The NHS T2 Treatment Regime

serenity648 said:

I am on a reduced income and i have found that low carbing is cheaper. You dont have to eat meat or any expensive foods. And I save on the cost of the high carb foods i used to buy. And no, I didnt eat processed or junk foods before.

I suggest that those on here who have said they cant afford it (I havent personally come across any of those posts, but thats just perhaps where I am looking) should have a look at the vegetarian meal suggestions, and there are many, many cheap meal which are low carb. Omelettes for a start, in lots of varieties, are one of my staple meals.

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Also there are inexpensive cuts of meat that just need more time to cook or a simple marinade.
If you go for chicken breast and beef it will be more costly.

Hotpepper20000 said:

Also there are inexpensive cuts of meat that just need more time to cook or a simple marinade.
If you go for chicken breast and beef it will be more costly.

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And using a slow cooker means the cost of the extra cooking time needed is minimal.

serenity648 said:

And using a slow cooker means the cost of the extra cooking time needed is minimal.

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Yes and slow cookers are pretty inexpensive.

Daibell said:

If you live in the USA as I did for 2 years there is no way you can avoid them!

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@Dainell. You say you couildnt avoid them in USA well I lived in Iran & had never heard of them till I came to England & my daughter saw them in Sainsburys, she still buys occasionally tho I've never ate one.

Brunneria said:

They are kind of like tasteless versions of Bourbon Cream biscuits.

I have had one. I won't have another.

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Same here - not the tastiest biscuit in the tin. I found some biscuits 'lurking' in the cupboard the other day with a best before date of Jan 2016 - a bit stale me thinks!!

As a skinny pre-diabetic I was horrified to be handed the 'official' diabetic advice guide from the doctors surgery. Yes it showed the Eatwell plate which would have had me eating way more carbs than I ever had before, which patently would have been disastrous for my health had I followed it.
It may be that the Eatwell plate is OK for those without any metabolic dysfunction but it certainly is NOT suitable for diabetics. And even for non-diabetics the low-fat' advice has had the side effect of allowing food manufacturers to sell stuff they can label as 'healthy' to an unsuspecting population when in reality the fat has been replaced with sugar in many of those foods making them 'unhealthy' for everyone.
Why does the NHS still push the Eatwell plate? Well they give out literature from diabetes UK which has sponsors that include food manufacturers, bread companies etc so there is a monetary interest in pushing the carb heavy plate. Also I think doctors receive so little nutrition training it simply would not occur to them that a condition could be improved with the right food. They are trained to give you medicines to make you better. Some are simply not interested, others will be happy to have you on their books as a diabetic as the surgery gets more money for each diabetic (which I believe ultimately goes to the doctors) so there is little incentive for them to help you reverse your diabetes. I wonder - if the NHS started incentivising doctors for every diabetic they could 'reverse', just how quickly the low carb high fat advice would get out there...
It annoys me when they cite no evidence for low carb diets working, when there is no evidence at all that the Eatwell plate has ever helped anyone reverse their diabetes, whilst we have a community of hundreds of thousands of actual diabetics who have 'reversed' their diabetes to some extent on low carb high fat and done in it a real work scenario and contrary to 'standard NHS' advice which shows it's not that difficult to achieve. Few studies have been done on it because the studies are sponsored by food manufacturers who want you to eat their carb laden foods. I spent days searching all the studies cited by PHE and couldn't find a single one that featured a ketogenic diet or compared a ketogenic diet with the Eatwell plate for glucose management.
It also annoys me when they say that people are too lazy to change or don't stick to the diets. Well if they only recommend Eatwell plate which doesn't work, then people have no incentive to change what they eat, as Eatwell plate is as bad or worse than whatever they ate before, due to it's high carb content. They don't offer the alternative of low carb high fat which is actually a fairly easy diet to follow that doesn't have to be expensive and doesn't involve any carb or calorie counting so is easy to do and effective.
Having reduced my HbA1c to a non diabetic level my doctor was not interested in how I achieved that - I was simply told by the receptionist that she'd written 'No action necessary' on my results sheet.

seadragon said:

Some are simply not interested, others will be happy to have you on their books as a diabetic as the surgery gets more money for each diabetic (which I believe ultimately goes to the doctors) so there is little incentive for them to help you reverse your diabetes.

