Success misinterpreted

[WillieGarvin]

I've read a lot on here of people who have success getting their BG down/under control and that they have a problem with the DN explaining that they did it by going against NICE dietary advice. What worries me is that when these healthcare professionals fill in their statistics it'll give the appearance that the NICE advice is working. So my question is this how do we as a group ensure that the statistics reflect the truth?

Cheers

 

[britishpub]

I agree, but unfortunately I'm not sure how else it could be reported by the NHS.

We can only hope that the message get's out there and becomes more mainstream and accepted, and eventually NICE and the NHS start to take notice.

The message is starting to get out, and it will be those who have succeeded by using different methods who will have the biggest influence on driving that message home.

 

[Lamont D]

Unfortunately, for some diabetics, the NICE guidelines and the NHS eat well plate does work by adding medication.

The problem that the establishment has, is the condition is so diverse and personal that the one size fits all policy doesn't work!

 

[AndBreathe]

I've read a lot on here of people who have success getting their BG down/under control and that they have a problem with the DN explaining that they did it by going against NICE dietary advice. What worries me is that when these healthcare professionals fill in their statistics it'll give the appearance that the NICE advice is working. So my question is this how do we as a group ensure that the statistics reflect the truth?

Cheers

We can only do what we do.

Whilst this is a large group, I can assure you, as a proportion of diabetic patients we are in the outer, outer edges, and I doubt our results, whether they be good, bad or plain ugly, would materially impact the overall statistics. You just have the read the National Diabetes Audit to understand the scale of those no achieving even the modest NHS diabetes targets.

On a personal level, I am unwilling to put my wellbeing at risk for the sake of ensuring a statistic isn't teenily, tinily affected. I have a duty to myself, my family and those who care for me to be in the best shape I can, to live the full and energetic life I want to live, for as long as possible.

 

[WillieGarvin]

I wouldn't suggest anybody should put their health any more at risk than it already is, in fact quite the reverse, just how to open the minds of the Health Professionals to the idea that NICE guidelines aren't the all and end all of options..

 

[TorqPenderloin]

Unfortunately, for some diabetics, the NICE guidelines and the NHS eat well plate does work by adding medication.

The problem that the establishment has, is the condition is so diverse and personal that the one size fits all policy doesn't work!

"Unfortunately" is a pretty poor word choice if you ask me.

I'm sure that the NHS would GLADLY switch to recommending a LCHF if it were that simple. That would save them a fortune in medication costs. Unfortunately, it isn't that simple.

While the basic act of eating minimal carbs is easy to understand, the other elements of the diet can be very complex. It's very easy to recommend a balanced diet and to advise people to avoid sugar and foods we know have little nutritional value. It's much harder to recommend a diet that literally changes your body's energy source.
What happens when someone goes to the ER because they're producing ketones and think they have DKA? That's an unnecessary expense.
What happens when someone has "Carb flu" and thinks they're having a heart attack? Unnecessary expense
What happens when someone can't adhere to avoiding carbohydrates and relapses? unnecessary expense.


It's simply not a good diet for people that need to be told what to do. Obviously, that doesn't apply to many of us as we're all here on this forum voluntarily and because we're eager to learn. However, for the people that are reluctant to make changes, a LCHF diet can be overwhelming. It's easier to tell someone to eat less of what they're already eating. That's easy to understand pretty hard to mess up (assuming they actually do it).

 

[NoCrbs4Me]

"Unfortunately" is a pretty poor word choice if you ask me.

I'm sure that the NHS would GLADLY switch to recommending a LCHF if it were that simple. That would save them a fortune in medication costs. Unfortunately, it isn't that simple.

While the basic act of eating minimal carbs is easy to understand, the other elements of the diet can be very complex. It's very easy to recommend a balanced diet and to advise people to avoid sugar and foods we know have little nutritional value. It's much harder to recommend a diet that literally changes your body's energy source.
What happens when someone goes to the ER because they're producing ketones and think they have DKA? That's an unnecessary expense.
What happens when someone has "Carb flu" and thinks they're having a heart attack? Unnecessary expense
What happens when someone can't adhere to avoiding carbohydrates and relapses? unnecessary expense.


It's simply not a good diet for people that need to be told what to do. Obviously, that doesn't apply to many of us as we're all here on this forum voluntarily and because we're eager to learn. However, for the people that are reluctant to make changes, a LCHF diet can be overwhelming. It's easier to tell someone to eat less of what they're already eating. That's easy to understand pretty hard to mess up (assuming they actually do it).

Are you better being serious?

 

[TorqPenderloin]

Are you better being serious?

