beneficail o T"s resulting in beter control and fewer hospital admissions and again - complications.

This is not intended as any sort of propsed draft. Just what i ruly believe. will,be of use o other diabeics if we manage o get good simple , dieary advice accepted as the way forward by hose making he decisions. This will be a GIANT step forward and everyhing else can folow.

Right, I now promise no o say another word on he subject.

 

[xyzzy]

That is why I supported the OP so wheheartedly in his original idea of a simple handout leafle giving he newly diagnosed some simple but potentially life saving advice. If we go hat idea suggested -even if he leaflet was didtriuted with saer packs giving BAD adice the patients would be given at least an option o take the path which works for so many of ius.
It would not be up o us to arrnge for the printing and disribution. The handout could include nformation about this websie.
If reference to his website and acceptance of our ideas could even be recognised by the NHS -even alongside DUK then a very important barrier would be broken and a great advance made.

Congrats on the victory with the appointments stuff!

Yes I agree and I thought that would be what a position statement would be, "a simple handout leaflet giving the newly diagnosed some simple but potentially life saving advice" a great sentence to some up what we want to achieve. Ian has suggested it be done by rewriting the infamous "Eating well with T2 Diabetes" . I'm sure we will all have differing viewpoints on its content but as a concept I thought it was a very good and clever idea.

http://www.diabetes.co.uk/diabetes-forum/viewtopic.php?f=2&t=29666

 

[noblehead]

Well done Unbeliever :clap:

 

[Scardoc]

Ok, bit of a rant against DUK coming up after reading their latest news report on the failing NHS! The theme of it really sums up my stance on the carb debate too. People need to look after themselves and find what works best for them. I eat a hell of a lot of carbs but I run a hell of a lot too so I need to. My HbA1c has always been low 6's and I am firmly in the camp that cutting down sugar, eating a healthy balanced diet and exercising will keep you right. To the NHS.........

My personal experience of the NHS is that they have looked after me brilliantly for the last four years. I believe I have made their job easier by looking after myself but I have received all of the care that is recommended. I'm at the stage where I now see them as a support. I appreciate that a service as big as the NHS is never going to produce 100% satisfaction but I have become dismayed with the seemingly constant attack they suffer from DiabetesUK, this is then reported in the press.

I would love to see figures published showing how many of the 24K "avoidable deaths" per year are as a direct result of NHS failings and how many are as a direct result of people not looking after their condition. It's probably impossible to measure. It's also more likely that people filling in questionnaires are more likely to blame others than themselves. Today's latest news story on DUK has Barbara Young saying "But by using the money we already spend on diabetes more wisely, we could stop 24,000 people dying unnecessarily every year." The story begins, however, with " poor healthcare being delivered in exchange for this money is one of the reasons why 24,000 people die from avoidable diabetes complications each year." One of the reasons. From what I have read DUK tend not to explore the other reasons. They will also quickly point out that only 49% of diabetics receive the recommended level of care and, while this is statistically true, I still believe that there is as big a problem amongst diabetics not taking responsibility as there is in the NHS.

Only 16% of diabetics meet their targets in the three main standards of blood glucose, blood pressure and cholesterol levels (National Audit Office report). Now, although only 49% receive all 9 healthcare checks, 94%, 91% and 90% received the checks for these three standards respectively. This means, if you take the lowest figure of 90% as an example, that of the estimated 3.1M diabetics in 2009-2010, 2.79M received the three standard health checks and yet only 496K met their targets. So who's to blame? This means that 2.294M people are not meeting all three targets, are the healthcare teams just ignoring the fact? Or are they telling people they need to improve? Or are they telling people and people don't understand and need more education? It's too big a question for me to answer but I think organisations like DUK need to stop using the headline making figures to attack and increase pressure on the NHS. Look beyond them and start to see how things can be improved. Maybe look for other figures and use them to attack the other people to blame for the other reasons that are not discussed.

If the NHS gave 100% of diabetics 100% of the recommended healthcare checks, what percentage of diabetics do you think would meet their targets?