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My wife is a member of her surgery's Patient Participation Group and the information she has been given is that the surgery gets £100 for each of it's 11,000 patients, young, old, fat, thin, diabetic, non-diabetic. This figure varies across the country and depends on whether they are APMS (Alternative Provider Medical Services), PMS (Personal Medical Services) or GMS (General Medical Services). As of this year GP's earnings will be published, excluding private work which seems fair to me.

So, by my reckoning, at my wife's surgery that's £1.1 million per annum. They have two surgeries, three full time and three part time doctors plus a practice manager and ancillary staff (3 full time at the local surgery) and then there's the nurses. £1.1 million sounds like a lot and I no doubt the GP earn a good living, even with medical indemnity insurance which they pay on top of income tax, N.I. and pension payments. I think a suggestion that diabetic patients earn more money for them needs validating because it doesn't tie up with what I'm hearing from my wife's surgery, maybe they're not telling the truth, who knows?

BTW I'd recommend that everyone, given the opportunity, joins their surgery's PPG and especially if you are not a middle class white professional person who seem to have done all the volunteering at my wife's surgery despite being in a very mixed area, ethnicity wise and financially.

DavidGrahamJones said:

My wife is a member of her surgery's Patient Participation Group and the information she has been given is that the surgery gets £100 for each of it's 11,000 patients, young, old, fat, thin, diabetic, non-diabetic. This figure varies across the country and depends on whether they are APMS (Alternative Provider Medical Services), PMS (Personal Medical Services) or GMS (General Medical Services). As of this year GP's earnings will be published, excluding private work which seems fair to me.

So, by my reckoning, at my wife's surgery that's £1.1 million per annum. They have two surgeries, three full time and three part time doctors plus a practice manager and ancillary staff (3 full time at the local surgery) and then there's the nurses. £1.1 million sounds like a lot and I no doubt the GP earn a good living, even with medical indemnity insurance which they pay on top of income tax, N.I. and pension payments. I think a suggestion that diabetic patients earn more money for them needs validating because it doesn't tie up with what I'm hearing from my wife's surgery, maybe they're not telling the truth, who knows?
y.

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I may be wrong - happy to be corrected but I was told (I forget who by) - that the surgery got extra money for each diabetic on it's books ( I presume to cover for the annual checks they are supposed to get or something). i just think it would be nice if the surgery got extra money for every diabetic they could get OFF their books and then they might be keener to help patients to explore the alternativess to meds and Eatwell plate. How many diabetics has that helped to reverse their diabetes? As far as I can ascertain precisely NONE. By contrast following a low carb high fat or ketogenic diet or the ND diet has helped a great many to attain non-diabetic BG results but virtually none of us have got there as a result of advice from our GPs or DN's. We've either researched for ourselves or as someone mentioned, got to this site by accident of mistyping when they've been sent to the Diabetes UK site. A sad state of affairs when people are saved by a typo rather than medical advice!

seadragon said:

I may be wrong - happy to be corrected but I was told (I forget who by) - that the surgery got extra money for each diabetic on it's books

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I see Dr Biffra reckons that if a practice can get 1/2 their type II diabetic patients to have an HbA1c less than 7% then the incentive is £3,000 per annum. I don't think that ends up in the doctor's pocket, there's too much else to fork out for.

So per person that's a figure that can be very different depending on practice size, % type II diabetics in the practice (it's 5.5% nationally) and whether or not they can achieve that target.

There is a thread from this forum back in 2014 that looks at this (http://www.diabetes.co.uk/forum/threads/how-much-are-you-worth.74492/) and it was complicated then, it's probably no better now.

At least as of this year GP practice figures will be available.