I'm not sure if that was an auto-correct, but yes I was being serious. You could certainly argue that my comments don't apply here in the US where healthcare is for the most part privately funded, but in countries with universal healthcare, it's absolutely about cost-saving.

I'm sure you're aware, but researchers in Australia recently performed a study to analyze the benefits of a low-carb diet for people with type 2. One particular goal for the study was to see if it helped to reduce medication (which of course it did) which would lessen the burden on their healthcare system.

 

[NoCrbs4Me]

I'm not sure if that was an auto-correct, but yes I was being serious. You could certainly argue that my comments don't apply here in the US where healthcare is for the most part privately funded, but in countries with universal healthcare, it's absolutely about cost-saving.

I'm sure you're aware, but researchers in Australia recently performed a study to analyze the benefits of a low-carb diet for people with type 2. One particular goal for the study was to see if it helped to reduce medication (which of course it did) which would lessen the burden on their healthcare system.

So you believe that the health care industry should advise type 2 diabetics to follow a dietary plan that they know will cause their diabetes to get progressively worse and require increasing medication rather than advise them to follow a diet plan that has been clinically shown to improve diabetes and reduce the need for medication?

 

[TorqPenderloin]

So you believe that the health care industry should advise type 2 diabetics to follow a dietary plan that they know will cause their diabetes to get progressively worse and require increasing medication rather than advise them to follow a diet plan that has been clinically shown to improve diabetes and reduce the need for medication?

That’s not even remotely close to what I said, and your question requires the assumption that it’s one or the other.

“Advice” is great, but I can’t take 1mg of “Advice” each day and improve my diabetes. I have to be willing to take that advice and make the necessary lifestyle adjustments.

The point of my comments was to say that sometimes it’s a matter of providing the best advice that people can actually follow. It’s considering the human element of the situation and the fact that NO ONE has the perfect diet.

I could try as hard as I could to teach an infant how to run, but that doesn't mean they could do it. Instead, it makes sense to teach them how to crawl, then walk, and then run. It's not a matter of picking one or the other, it's a matter of teaching them what they can learn.

 

[NoCrbs4Me]

That’s not even remotely close to what I said, and your question requires the assumption that it’s one or the other.

“Advice” is great, but I can’t take 1mg of “Advice” each day and improve my diabetes. I have to be willing to take that advice and make the necessary lifestyle adjustments.

The point of my comments was to say that sometimes it’s a matter of providing the best advice that people can actually follow. It’s considering the human element of the situation and the fact that NO ONE has the perfect diet.

I could try as hard as I could to teach an infant how to run, but that doesn't mean they could do it. Instead, it makes sense to teach them how to crawl, then walk, and then run. It's not a matter of picking one or the other, it's a matter of teaching them what they can learn.

So what advice would you give a newly diagnosed type 2 diabetic? What the health care industry currently gives them or something different?

 

[TorqPenderloin]

So what advice would you give a newly diagnosed type 2 diabetic? What the health care industry currently gives them or something different?

I think you meant to ask "What advice would I give a PERSON newly diagnosed with type 2 diabetes?"
This disease does not define who we are as a PERSON so my answer would be: it depends on the PERSON rather than the disease (Type 2).

 

[NoCrbs4Me]

I think you meant to ask "What advice would I give a PERSON newly diagnosed with type 2 diabetes?"
This disease does not define who we are as a PERSON so my answer would be: it depends on the PERSON rather than the disease (Type 2).

LOL. Let's say the person was you. What advice would you give yourself if you were a newly diagnosed type 2?

 

[Kyi]

Its always interesting when a Type 1 diabetic starts talking to a diabetic Type 2. You can practically see they blame us for eating too much sugar and food in general. There are many reasons why Type 2 diabetes exist not all due to food intake. As to does diabetes define you as a person. It does. We all look at food differently. We calculate the effects of our lifestyle and what we need to change. If you do not have diabetes you do not think about what you eat, how often you eat, and how often you exercise. Of course diabetes changes the person.

 

[Kyi]

That’s not even remotely close to what I said, and your question requires the assumption that it’s one or the other.

“Advice” is great, but I can’t take 1mg of “Advice” each day and improve my diabetes. I have to be willing to take that advice and make the necessary lifestyle adjustments.

The point of my comments was to say that sometimes it’s a matter of providing the best advice that people can actually follow. It’s considering the human element of the situation and the fact that NO ONE has the perfect diet.

I could try as hard as I could to teach an infant how to run, but that doesn't mean they could do it. Instead, it makes sense to teach them how to crawl, then walk, and then run. It's not a matter of picking one or the other, it's a matter of teaching them what they can learn.

I think no one can follow a perfect diet because the perfect diet does not exist. Unlike teaching an infant to run which has only one end result.

