"This does my head in".

[catherinecherub]

Everyone who visits the forum sees something to their advantage in managing their diabetes. I think, after reading this report, we are the lucky ones.

This study compiled by Health Services Research shows that there is much more to being able to manage diabetes than being told what to do or being given advice. The participants were Type1 and Type2 diabetics.

It really is worth a read to show what some diabetics are up against when they try and manage the condition. People were interviewed in their homes and the results of this study may surprise some people here. It is quite a long document.
http://www.biomedcentral.com/content/pd ... -12-83.pdf

 

[lucylocket61]

Very interesting report. Thank you for the link.

 

[xyzzy]

Thanks for the link Catherine. It looks a very interesting report. I've just skimmed over it at the moment and as you say it makes some very interesting observations. If you've read it in detail could your summarise what you think it recommends / concludes as it really is a big document.

As you say we are likely to be the lucky ones but we can share that good fortune and our own experiences with others. If we get to a point where we can deliver a very simple "be safe" life style message presented in an easy to understand way for the newly diagnosed arriving at the forum gates then perhaps the outcomes for future yet to be diagnosed diabetics can be made better.

 

[noblehead]

I can concur with the following which is often overlooked:

''Self-management of diabetes is physically, intellectually, emotionally and socially
demanding. Non-engagement with self-management may make sense in the context of low
personal resources (e.g. health literacy, resilience) and overwhelming personal, family and
social circumstances''.

 

[xyzzy]

I can concur with the following which is often overlooked:

''Self-management of diabetes is physically, intellectually, emotionally and socially
demanding. Non-engagement with self-management may make sense in the context of low
personal resources (e.g. health literacy, resilience) and overwhelming personal, family and
social circumstances''.

If I read that right it says you agree that if as a diabetic you are challenged physically, intellectually or emotionally or are poor it may make sense not to have a personal interest in looking after yourself?

What a depressing message for you to push. Surely even if it were true then it's society's responsibility to set the norms that most people would then adopt without realising they are doing it. So in this country most people do the 5 a day, 50% carbs, Low fat stuff as that's what society tells them they should do.

In other society's that aren't so defeatist they take the view that you can help the entire population by CHANGING the norms. Banging back to my Swedish lot where LCHF (Low Carb High Fat) is now pushed as the message then getting the population to accept that LCHF message also pushes their dietary recommendations for diabetics which implicitly helps those members of the diabetic population where "It does my head in" as all they need to do is follow the social norms to get helped.

Yes you can argue that in this country we push a diet message that "helps" the diabetic population but the problem is we don't do we? We push a message that "does peoples heads in" because it doesn't work.

All it takes is for society via its government and health system to have the balls to man up and do something about things as it did with smoking. I thought that was why the NHS was originally founded.

 

[catherinecherub]

Didn't get back to you zxxy, I have been out shopping. Two lads home from University are eating me out of house and home.

I read it that the barriers of social circumstances, intelligence, low personal resources etc., make it difficult for some to engage in appropriate management of their diabetes. They do not have the necessary resources that we have and that is why I said that we were lucky in my OP.

I wonder if we explained things in a more simple way here on some occasions that people would be able to engage better? We know what we are talking about but do some of the members who are trying to understand what needs to be done to manage their condition? Some newbies make a couple of posts and never come back.

There are people who have posted here in the past who do not understand the basics, something as simple as carbohydrates had to be explained. This is no reflection on them, they have not been taught. I have met people who think crisps are O.K. to eat if they are cheese and onion because they have other food groups in them.

 

[Unbeliever]

Thanks very much for the link catherinecherub. Fantastic study. Putting together so much of what those of us dignosed for some time or familiar with many of the social factors referred to had alreaady worked out for ourselves but in a sructured form.

There wee so many parts of it I could relate to my own experience and o that of others I have encountered.

It should be required reading for all HCPs involved in the treatment of diabetes. I am still hoping [who said I am not an optimist} that at some point, treatment will be more tailored to the individual in the future. In the meantime educating the HCPs on some of the issues governing the behaviour of their patients and emphasising that these must be considered when treating them , would be a huge step forward I am sure many do not have a clue about the difficulties faced by many diabetics,
Much depends upon their own experience and intelligence . it shouldnt be left to the individuaal but should be an integral par of the training for all.