How many are tested for T2D while they're not "overweight"? Precious few, I'm guessing.
The testing usually follows the weight problem and a higher than normal reading is obtained. You are diagnosed as T2D and then told to follow a diet pretty similar to the one you've been on.
Assuming you're sensible you then do a little homework, join the forum and the LCHF programme.[/QUOTE]

You are right about testing. I lost half a stone in less than a week and was peeing every hour or so before I was tested. I was not overweight when diagnosed Type 2 three years ago. Anecdotally, I went low carb in conjunction with gluten and lactose free for 3 months (December - March) and my weight hasn't changed (5'10" 13 st.). I felt worse, had hair loss, developed signs of skin ageing, had neuropathy signals in my feet and hives on my thighs so stopped.
I have since then researched further and found a treatment for T2 reversal. The fact is that ALL major studies show an INCREASE in disease and death from from low carbohydrate diets. No studies of high carbohydrate diets show similar effects. Demonising carbohydrates in founded on a 2013 celiac disease study. Celiac disease is relatively rare affecting about 1% of people. Greater whole grain intake was shown in a 2012 study to reduce the risk of T2 diabetes by 26% together with a 21% reduced risk of heart disease (independent of cardio-vascular disease). Low carb advocates confuse people by saying inflammation is the cause of disease whereas it is injury that causes inflammation (e.g. smoking injures lungs leading to inflammation and emphysema). Many studies show that it is animal foods and not plant foods that cause inflammation. Some doctors say that carbohydrates are the cause of diabetes however; worldwide, obesity is found mainly in the western world where animal foods (red meat, dairy, eggs) form a large part of the diet.
A study by Hemsworth as long ago as 1934 showed that glucose tolerance is significantly impaired by a low carb high fat diet. In 1948 Walter Kempner MD published the results of his rice diet. This diet was found to reverse morbid obesity, retinopathy, severe kidney disease, hypertension, psoriasis and heart enlargement. What his studies show is that nutritional deficiencies do not occur with simple plant based diets (even with the addition of lots of sugar). You can find out more from this YouTube video presentation by Dr McDougall I'm going to give it a shot. Daily diet, 565 grams of carbohydrates + 25 grams protein + 5 grams of fat for 28 days followed by the "McDougall Diet". I'll be seeing my GP shortly to tell him my intention and will post my experience and results. Good luck with the low carb diet.

Shoveller said:

I'm going to give it a shot. Daily diet, 565 grams of carbohydrates + 25 grams protein + 5 grams of fat for 28 days followed by the "McDougall Diet". I'll be seeing my GP shortly to tell him my intention and will post my experience and results. Good luck with the low carb diet.

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Welcome to the forum. Do test and share your success with the McDougall Diet.

The Low Carb Heavenly Fats diet works for me. Here's my typical shocking glucose reading after a plate of roast pork belly...5.0mmol

And the best of British with that one @Shoveller . You will need it.

Do let us know how you go on.

I had my success with a very low carb high fat diet and am sticking to it.

DavidGrahamJones said:

My wife is a member of her surgery's Patient Participation Group and the information she has been given is that the surgery gets £100 for each of it's 11,000 patients, young, old, fat, thin, diabetic, non-diabetic. This figure varies across the country and depends on whether they are APMS (Alternative Provider Medical Services), PMS (Personal Medical Services) or GMS (General Medical Services). As of this year GP's earnings will be published, excluding private work which seems fair to me.

So, by my reckoning, at my wife's surgery that's £1.1 million per annum. They have two surgeries, three full time and three part time doctors plus a practice manager and ancillary staff (3 full time at the local surgery) and then there's the nurses. £1.1 million sounds like a lot and I no doubt the GP earn a good living, even with medical indemnity insurance which they pay on top of income tax, N.I. and pension payments. I think a suggestion that diabetic patients earn more money for them needs validating because it doesn't tie up with what I'm hearing from my wife's surgery, maybe they're not telling the truth, who knows?

BTW I'd recommend that everyone, given the opportunity, joins their surgery's PPG and especially if you are not a middle class white professional person who seem to have done all the volunteering at my wife's surgery despite being in a very mixed area, ethnicity wise and financially.

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I've been recommending PPG's to people here for at least 4 years. There is so much more info given than you would other wise find out.

Gp's do get other funding too, ie DES targets-which covers diabetes, heart and various standard illnesses and tgey also get paid for flu jabs, vaccines etc.

