Success At Local Surgery

Listlad · Jul 6, 2019

Double the reason to celebrate right now.

Firstly Type 2 Diabetes Reversal is now on the local Patient Participation Group agenda this Monday afternoon. This will give me an opportunity to present the case for dispensing with the Eatwell programme as a means of reversing T2 diabetes and bringing in across the board the low carb alternatives.

Secondly and simultaneously, work has been going on at administrative level to go about replicating the work being carried out in Debandez’s surgery only a few miles away in the Fylde region. Favourable responses (from GP’s and practice managers) have been received on the idea of providing support to the two local surgeries in my town, to those needing support on dealing with T2 diabetes. They are now looking at how this can be achieved in practice.

This represents major progress and exciting times in this area.

Listlad · Jul 7, 2019

It’s worth bumping this. If it were to be replicated across the country it would be marvellous.

shelley262 · Jul 7, 2019

Sounds excellent - well done @Listlad

carol43 · Jul 7, 2019

@Listlad. Well done. Got my annual review at the end of the month. Will be having a chat with the nurse about joining the PPG.

Listlad · Jul 7, 2019

carol43 said:
@ListladWill be having a chat with the nurse about joining the PPG.

Thanks.

Good luck with that.

@carol43 Carol. Are you by chance up in the north west region as in Blackpool / Preston?

Dark Horse · Jul 7, 2019

Listlad said:
present the case for dispensing with the Eatwell programme as a means of reversing T2 diabetes

You might experience less resistance to your ideas if you initially pitched them as 'an alternative approach which has been shown to be more suitable for some people' rather than going straight for the jugular by advocating 'dispensing with' the Eatwell guide. If the GPs see success with low carb, they are then more likely to suggest it to their patients.

Listlad · Jul 7, 2019

Dark Horse said:
You might experience less resistance to your ideas if you initially pitched them as 'an alternative approach which has been shown to be more suitable for some people' rather than going straight for the jugular by advocating 'dispensing with' the Eatwell guide. If the GPs see success with low carb, they are then more likely to suggest it to their patients.

Agreed.

The objective will be that. But I take your point on how it is tackled.

The circumstance(s) are very fluid. I only learned on Friday that the topic was going on the agenda at my request. And only learned on Friday that both surgeries are amenable to using another local surgery in the region as a model, one without reservation and the other wanting to know more about how it can be done. There is a good plan in place to deal with the latter. We have an ace up our sleeves.

A lot of work has gone on by the surgery administrator in liaising with myself, the various GPs at both practices and other practices in the region to get things to an advanced stage.

There is if course a possibility that things might not go according to plan, for example the GP representative on the PPG panel is also the surgery specialist on diabetes and as I have never spoken to her I do not know her thinking, despite the Doc that I see being a full convert to LCHF. It may be a case of having to deal with one or two Luddites but having said that it all looks promising.

Debandez · Jul 8, 2019

Dark Horse said:
You might experience less resistance to your ideas if you initially pitched them as 'an alternative approach which has been shown to be more suitable for some people' rather than going straight for the jugular by advocating 'dispensing with' the Eatwell guide. If the GPs see success with low carb, they are then more likely to suggest it to their patients.

I'm currently working on a leaflet with my practice manager who has been so very supportive. They are working on the following which is why they are being so proactive:

Patients helping patients
Empowering people in community
Social prescribing

The leaflet will be from a 'this worked for me and works for many others' and will be directed towards not only controlling blood sugars but weight loss too. An alternative approach kind of angle so as not to upset the apple cart. Once its finished my practice manager will be arranging the printing and CCG will be paying the costs. I'm hoping that the HCPs will be happy to give out to any pts that might want to give this way of eating a try. It won't be for everyone.

Listlad · Jul 8, 2019

Debandez said:
I'm currently working on a leaflet with my practice manager who has been so very supportive. They are working on the following which is why they are being so proactive:

Patients helping patients
Empowering people in community
Social prescribing

The leaflet will be from a 'this worked for me and works for many others' and will be directed towards not only controlling blood sugars but weight loss too. An alternative approach kind of angle so as not to upset the apple cart. Once its finished my practice manager will be arranging the printing and CCG will be paying the costs. I'm hoping that the HCPs will be happy to give out to any pts that might want to give this way of eating a try. It won't be for everyone.