I was veey impressed wih this study which is one of the few I have read which managed not to patronise and generalise .

Congratulations to the authors I say. I hope the study c will be put to good use.but accept that it might be inconvenient so will probably lngish on a shelf somewhere.

 

[xyzzy]

Didn't get back to you zxxy, I have been out shopping. Two lads home from University are eating me out of house and home.

Catherine, yes I know all about "home from university" we were blessed with all four of ours being able to get to university and the subsequent emptying of everything edible from the house whenever any of them came home. All mine have now flown the nest and have luckily in today's climate managed to get good jobs. Probably why I have so much time on my hands nowadays :lol:

Catherine, this is going to be a shock so sit down. I'm agree with you absolutely and totally.

I know my current "tome" for new member posts does mention specific carbohydrate targets and other "deep" stuff about levels but that's simply because I feel I have to justify what I say because it is different to the NHS message. What I have started to do is to try and separate out the science by pointing people at my "position statement" thread and will continue to simplify it. To be frank if I felt I was not going to get attacked for presenting my Swedish diet "in the raw" I would love to remove much of the science and grams from it as it does have to overly complicate things in my opinion

We may differ over what we would end up telling people but I am in complete agreement that whatever that message was it should be stated in as simple terms as possible. So no talk of carbohydrates, grams, ketosis, G.I but some simple guidelines along the lines of these are the things you should try and eat, these should be avoided and importantly an indication of how much is acceptable. I would also argue you need to put in that message the truthful consequences of what will happen if you ignore the message.

Now behind the scenes people like me and you and everyone else may argue tooth and nail that the details behind the content of that simple advice should be for arguments sake be based on a low GI or Swedish LCHF or the Americans 130g of carbs per day or even VLC.

That is where you and me and others will have our little debates, disagreements and even spats but that to me is where those disagreements should end as the final message should get translated into plain simple English advice.

Given we both support the "Eat to your meter less than 8.5" stance how would you simplify that? I have problems with seeing how to do that but I know you and others have pushed that meter message for longer than I've been around. I always say the weakness of the current message is that it seems to have got watered down over the years for whatever reason. I can see that dictating "BE LESS THAN 8.5" is a tough thing to get over to people who maybe don't want to hear it. My argument is simply tell them the truth in the same way as happens on cigarette packets with their horrible images. Yes it may not get across to everyone but it would get across to progressively more people as the years went by. You have to make a start somewhere.

I hope you do see with my recent "NHS rants" that I really do see this whole thing at a far deeper level than just carbs / day and hope you would acknowledge that. I am genuinely impressed by the Swedish model in how it seems to be strategically attempting to change its populations mindset, all its populations mindset and not just its diabetics, in a long term attempt to slow down the progression of obesity and T2 which is why I agree with their ease up on the starchy carb message and that pushing a LCHF alternative is ok. If anything it looks like the Americans are beginning to put an even stronger low carbohydrate message than the Swedes.

Another of my personal beliefs. This forum while it has a .co.uk domain IS read by many people around the world and rightly so. It is brilliant! I do think however it should consider promoting a global view on diet and testing and end up as you suggest stating that in very simple terms that anyone can understand.

So in broad terms I do accept that certain members of society cannot be expected to self manage their condition. I think the difference though is my willingness to embrace and shout my reformist stance to all of it like the Swedes do and not just tinker around the edges. Just accepting that because certain members of society cannot be expected to self manage their condition does not mean we shouldn't actively and maybe, yes aggressively intervene and help them.

If you change what society thinks is normal to something "better" then implicitly some of those people who can't or wont self manage will do better without even knowing. That may sound very big brother like but again is it any different to the pressure society i.e. government put on us all via its anti smoking or drink drive or low fat high carb message over the years?

 

[noblehead]

If I read that right it says you agree that if as a diabetic you are challenged physically, intellectually or emotionally or are poor it may make sense not to have a personal interest in looking after yourself?