Some GPs that have formed "hub" services for out of hours care also get extra funding now for doing this. Ie from 6-8pm and weekend appts our GPs are getting extra money if they go to the hub place. Its offering extended hours to all of those parltients in x qty of practices that cover the extra hoyrs wanted by the govt. when you book an appt with our GP, those that need to be seen in the extended hours have to agree that other GP's can view notes and treat, other than our normal GPs.

Earnings of GP's should have been aleasy been published. Certainly my two Practices that I've got an interest in have had them online since last year.

The govt are wanting large practices covering upward of 100,000 patients... the only way to manage this is for Practices to form a 'combined"
Consortium of Practices.

You only get this sort of info from PPGs. They dont cost anything to join.

Only thing is, some offer only online PPG's and not meetings in person. The groups that meet in person can be brillyant but it all depends who is rhe Chair, Secretary and Treasurer...

donnellysdogs said:

Only thing is, some offer only online PPG's and not meetings in person. The groups that meet in person can be brillyant but it all depends who is rhe Chair, Secretary and Treasurer...

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100,000 eh? If my wife's surgery has 11,000 with 3 full time and 3 part time doctors and only just about caters for on the day emergency appointments, the thought of 100,000 is frightening. It would also mean that people, round here anyway, would be traveling a lot further, not good.

My wife has only been to one meeting and she's found it hilarious because of the stronger willed characters already showing their teeth and disagreeing on how to word a letter. I found some interesting info about GP practices @ https://apps.nhsbsa.nhs.uk/infosystems/home/homepage.do

Shoveller said:

You are right about testing. I lost half a stone in less than a week and was peeing every hour or so before I was tested. I was not overweight when diagnosed Type 2 three years ago. Anecdotally, I went low carb in conjunction with gluten and lactose free for 3 months (December - March) and my weight hasn't changed (5'10" 13 st.). I felt worse, had hair loss, developed signs of skin ageing, had neuropathy signals in my feet and hives on my thighs so stopped.
I have since then researched further and found a treatment for T2 reversal. The fact is that ALL major studies show an INCREASE in disease and death from from low carbohydrate diets. No studies of high carbohydrate diets show similar effects. Demonising carbohydrates in founded on a 2013 celiac disease study. Celiac disease is relatively rare affecting about 1% of people. Greater whole grain intake was shown in a 2012 study to reduce the risk of T2 diabetes by 26% together with a 21% reduced risk of heart disease (independent of cardio-vascular disease). Low carb advocates confuse people by saying inflammation is the cause of disease whereas it is injury that causes inflammation (e.g. smoking injures lungs leading to inflammation and emphysema). Many studies show that it is animal foods and not plant foods that cause inflammation. Some doctors say that carbohydrates are the cause of diabetes however; worldwide, obesity is found mainly in the western world where animal foods (red meat, dairy, eggs) form a large part of the diet.
A study by Hemsworth as long ago as 1934 showed that glucose tolerance is significantly impaired by a low carb high fat diet. In 1948 Walter Kempner MD published the results of his rice diet. This diet was found to reverse morbid obesity, retinopathy, severe kidney disease, hypertension, psoriasis and heart enlargement. What his studies show is that nutritional deficiencies do not occur with simple plant based diets (even with the addition of lots of sugar). You can find out more from this YouTube video presentation by Dr McDougall I'm going to give it a shot. Daily diet, 565 grams of carbohydrates + 25 grams protein + 5 grams of fat for 28 days followed by the "McDougall Diet". I'll be seeing my GP shortly to tell him my intention and will post my experience and results. Good luck with the low carb diet.