 

[NoCrbs4Me]

That’s not even remotely close to what I said, and your question requires the assumption that it’s one or the other.

“Advice” is great, but I can’t take 1mg of “Advice” each day and improve my diabetes. I have to be willing to take that advice and make the necessary lifestyle adjustments.

The point of my comments was to say that sometimes it’s a matter of providing the best advice that people can actually follow. It’s considering the human element of the situation and the fact that NO ONE has the perfect diet.

I could try as hard as I could to teach an infant how to run, but that doesn't mean they could do it. Instead, it makes sense to teach them how to crawl, then walk, and then run. It's not a matter of picking one or the other, it's a matter of teaching them what they can learn.

Most of your arguments are based on faulty analogies and untrue premises. Can you teach a baby to run that is still crawling? Of course not. Do you really think it is impossible to teach someone to eat fewer carbs? Why not? Do you think people who develop type 2 diabetes are all uncontrollable gluttons?

Low carb flu is when someone has flu-like symptoms, not symptoms of a heart attack. And the person giving advice to reduce carbs could easily warn about the possibility of low carb flu symptoms. A low carb diet will not cause DKA. If someone can't adhere to a low carb diet, there is no additional expense - it's the same expense as for not going on a low carb diet at all.

You say "for the people that are reluctant to make changes, a LCHF diet can be overwhelming. It's easier to tell someone to eat less of what they're already eating." Except people are not told to eat less of what they are eating. They are told to follow the NHS healthy plate, or the USDA food guideline, or the Canada food guideline. Are people reluctant to make changes any more likely to follow the government "healthy" diet than LCHF? And when people do follow that high carb low fat diet, their type 2 diabetes progresses to more and more meds until they ultimately get put on insulin.

Should advice be based on what is easier? Should it be based on the HCP's judgement of how likely a patient will follow the advice? Or should it be based on what has been shown to work?

 

[Andy-Sev]

I can see both sides of the argument but here is something from my own experience

When I was diagnosed last year I set about reducing my daily carb intake, giving up things which I loved such as chips and switching things out to healthier lower carb options, gradually reducing things down to a total of 100g of carbs a day, this was from what I learned online. My dad who is in his 80s and was diagnosed Type 2 just 3 years ago looks at how I changed my diet and admits that there is no way he could change to what I eat as he loves his roast potatoes and chips and is stuck in his ways.

Do I want my dad to get complications, No. But do I want him miserable trying to stick to an eating plan he doesn't want to and will probably feel bad about if he can't stick to it then the answer is, No. And further do I want my Mum who isn't a diabetic and eats the same meals as my father have to change to a different diet because my dad has been told he must change, No. It is why in my opinion what all this comes down to is health professionals getting to know their patients and their level of knowledge along with willingness to change rather than trying to treat everyone with the same advice.

 

[NoCrbs4Me]

I can see both sides of the argument but here is something from my own experience

When I was diagnosed last year I set about reducing my daily carb intake, giving up things which I loved such as chips and switching things out to healthier lower carb options, gradually reducing things down to a total of 100g of carbs a day, this was from what I learned online. My dad who is in his 80s and was diagnosed Type 2 just 3 years ago looks at how I changed my diet and admits that there is no way he could change to what I eat as he loves his roast potatoes and chips and is stuck in his ways.

Do I want my dad to get complications, No. But do I want him miserable trying to stick to an eating plan he doesn't want to and will probably feel bad about if he can't stick to it then the answer is, No. And further do I want my Mum who isn't a diabetic and eats the same meals as my father have to change to a different diet because my dad has been told he must change, No. It is why in my opinion what all this comes down to is health professionals getting to know their patients and their level of knowledge along with willingness to change rather than trying to treat everyone with the same advice.

I think that the advice should be based on what works. If the person getting the advice chooses to do something else, that is not the fault of poor advice. I'm guessing your father doesn't follow the NHS healthy plate diet either, although he most certainly would have been advised to do so.

So just because some people will choose to knowingly disregard advice that would more likely work is not a reason to only provide advice that generally doesn't work. What''s ironic is that type 2 diabetics are now all being given the same dietary advice: follow the NHS healthy plate.

People who eat lots of carbs usually can't imagine it's possible to do, but most who try are able to do it. If you are not willing to even try, there's not much hope. Of course, there's always meds and insulin for those unwilling to reduce carbs.

Why not offer 3 options?

1. Eat what your eating now, then go on meds, then insulin, then die from diabetes complications.
2. Eat to the healthy plate, then go on meds, then insulin, then die from diabetes complications.
3. Reduce carb intake and possibly avoid meds, insulin, and complications.