I am almost certain our local practices will be interested in the leaflet. Leaflets of that nature except more generalised, were on the agenda at the last PPG meeting.

Debandez · Jul 9, 2019

Listlad said:
I am almost certain our local practices will be interested in the leaflet. Leaflets of that nature except more generalised, were on the agenda at the last PPG meeting.

Worked on it yesterday and ive sent it to my practice manager very late last night for her to see what she thinks. Very difficult to get the right words so as not to upset the apple cart! See what she says. I have a PPG networking meeting in Wesham next Monday (funnily enough!) and would love to be able to take it. Could throw around a few copies to fellow PPG and CCG members. Not sure she can get it ready that soon (if she is happy with it)

ringi · Jul 9, 2019

Remember that there is total agreement that "drinking suger is bad" yet many people with type2 still drink fruit joice as they think it is natural. There is also agreement that people do better when they advoid ready meals (and takeaways) cooking their all food instead. Hence it may be worth first talking about these in the leaflet before moving on to lowcarb.

Diakat · Jul 9, 2019

ringi said:
Remember that there is total agreement that "drinking suger is bad" yet many people with type2 still drink fruit joice as they think it is natural. There is also agreement that people do better when they advoid ready meals (and takeaways) cooking their all food instead. Hence it may be worth first talking about these in the leaflet before moving on to lowcarb.

Yep, my T2 MIL has fruit juice every morning and can not comprehend why I won’t touch it.

Listlad · Jul 9, 2019

Debandez said:
Worked on it yesterday and ive sent it to my practice manager very late last night for her to see what she thinks. Very difficult to get the right words so as not to upset the apple cart! See what she says. I have a PPG networking meeting in Wesham next Monday (funnily enough!) and would love to be able to take it. Could throw around a few copies to fellow PPG and CCG members. Not sure she can get it ready that soon (if she is happy with it)

My PPG meeting is Thursday this week. Am looking forward to it.

Good luck with launching the leaflet.

NicoleC1971 · Jul 9, 2019

Debandez said:
I'm currently working on a leaflet with my practice manager who has been so very supportive. They are working on the following which is why they are being so proactive:

Patients helping patients
Empowering people in community
Social prescribing

The leaflet will be from a 'this worked for me and works for many others' and will be directed towards not only controlling blood sugars but weight loss too. An alternative approach kind of angle so as not to upset the apple cart. Once its finished my practice manager will be arranging the printing and CCG will be paying the costs. I'm hoping that the HCPs will be happy to give out to any pts that might want to give this way of eating a try. It won't be for everyone.

This is impressive work given that you have gotten inside the NHS and achieved cooperation and funding! Would love to hear how this goes for you.
I've run a Walk and Talk group with a couple of other volunteers (about the low carb approach) in which we go for a walk followed by a discussion on matters diabetic (they are all type 2 or borderline). I kept the low carb bit under the radar and always emphasise that we are not providing clinical advice. We were kindly supported with the free use of a room at the local leisure centre (persuaded by the council who manage the contract with them) and a friendly GP who supported the handing out of flyers to patients via community and practice nurses plus some advertising and free press.
Ideally I'd have preferred that our group had some baseline stats taken re HBA1c and other markers but we have had to make do with waist, weight and blood pressure. I have encouraged the group to get meters to track their reaction to any dietary changes.
My experience so far is that it takes a while for people to take on board the information we are giving them and translate it into action but that barring 1 lady who was a misdiagnosed type 1, our initial group are still coming after 7 weeks and have made some changes (cutting sugar out and happily eating 'high cholesterol' food like prawns). Hopefully we will continue over the Summer.
I love doing it but feel it would all be so much more powerful if it could be done officially via the GPs just like Drs McCormack and Unwins! Incidentally when we talked to the CCG diabetes group initially, we found lots of objections and barriers being thrown up not so much about the concept but that ti was far too time consuming and costly for GPs to issue strips or do baseline tests.
Hope you will all continue sharing your experiences like this as I think there's a need for this given that the current education prevention and type 2 programmes do seem to focus on losing weight via low fat and exercise (I am aware that XPert do discuss low carb but in our area they are deemed to bee too long a course so are being replaced).