Thankfully I'm neither challenged physically or intellectually but there has been many times in my life where I have been emotionally challenged due to family bereavements/crisis for example, diabetes doesn't always take precedence and some things are more important in life (that's not to say I don't take my insulin, only missed one injection in 30 years ). Those who have diabetes and are physically/intellectually challenged face barriers we can only imagine.


''What a depressing message for you to push''.

Sorry I had to laugh at this :lol:........ what message is it that I'm trying to push?

 

[xyzzy]

If I read that right it says you agree that if as a diabetic you are challenged physically, intellectually or emotionally or are poor it may make sense not to have a personal interest in looking after yourself?

Thankfully I'm neither challenged physically or intellectually but there has been many times in my life where I have been emotionally challenged due to family bereavements/crisis for example, diabetes doesn't always take precedence and some things are more important in life (that's not to say I don't take my insulin, only missed one injection in 30 years ). Those who have diabetes and are physically/intellectually challenged face barriers we can only imagine.


''What a depressing message for you to push''.

Sorry I had to laugh at this :lol:........ what message is it that I'm trying to push?

Where you said

I can concur with the following which is often overlooked:

''Self-management of diabetes is physically, intellectually, emotionally and socially
demanding. Non-engagement with self-management may make sense in the context of low
personal resources (e.g. health literacy, resilience) and overwhelming personal, family and
social circumstances''.

I find it depressing that you concur that physically, intellectually, emotionally ... and poor people may not be able to self manage. That would seem to mean that you accept that state of affairs and are therefore accepting those people will go to an early grave in many cases.

I can accept that the statement may be true in some cases and I have just done as much in my reply to Catherine however I am unwilling to just accept that nothing much can be done about it and that's the difference.

You did not make it clear if you share a similar view as me that there is loads that could be done about it. If you do great and I'd love to hear your suggestions as I've already stated some of mine.

 

[lucylocket61]

I agree with xyzzy and the others that a simple, straightforward message is best to begin with.

That is why I found the message Daisy1 sends to each newbie to be very, very helpful to me to begin with and I keep referring back to it.

I think, maybe in a few months, I will understand the message xyzzy put up as well. but not just yet.

For me this forum can be a bit like walking into a computer club. I sort of know I need to use a computer, I sort of know a few terms being used, but any debate between members confuses me at that point and makes me want to back away and get overwhelmed. Coping with the initial shock is bad enough, but trying to wade through all the very helpful and pertinent info given is difficult to absorb.

Perhaps there could be a sub-group on the forum for the Not Newbie, but ready to Discuss types?

I am not criticising here. You have all raised the point of what is helpful or not to newbies. And I am giving my own personal view of the forum as I see it at this stage of my diagnosis.

PS I read nobleheads post as an honest appraisal of some of the problems, as a base point of being able to start to help those the medical system is failing. I do not find it depressing, I find straightforward talking refreshing and positive.

 

[phoenix]

(posted in response to XYZZs earlier post... there have been a few in between that I haven't read yet.
I found it an excellent study. I shall read it more carefully later.
It certainly emphasizes the many different factors that can impact on peoples ability to self manage.

Even though people on forums are a fairly 'select' group it's worth remembering there will be people with unseen and possibly undisclosed barriers to self management. People don't reveal their all on the internet . People may have restricted incomes. They may have other illnesses, some may have dietary restrictions. They may have an eating disorder, mental illness.They may neither know what a carb is nor yet be able to calculate them. We don't know
We are not one standard size.

Surely even if it were true then it's society's responsibility to set the norms that most people would then adopt without realising they are doing it. So in this country most people do the 5 a day, 50% carbs, Low fat stuff as that's what society tells them they should do.
other society's that aren't so defeatist they take the view that you can help the entire population by CHANGING the norms. Banging back to my Swedish lot where LCHF (Low Carb High Fat) is now pushed as the message then getting the population to accept that LCHF message also pushes their dietary recommendations for diabetics which implicitly helps those members of the diabetic population where "It does my head in" as all they need to do is follow the social norms to get helped.