 

[lucylocket61]

I think that giving 100% of diabetics the healthcare checks wont work because:

They are checking progress of the disease, but not altering the advice so the disease can be controlled and maybe slowed down or halted.

The current advice is contributing to the problem of unnecessary deaths

So the deaths wont stop, regardless of how many checks are made, until the correct advice and treatment is given.

 

[Unbeliever]

I tend to agree with much of what you say scardoc though this may come as a surprise o some. I think many problems arise because of the way the NHS is funded.
Instead of having hospitals and Gps working together hey are in competition for the same money and hus in compeiion with each other. There is much wrangling over who pays for what and the patient is the loser.

Often when we say the NHS we acually mean the government or sometimes the BMA.
These essenial checks are a smokescreen and a soundbite for DUK. Testing in iself means litle . Just as we say of self testing the results must be used correctly. The larger number of tests adocated by DUK would achieve very little iimprovement in diabetes care IMHO.
Where are all the extra dietitians , podiatrists , opthalmologists etc which would be required to make these tests meaningful.

The real problem for many people is the way in which diabetes care was delegated to the local practice. There was inadequate trainng for and supervision of this process. Doctors- more aware than the Nurses of the full scope of the condition , in many cases , tried to distance themselves from the "care " on offer and their diabetic patients. This happened at the same time as referrrals to consultants was discouraged /

The nurses -given responsibilities often beyond their capabilities were reluctant to admit they were struggling and patients , both T! and T2 were often inappropriately ond over-medicated as a result.
of course this was not the experience of everyone . Patients differ as do H amd different areas cope with these things in different ways.
My personal experience is of both good and very poor care. I owe my present good results and health, paradoxically to my eye complications as my womnderful opthalmologist enabled me to get appropriate advice and treatment for my diabetes thus saving money for the
tthe NHS. A GP in my former practice had earlier intervened on my behalf when the hospital were -subject to the prevailing fashion at the time - pressurising me to go onto insulin which he thught was inappropriate. Very few would have done that and he made quite an impression on the hospital as that Practice actually had another designated diabetes GP. I haave also suffered from incorrect advice and treatmment and have had to l fight the system quite aggressively to ensure I didn't suffer further harm..

You saty that you have made their ob easier by looking after yourself. Of course that is what we should all do in an ideal world.

The present attitude of nannying patients and telling them to leave it all to nurse ihardly encourages patients to take responsibility .
does it?
I agree that some will never take care of themselves or cooperate wih HCP's but they should all be gibven the opportunity to do so.

Not everyone is physically or mentally fit to do that. You menion your running. I know all about that as my husannand ran marathons for years. I walk a lot but would find conrol very difficul if I couldn;t do this as I find other forms of exercise do lile for
my bg g levels/

Inso far as DUK and the NHS are concerned - well personally I wouldn't worry about that. It is a complicated relaionship no doubt but i find hat DUK are considered by Drs as THE authority on diabetes. I have had their policies quoted at me by Drs and consultants as if they were part of the NHS . That is because DUK and NHS policies are identical, Their aims are not . DUK is supposed to be a Charity represening and researching diabetes. The NHS is for everyone and all conditions.
DUK is in the business of bringing diabetes to he fore . Naurally they will seize upon everything and everything to this end.
I should very much lie to read he full ext of the excellent NAO 's report. The detail migh acually nit have been as suitable for their purposes as tthe headline.
As posted elsewhere I have had some considerable experience of NAO mehods and would expect to find far more than stats. As they are "awaiting execution " however , who knows?

nothing is ever black r whiite is it? Some of us have good experiences of the NHS some bad. I have had both and feel that the bad is totally avoidable.
others have a great regard and respect for DUK for many resasons. In the case of daibetes care DUK and the NHS cannot be separated . In his case they are not seperate enitities and therein lies he power of DUK.
I do not know if other charities for other conditions have the same power and influence. They may well. I hink DUK is seen as the specialist diabetes arm of he NHS by doctors. In which case I wouldn't ake any apparent disagreemens between them too seriously.

I have also been the victim of some appalling treatment and incorrect advice- and I do mean victim.