Listlad · Jul 9, 2019

NicoleC1971 said:
This is impressive work given that you have gotten inside the NHS and achieved cooperation and funding! Would love to hear how this goes for you.
I've run a Walk and Talk group with a couple of other volunteers (about the low carb approach) in which we go for a walk followed by a discussion on matters diabetic (they are all type 2 or borderline). I kept the low carb bit under the radar and always emphasise that we are not providing clinical advice. We were kindly supported with the free use of a room at the local leisure centre (persuaded by the council who manage the contract with them) and a friendly GP who supported the handing out of flyers to patients via community and practice nurses plus some advertising and free press.
Ideally I'd have preferred that our group had some baseline stats taken re HBA1c and other markers but we have had to make do with waist, weight and blood pressure. I have encouraged the group to get meters to track their reaction to any dietary changes.
My experience so far is that it takes a while for people to take on board the information we are giving them and translate it into action but that barring 1 lady who was a misdiagnosed type 1, our initial group are still coming after 7 weeks and have made some changes (cutting sugar out and happily eating 'high cholesterol' food like prawns). Hopefully we will continue over the Summer.
I love doing it but feel it would all be so much more powerful if it could be done officially via the GPs just like Drs McCormack and Unwins! Incidentally when we talked to the CCG diabetes group initially, we found lots of objections and barriers being thrown up not so much about the concept but that ti was far too time consuming and costly for GPs to issue strips or do baseline tests.
Hope you will all continue sharing your experiences like this as I think there's a need for this given that the current education prevention and type 2 programmes do seem to focus on losing weight via low fat and exercise (I am aware that XPert do discuss low carb but in our area they are deemed to bee too long a course so are being replaced).

Yes, stepping inside the NHS, if you will. In my area the thinking at the moment is that the GPs don’t have the time to provide the necessary support for an LCHF solution to T2 reversal and the idea of a “Diabetes Champion” to provide that support is seriously being looked at right now. It is a work in progress but looks very promising.

My two local surgeries are evaluating GP support for it which again is looking promising.

Debandez · Jul 9, 2019

ringi said:
Remember that there is total agreement that "drinking suger is bad" yet many people with type2 still drink fruit joice as they think it is natural. There is also agreement that people do better when they advoid ready meals (and takeaways) cooking their all food instead. Hence it may be worth first talking about these in the leaflet before moving on to lowcarb.

Fruit juice is in there as a no no!

Debandez · Jul 9, 2019

Listlad said:
My PPG meeting is Thursday this week. Am looking forward to it.

Good luck with launching the leaflet.

Sent everything to my PM. Will let you know if its binned or it moves on to next stage = print!

Debandez · Jul 9, 2019

NicoleC1971 said:
This is impressive work given that you have gotten inside the NHS and achieved cooperation and funding! Would love to hear how this goes for you.
I've run a Walk and Talk group with a couple of other volunteers (about the low carb approach) in which we go for a walk followed by a discussion on matters diabetic (they are all type 2 or borderline). I kept the low carb bit under the radar and always emphasise that we are not providing clinical advice. We were kindly supported with the free use of a room at the local leisure centre (persuaded by the council who manage the contract with them) and a friendly GP who supported the handing out of flyers to patients via community and practice nurses plus some advertising and free press.
Ideally I'd have preferred that our group had some baseline stats taken re HBA1c and other markers but we have had to make do with waist, weight and blood pressure. I have encouraged the group to get meters to track their reaction to any dietary changes.
My experience so far is that it takes a while for people to take on board the information we are giving them and translate it into action but that barring 1 lady who was a misdiagnosed type 1, our initial group are still coming after 7 weeks and have made some changes (cutting sugar out and happily eating 'high cholesterol' food like prawns). Hopefully we will continue over the Summer.
I love doing it but feel it would all be so much more powerful if it could be done officially via the GPs just like Drs McCormack and Unwins! Incidentally when we talked to the CCG diabetes group initially, we found lots of objections and barriers being thrown up not so much about the concept but that ti was far too time consuming and costly for GPs to issue strips or do baseline tests.
Hope you will all continue sharing your experiences like this as I think there's a need for this given that the current education prevention and type 2 programmes do seem to focus on losing weight via low fat and exercise (I am aware that XPert do discuss low carb but in our area they are deemed to bee too long a course so are being replaced).