In th UK in spite of what is promoted three quarters of the people aren't eating 5 portions of fruit and veg . Consumption is affected by income with "consumption associated with higher income, and vice versa" 32 per cent of men and 37 per cent of women in the best off households ate 5 or more but only 18 per cent of men and 19 per cent of women in the lowest quintile did so.”
People eat more saturated fat than recommended. They may eat nearly fifty percent of their diet as carbohydrate (48%) but 46% of those carbs are sugar!(29% of the carbs come in the form of added sugar .. technically from non milk extrinsic sugars ie not from milk or from within the plant cell. )
http://www.ic.nhs.uk/webfiles/publicati ... d_2012.pdf
http://www.defra.gov.uk/statistics/file ... 112131.pdf

The Swedish diet guidelines , rightly in my opinion , don't suggest the impostion of any particular diet as the best starting advice . They recognises that people are different and that you have to start from where they are. The mangled google translation of the document you use says

Changing as little as possible is often successful in counseling about diets. In simple terms, the existing diet often become more like any of the diets that may be helpful in diabetes without the patient fully must abandon their previous eating habit.......

A first step in dietary advice is to work with the patient revise your eating habits and replace individual foods to more favorable options, such as increasing the proportion of unsaturated fat and carbohydrate foods with low GI (at the expense of saturated fat and foods rich in simple carbohydrates). If the patient needs to change its eating habits radically to achieve a good diet, it is often easier to make changes incrementally. Many patients need to lose weight. Adapting energy intake to the individual need is just as important as introducing new foods

Good advice I think
But individual advice tailored to a persons circumstances is not necessarily part of the experience in Sweden either.
I had a look at the Swedish associations magazine. Some of the editorials made clear that there were problems One said' Many people' told the association that they were rarely called to see a doctor and never saw a nurse or dietitian.Several said they do not get any blood glucose meter, but only one value during the visit. (and indeed they have been fighting for strips for T2)
XyZZ
Have you read the scientific evidence document ? The guidelines are meant to be read alongside it. It makes clear that there is evidence (such as it is) for a range of strategies/diets.
http://www.sbu.se/upload/Publikationer/ ... 110517.pdf
Also have you seen Jennifer's advice (google) for simple eat to your meter advice (though unfortunately it does rely on strips)

 

[lovinglife]

I agree with xyzzy and the others that a simple, straightforward message is best to begin with.

That is why I found the message Daisy1 sends to each newbie to be very, very helpful to me to begin with and I keep referring back to it.

I think, maybe in a few months, I will understand the message xyzzy put up as well. but not just yet.

For me this forum can be a bit like walking into a computer club. I sort of know I need to use a computer, I sort of know a few terms being used, but any debate between members confuses me at that point and makes me want to back away and get overwhelmed. Coping with the initial shock is bad enough, but trying to wade through all the very helpful and pertinent info given is difficult to absorb.

Great post Lucy :clap:

I am in no way knocking all the hard work that xyzzy has put into his "tome" (his own words) but I think if I had read that as a newbie I would have curled up and died! - the post that daisy uses is far simpler to understand and digest - although I see where xyzzy is coming from and the info is great there is a lot of it for someone who is new and confused.

I have no axe to grind and say this with the greatest respect and this my own opinion I think posting the two along side each other is too much - maybe a link to xyzzy's info incorperated into daisys post for those who then want or feel the need to go deeper for more info when they are ready - I dunno maybe that is the way

 

[noblehead]

''I find it depressing that you concur that physically, intellectually, emotionally ... and poor people may not be able to self manage. That would seem to mean that you accept that state of affairs and are therefore accepting those people will go to an early grave in many cases''.

Poor people are disadvantaged if their gp doesn't prescribe test strips and they have no means of purchasing themselves, it has often been the subject of discussion on the forum and only today we had a member on benefits rejoicing that her gp had prescribed strips for a trial period of 4 weeks, beforehand she couldn't afford them. Food choices become limited on a tight budget also, often the needs of the family over-ride their own food choices.

''I can accept that the statement may be true in some cases and I have just done as much in my reply to Catherine however I am unwilling to just accept that nothing much can be done about it and that's the difference''.

Well we are getting somewhere if you are beginning to accept the statement, there is much that I would like to see changed across the NHS and not just in diabetes health care!

''You did not make it clear if you share a similar view as me that there is loads that could be done about it. If you do great and I'd love to hear your suggestions as I've already stated some of mine''.