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Well I'll be very interested in hearing how you get on. From everything I've read and researched, then a low carb high fat diet is usually more effective for weight loss and blood sugar management. It has certainly worked for me and I have way more energy than when I was eating a lot of starchy foods. I do find that any diet promoted by vegans tends to hinge on their ethical rejection of eating animal products rather than a proper scientific basis for comparison. McDougall's video cherry picked data again and while I would agree that compared to the SAD diet then the vegan diet has many benefits it must be said that compared to the SAD diet then low carb high fat seems to have similar benefits. Therefore it seems that both are better than SAD diet. What I disliked in McDougall's video is that he claimed to be comparing veganism with low carb when in fact his 'scientific papers' were actually comparing veganism with SAD which is a very different thing. He did not look at any science on vegan diets vs ketogenic diets (probably because there aren't any!)
It's misleading to say that animal foods are the problem in the western world when in fact it is the combination of fat and carbs in many processed foods that are a bigger issue.
Contrary to McDougall's claim, ketosis is not sickness - it is simply utilising an alternative energy source. The only sickness comes from the adjustment phase when the body is adapting. If I eat carbs now I get the same sort of 'sickness' in reverse.
If a vegan diet suits you then that's great although it is just as possible to have an unhealthy vegan diet as a healthy one. I know a few overweight vegans. It is just as possible to have an unhealthy low carb high fat diet as a healthy one too but it does seem a lot easier and less restrictive to have a good low carb high fat diet with plenty of non -starchy veg.
Having watched McDougalls videos and looked at the dietdoctor.com low carb high fat site I would still go with low carb high fat every time.
Hope the diet works well for you.

seadragon said:

I do find that any diet promoted by vegans tends to hinge on their ethical rejection of eating animal products

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Erm...that is the very definition of veganism!

@Shoveller
In my experience, my numbers dropped a lot when I switched from vegetarian to vegan so I suspect the dairy was inflammatory in my case. All the very best to you

Avocado Sevenfold said:

Erm...that is the very definition of veganism!

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Yes exactly - my point being that vegans often/usually try to portray themselves as pushing veganism because it is, in their eyes, first and foremost a 'healthy' diet for everyone. Indeed this is just the stance McDougall takes. He barely touches on the 'Don't eat animals bit' which is what it is really all about. This pushes them to then try and find arguments to support the ' don't eat animals ' thing - but they present it as 'this is the healthiest diet ever' which I do not believe is true and particularly do not believe is true for those on the diabetic spectrum.
They pick on saturated fat and then have shot themselves in the foot as they then shun even healthy plant fats like avocado and coconut oil because if they don't shun "all' sat fat then it is admitting that sat fat is not the problem and ergo you can eat animals if you want to and it's still healthy.
If you (the general you) don't want to eat animals and want to persuade others not to eat animals that's fine but just be honest and stop pushing the dubious health benefits in an effort to get others to follow veganism. If a diet is lacking in a vital vitamin (B12) then it can't possibly be the healthiest diet there is for a human.
A vegan diet would mean I had to eat way more carbs and yet my body cannot deal with carbs so why on earth would I choose to add more carbs to my diet - it makes no sense. The insulin sensitivity thing is a bit of a red herring. If the body is not needing glucose then the cells don't need to be that sensitive to glucose anyway. It's like alcohol - if you don't drink alcohol much it has a greater effect on you than if you've been drinking it regularly as the body is not used to it and the liver doesn't detox as fast but if you are tee total or almost then it doesn't matter that your body doesn't deal with alcohol very well - it doesn't need to.
If you believe the theory of diabetes actually being a result of hyperinsulineamia then adding carbs which requires even more insulin is not going to help. There may well be various causes of diabetes type problems and so once again one size does not fit all and that includes a vegan diet.

seadragon said:

Yes exactly - my point being that vegans often/usually try to portray themselves as pushing veganism because it is, in their eyes, first and foremost a 'healthy' diet for everyone. Indeed this is just the stance McDougall takes. He barely touches on the 'Don't eat animals bit' which is what it is really all about. This pushes them to then try and find arguments to support the ' don't eat animals ' thing - but they present it as 'this is the healthiest diet ever' which I do not believe is true and particularly do not believe is true for those on the diabetic spectrum.
They pick on saturated fat and then have shot themselves in the foot as they then shun even healthy plant fats like avocado and coconut oil because if they don't shun "all' sat fat then it is admitting that sat fat is not the problem and ergo you can eat animals if you want to and it's still healthy.
If you (the general you) don't want to eat animals and want to persuade others not to eat animals that's fine but just be honest and stop pushing the dubious health benefits in an effort to get others to follow veganism. If a diet is lacking in a vital vitamin (B12) then it can't possibly be the healthiest diet there is for a human.
A vegan diet would mean I had to eat way more carbs and yet my body cannot deal with carbs so why on earth would I choose to add more carbs to my diet - it makes no sense. The insulin sensitivity thing is a bit of a red herring. If the body is not needing glucose then the cells don't need to be that sensitive to glucose anyway. It's like alcohol - if you don't drink alcohol much it has a greater effect on you than if you've been drinking it regularly as the body is not used to sit and the liver doesn't detox as fast but if you are tee total or almost then it doesn't matter that your body doesn't deal with alcohol very well - it doesn't need to.
If you believe the theory of diabetes actually being a result of hyperinsulineamia then adding carbs which requires even more insulin is not going to help. There may well be various causes of diabetes type problems and so once again one size does not fit all and that includes a vegan diet.

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I am not here to persuade anyone to do anything. I was vegetarian when I was diagnosed with type 2 diabetes. I switched to veganism for ethical reason, not for health reasons. The fact that my diabetes markers have improved is a bonus. If sharing my experience helps anyone else, then that's good. That is what this health forum is about I think.

I don't follow any particular guru for my dietary advice so can't comment on anyone shunning or not avocados or the like. I am eating to my meter, as you say, one size does not fit all. It is often assumed that a vegan way of eating is high carb. It doesn't need to be. I also have ketones from time to time.

B12 is an old chestnut. I have read that anyone over 50 should be taking a B12 supplement. This would be especially true of anyone at risk of neuropathy or taking metformin long term. B12 is a bacteria from soil. Eat the vegan animal which eats the soil bacteria or is injected with B12 supplements or just take a tablet. It is not a big deal for me.

Avocado Sevenfold said:

I am not here to persuade anyone to do anything. I was vegetarian when I was diagnosed with type 2 diabetes. I switched to veganism for ethical reason, not for health reasons. The fact that my diabetes markers have improved is a bonus. If sharing my experience helps anyone else, then that's good. That is what this health forum is about I think.

I don't follow any particular guru for my dietary advice so can't comment on anyone shunning or not avocados or the like. I am eating to my meter, as you say, one size does not fit all. It is often assumed that a vegan way of eating is high carb. It doesn't need to be. I also have ketones from time to time.

B12 is an old chestnut. I have read that anyone over 50 should be taking a B12 supplement. This would be especially true of anyone at risk of neuropathy or taking metformin long term. B12 is a bacteria from soil. Eat the vegan animal which eats the soil bacteria or is injected with B12 supplements or just take a tablet. It is not a big deal for me.

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That's great that it works for you but my original reply was to @Shoveller who included McDougall's video. From watching it, he is pushing the vegan diet as 'healthy for diabetics'. To me that is not honest. The data is cherry picked and much of it old and has been superseded. He does warn you off Avocado (from your name I guess you love avocados, (me too)) and coconut oil, so once again I was speaking vegans in general (that follow McDougall in particular) and not about you specifically. He also talks about Kempner and the rice diet (but one wonders if that success was not more due to the very low calorie and consequent weight loss rather than the fact rice is carbs - in the same way the Newcastle diet works for some of those willing to follow such an extreme diet), which cannot be long term healthy. So basically I am not knocking you or a diet that works for you and agree that the more sharing the better. If we all can post what works for us as diabetics ourselves, then those that find this forum have the best chance of finding what works for them.
I was however, taking issue with the McDougall video in @Shovellers post.
Any diet that is better than the SAD or ADA or Eatwell plate is going to be beneficial but I would be interested in more science comparing a ketogenic diet vs a vegan diet specifically for diabetes.
I am also genuinely interested in your point about vegan diet not necessarily being high carb (though once again this is the 'health' angle McDougall pushes and the one I feel is based on dubious science). If you are eating very little fat (no dairy , no animal fat) are you eating a lot of protein rather than carbs or do you use a lot of vegetable oils? Can you give an idea of the proportions of each in what you personally eat as I can't envisage a low carb vegan diet and it might help me to understand this?