I was dx Dec 17. Hba1c 62 In non diabetic numbers following low carb by Feb. Even lower by May where I remain. Could not believe the rubbish advice being given out to us despite the science and proof out there that carbs need to be controlled not encouraged. I was so mad. My mum suffered at the hands of diabetes. Massively . So, I organised a big meeting last September and invited all from forum. Only @ 4 weeks to arrange. Dcuk got wind and gave brilliant support including their PR team, videographer and even Charlotte Summers joined us. Lots of us had lost weight on our journey so we took our big clothes to show just how much! I pulled together some amazing inspirational stories from forum members. And put hba1c stats in doc (attached). Many forum members helped with pulling things together. @Rachox did an amazing leaflet on blood sugar monitoring. @shelley262 pulled together a booklet on what is good for us to eat, recipes, hints and tips for cooking. And so much more help was given. It was an amazing day. So armed with all this amo i bombarded my surgery. Sent everything in to them, delivered by hand. Brown envelope. Noted all HCPs names on front. Asked for enclosures to be read by all members if staff. Joined the PPG (this was definitely the stepping stone into the surgery). Spoke about my journey at the first meeting. The PM was nothing but supportive. I said I wanted to help others. Presentations to start with. She got me a room and sent invite to all relevant CCGs. @xfieldok was a great support and shared her journey in this presentation too. Since then I've had a bit of a set back in that my BIL has been poorly (diagnosed t2!) I'm his carer and have had a lot to deal with over the past few months but getting there now so able to continue the fight. Next step is another presentation aimed at not only diabetes but tackling weight loss. And i thought a leaflet would be good too. To be handed out to anyone remotely interested in lc.There is currently no alternative to eatwell advice. The leaflet is an alternative. I dont know how it will be received by my PM. No feedback today! Massive step for them to give this to pts. But if any surgery is up for this mine will be. I'm keeping everything crossed. Not everyone will want to listen. Many t2 want to just take tablets and eat what they want. It will be progressive but they seem ok with this. I wasnt. I educated myself through this forum and it's amazing members, you tube, books and such. I just think it's only fair people are given the option. The 1936 guidelines for diabetics = lchf! Then along came Ancel Keys!!! Low fat theory and look where that's got us. Things need to change.

Well done on your sterling work. I know how hard it is drumming up interest. You sound like you too are making great strides in your community.

NicoleC1971 said:
This is impressive work given that you have gotten inside the NHS and achieved cooperation and funding! Would love to hear how this goes for you.
I've run a Walk and Talk group with a couple of other volunteers (about the low carb approach) in which we go for a walk followed by a discussion on matters diabetic (they are all type 2 or borderline). I kept the low carb bit under the radar and always emphasise that we are not providing clinical advice. We were kindly supported with the free use of a room at the local leisure centre (persuaded by the council who manage the contract with them) and a friendly GP who supported the handing out of flyers to patients via community and practice nurses plus some advertising and free press.
Ideally I'd have preferred that our group had some baseline stats taken re HBA1c and other markers but we have had to make do with waist, weight and blood pressure. I have encouraged the group to get meters to track their reaction to any dietary changes.
My experience so far is that it takes a while for people to take on board the information we are giving them and translate it into action but that barring 1 lady who was a misdiagnosed type 1, our initial group are still coming after 7 weeks and have made some changes (cutting sugar out and happily eating 'high cholesterol' food like prawns). Hopefully we will continue over the Summer.
I love doing it but feel it would all be so much more powerful if it could be done officially via the GPs just like Drs McCormack and Unwins! Incidentally when we talked to the CCG diabetes group initially, we found lots of objections and barriers being thrown up not so much about the concept but that ti was far too time consuming and costly for GPs to issue strips or do baseline tests.
Hope you will all continue sharing your experiences like this as I think there's a need for this given that the current education prevention and type 2 programmes do seem to focus on losing weight via low fat and exercise (I am aware that XPert do discuss low carb but in our area they are deemed to bee too long a course so are being replaced).

Ryhia · Jul 9, 2019

Really interested in this thread and the inroads you are making at your surgery @Listlad great work. Just wonder, if they do instate a diabetes champion (or champions) how would that work in practice?

Listlad · Jul 10, 2019

ryhopian said:
Really interested in this thread and the inroads you are making at your surgery @Listlad great work. Just wonder, if they do instate a diabetes champion (or champions) how would that work in practice?

We already know of a good working model in a nearby region. This it what is up for review at my local surgeries. This will all become clearer in due course. Next meeting on the very topic of T2 Diabetes Champion will be next week.

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