I won't say what my views are as I am not an opinionated person and I don't want to bore people, as I said there is much that could be done to improve the health and welfare of patients in the NHS....but I don't see it happening anyday soon.

 

[Defren]

I agree with xyzzy and the others that a simple, straightforward message is best to begin with.

That is why I found the message Daisy1 sends to each newbie to be very, very helpful to me to begin with and I keep referring back to it.

I think, maybe in a few months, I will understand the message xyzzy put up as well. but not just yet.

For me this forum can be a bit like walking into a computer club. I sort of know I need to use a computer, I sort of know a few terms being used, but any debate between members confuses me at that point and makes me want to back away and get overwhelmed. Coping with the initial shock is bad enough, but trying to wade through all the very helpful and pertinent info given is difficult to absorb.

Perhaps there could be a sub-group on the forum for the Not Newbie, but ready to Discuss types?

I am not criticising here. You have all raised the point of what is helpful or not to newbies. And I am giving my own personal view of the forum as I see it at this stage of my diagnosis.

PS I read nobleheads post as an honest appraisal of some of the problems, as a base point of being able to start to help those the medical system is failing. I do not find it depressing, I find straightforward talking refreshing and positive.

Good post Lucy +1.

I want to say at this juncture, I am physically challenged, or put bluntly I am physically disabled. HOWEVER!! That does not make me incapable of managing my diabetes. I will say for people who live alone it may be a challenge, but with supermarkets offering home delivery it need not be. I am lucky that as I can't get out without a load of pallava and the dreaded contraption (wheelchair) I do still have an abundant and daily supply of fresh veg, salad, meat, fish, dairy etc brought home each day as I need it by my daughter. That said, I also keep two freezers full of all the above except salad and dairy. I also have bags of frozen berry's. Frozen is as good as fresh, if getting out and about is a problem. I just feel I have to defend those of us who are physically challenged, as it seems we could be seen as unable to manage our own condition. Even meter's and strips are bought on line, as well as supplements and Ketostix. So there really is no excuse. The only excuse ANY diabetic has, is being given the wrong information in the first place!

 

[jopar]

xyzzy

I think you'll missing the point and a tad bit naive if I may say so!

Simplistic

Making something simplistic doesn't necessary means it's better or easier for somebody..

The DUK and NHS both give a simplistic out line of a dietary needs... They don't actually give information on carb amounts apart from the infamous words of Some can't get more simplistic than that!

Now in my minds eye, Some to me is around 20g to 30g's of carbs within a meal..

For somebody else Some could be 150g of carbs in a meal..

So your again if I'm permitted naive idea that promoting a LCHF diet is the best way to go as being Simplistic Yes the Swedish have gone a step further and put a 'figure' to a carb content...

So is a diabetic following the advice going to be healthy and have good control.. I have my doubts and suspect when the Swed's have been running this advice long enough to get a good indicator of it's merits, you probably find that their isn't a great deal of change in out come..

Because both diets and that of the 5 A day, are being given in Simple format for the majority, and all these 3 diets not only need the individual to understand how 'food' itself works and impacts on us they also need the information tailored to them individually, to ensure which ever one they use it's is balanced in nutrition to maintain their health long term,

As

''Self-management of diabetes is physically, intellectually, emotionally and socially
demanding. Non-engagement with self-management may make sense in the context of low
personal resources (e.g. health literacy, resilience) and overwhelming personal, family and
social circumstances''.

These factors will always impact on individual outcome, however good the advice is being given...

 

[Unbeliever]

Totally agree with Jopar I am very glad that Defren manages so well and I too, have been in a siuation where I might have staved but for the internet but what of those who dont have access to a compoputer or an accepable way of paying for goods bought online

It is not all about food, It is not a single and straightforard issue like smoking. I agree that much could be done about diet for the population as a whole but that wouldnt affect many of the other problems recognised in he study.
Past studies I have read have just assumed that T2 diabees for exaample is restricted to an uneducated unemplloyed sub class living in certain depried areas where fresh food is not readily available. The study in question refers to these aerlier studies but is more detailed and less generalised.

t certain times in our lives the categories may change for us. Often this is outside our own control.. This does not happen to everyone and some lead a charmed life which does not equip them to understand the problems faced by others.
Of course many of us work in areas where we do meet people from different cultural and social bacjkgrounds which creates a more rounded pview of life.
Of course I am not suggesting hat anyone her belongs o the former class but I sometimes wonder about some of the researchers!
The main problem with treaing diabetes is that it is so complex and to some etent MUST be self-managed by the patient perhaps with assistance.

Reducing it to one single issue like lowcarb may succeed in helping some perhaps but most of the problems are too complex to be addressed in this way.

If the governments main advisory body on diabetes {DUK} cannot get its dietary advice right and HCPs are often in conflict with their patients then maybe there is a point in BANGING ON ABOUT IT but then what? Would lowcaerbig be imposed on everyone ? Could the NHS cope with that? What IS lowcarbing> {thatwas rhetorical} So we tell everyoe to reduce their carbs?
Wght does that mean?
Certainly it might be a good idea to get "them " to revise heir dietary advice but II too feel that this is too simplistic.
So many ignore any dietary advice.
The whole subject need lookig at again in depth but how long would that take? So no one single issue , no soundbites therfore no simple solutions. The most effective way is to treat people as individuals and I think this study underlines this .

 

[catherinecherub]

I agree with xyzzy and the others that a simple, straightforward message is best to begin with.

That is why I found the message Daisy1 sends to each newbie to be very, very helpful to me to begin with and I keep referring back to it.

I think, maybe in a few months, I will understand the message xyzzy put up as well. but not just yet.

For me this forum can be a bit like walking into a computer club. I sort of know I need to use a computer, I sort of know a few terms being used, but any debate between members confuses me at that point and makes me want to back away and get overwhelmed. Coping with the initial shock is bad enough, but trying to wade through all the very helpful and pertinent info given is difficult to absorb.

Perhaps there could be a sub-group on the forum for the Not Newbie, but ready to Discuss types?

I am not criticising here. You have all raised the point of what is helpful or not to newbies. And I am giving my own personal view of the forum as I see it at this stage of my diagnosis.

PS I read nobleheads post as an honest appraisal of some of the problems, as a base point of being able to start to help those the medical system is failing. I do not find it depressing, I find straightforward talking refreshing and positive.

Well done Lucy, you have told it like it is for a newbie. :clap: :clap:

The advice that Daisy posts has been compiled for newbies and is a good starting point IMHO. It gives the newly diagnosed a guide to help them understand what needs to be done and if there is anything they don't understand there they can ask questions.
Sometimes a newbie posts and there are several replies about diet including the one from Daisy. It becomes information overload and must be even more bewildering for a newbie. Some of it is too advanced for them to cope with. They have all this information but cannot get their head around it all so are feeling more confused than ever. People are posting how they manage their diabetes and yet they are saying different things so who do they go with? Why does someone say that you cannot eat a.b. and c.? Why does someone say you can eat a. but not b. and c.? Why does someone say that you can eat a.b. and c if your meter agrees? They are now getting confused and rightly so. Welcome the newbie by all means but let them get into gear before they are bombarded with information.
If people think that the information posted by Daisy is not enough then take it up with the Admin. I think it is a good starter for newbies as they can then ask questions from there if they do not understand.

 

[xyzzy]

Even though people on forums are a fairly 'select' group it's worth remembering there will be people with unseen and possibly undisclosed barriers to self management. People don't reveal their all on the internet . People may have restricted incomes. They may have other illnesses, some may have dietary restrictions. They may have an eating disorder, mental illness.They may not know what a carb is nor yet be able to calculate them. We don't know
We are not one standard size.

I have said I accepted that Phoenix but what I won't except is that there is nothing that can't be done for these people. They may not be able to help themselves individually in which case its societies responsibility to help them. If they are for example T2D people who eat a rubbish diet and will not change no matter what then no amount of societies help is going to do much but if they are T2D people eating the 50% carb regime they are recommended to do by an increasingly out of touch state health system then the damage it cause in lives, blindness and lost limbs is on the hands of the people who recommend that diet and its supporters.

I have also never stated that other kinds of diet to the Swedish one I advocate will not work and the continual portrayal of me being an extremist pushing a single viewpoint is getting very tiresome and very see-through by everyone who reads these posts.

I just want that moderate carb diet accepted in this countries guidelines as an option and by this forum. It is not an option in the UK at the moment. I could argue the same thing back at you "We are not one standard size" so why do you always tell everyone continually that a low GI diet is best. Same problem Phoenix. The difference is I have never seen you actively promote the moderate carb one whereas here

http://www.diabetes.co.uk/diabetes-forum/viewtopic.php?f=15&t=28107&hilit=Sarah&start=30

in the last two lines of my post I do recognise everyone is different and recommended your approach.

So come on Phoenix would you recommend the Swedish moderate carbohydrate restricted diet to a diabetic? Would you have recommended it to me as a newly diagnosed T2? I'll wait for your answer with interest. If you did come out with a "yes" then when as your "patient" I come back and say sorry Phoenix the 30% Swedish diet still spikes me too high as its equating to around 160g on a 2000 calorie a day diet would you then say "Try dropping to 130g / day" like the ADA in the States suggest. Waiting again Phoenix...

In th UK in spite of what is promoted three quarters of the people aren't eating 5 portions of fruit and veg . Consumption is affected by income with "consumption associated with higher income, and vice versa" 32 per cent of men and 37 per cent of women in the best off households ate 5 or more but only 18 per cent of men and 19 per cent of women in the lowest quintile did so.”
People eat more saturated fat than recommended. They may eat nearly fifty percent of their diet as carbohydrate (48%) but 46% of those carbs are sugar!(29% of the carbs come in the form of added sugar .. technically from non milk extrinsic sugars ie not from milk or from within the plant cell. )

Again a plain baffle us with science approach.

All that you say may be true and whatever state sponsored diet is in place there will always be those who ignore it. Lets for sake of argument call that a 50 / 50 split (no idea what that split is) so in that scenario no matter what diet is recommended 50% are going be unaffected by any recommendation.

For the 50% left who are told if you get T2 then it **** well makes one hell of a difference if you find out the state encouraged diet kills you and that if you adopted another diet it would save your life. That happened to me Phoenix and a lot of other T2's on this forum and that's what you and the others wont ever admit.

On the 50% that wont change then you still don't give up. You fight for every **** last one of them even if they don't realise you're doing them a favour. You do it through interventionist policies by promoting good diets, making it financially attractive to swap to a good diet all those kind of things. You don't just throw your hands up and go "woe is me" I can't help them. That is self defeatist rubbish. In fact not fighting tooth and nail for every individual is tantamount to saying those people aren't worth saving, sounds like eugenics to me.

The Swedish diet guidelines , rightly in my opinion , don't suggest the impostion of any particular diet

Good we agree on something as that's what I say here http://www.diabetes.co.uk/diabetes-forum/viewtopic.php?f=2&t=28402 when I explain my position.

Changing as little as possible is often successful in counseling about diets. In simple terms, the existing diet often become more like any of the diets that may be helpful in diabetes without the patient fully must abandon their previous eating habit.......

So as a T1.5 yourself and as say a newly diagnosed T1 you would not recommend changing your current diet quickly if they were on a rubbish diet? Are we T2's less important to you somehow? Tell us the truth about our condition and see how many of us WANT to change our diets pretty **** quickly! That argument is nothing less than the equivalent of don't give T2's test strips as it sends them mad. Didn't send you as LADA mad did it?

One said' Many people' told the association that they were rarely called to see a doctor and never saw a nurse or dietitian.Several said they do not get any blood glucose meter, but only one value during the visit. (and indeed they have been fighting for strips for T2)

But yet they have implemented some changes Phoenix and continue to do so. Just because they aren't perfect doesn't make them more legitimate than the NHS view here does it.

I will restate what the doc says is a good diet for a diabetic. It has no numbers, no carbs, but specifically states it is different from a normal diabetic diet.

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.

 

[Defren]

Totally agree with Jopar I am very glad that Defren manages so well and I too, have been in a siuation where I might have staved but for the internet but what of those who dont have access to a compoputer or an accepable way of paying for goods bought online.

Good point, and a true one. I was more thinking that physically challenged were looked upon as incapable, where when they have the 'tools' there is no need to be. Apologies.