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This just proves it all

Discussion in 'Type 2 Diabetes' started by sdgray22, Feb 14, 2012.

  1. borofergie

    borofergie Type 2 · Well-Known Member

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    How so? We are specifically talking about T2 Diabetics on diet and/or metformin here (and not insulin controlled diabetics who have, I think, better support, and more options).

    Do you know of any successful T2 diabetics that achieve good results without some sort of carb-management?

    Certainly in this thread me, Grazer, Catherine, Daibell, Sid, xyzzy, Dillenger, and Unbeliever (to name just a few) agree. Between us we represent the full spectrum of "carb opinion", but all of us agree that it comes down to carbohydrates in the end. Do you have an alternative solution?

    [By the way - you used the "low-carb" word. I deliberately chose not to, because it is unnecessarily divisive]..
     
  2. Pneu

    Pneu · Well-Known Member

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    borofergie.. lets clarify I am in total agreement that carbohydrate management is imperative irrespective of your type of diabetes. That does not however mean that 'low carb' i.e. sub 75g is the only way to achieve good control.

    What needs to be done is greater access to information.. reducing carbohydrate is one measure, increasing medication another... more exercise a third... I know from my own experience that an increase in exercise dramatically reduces the need for insulin and increases the amount of carbohydrate that I can consume by some margin.

    Control is about achieving a life balance between these all elements that the individual is happy with..

    In essence most people in this thread are in agreement... just approaching the discussion from different perspectives.

    [Edit - So yes we were saying the same thing... better access to information... an ability for individuals to find there own balance... and an acceptance that different individual will have a different balance between carbs, medication and exercise.... what should not be promoted is the current one - size fits all policy]
     
  3. borofergie

    borofergie Type 2 · Well-Known Member

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    Then with respect, I never suggested any carbohydrate amount (I don't think there is one) nor did I call it "low-carb".
    I most certainly do not think that "sub 75g is the only way to achieve good control" nor has anyone else in this thread suggested it. In fact I went out of my way to suggest that there are lots of potential approaches.

    This is a great thread, and as others have noted, we're all close to agreeing on something. It's important that this whole thing isn't derailed by the constant injection of "carb-politics".
     
  4. Pneu

    Pneu · Well-Known Member

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    I am agreeing with you man!

    If you go back a couple of pages then you will see the discussion where the phase 'low carb' is specifically used in relation to dietary guidance.. that is what my comments were in relation to..

    Reference carb politics there is a reason I stopped frequenting the low-carb forum... :wink:
     
  5. xyzzy

    xyzzy Other · Well-Known Member

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    well noblehead lets try to start our relationship again shall we :)

    I agree that everyone has a view on what's right and wrong in the NHS and that mine or your view is no more valid than each others.

    but I respectfully suggest you are missing the point of my argument.

    My argument is about the accountability of HCP's. It is why I suggested in my initial post that I would like to see equal weighting to a thread critical to HCP care as one that shows positive things about HCP care. I honestly believe that if HCP's could come to this site and see in one thread what people complained about it would make them more accountable to their patients.

    It is also why I have been pressing the HCP's who have read this thread to comment on the two examples I provided. In my mind I specifically picked them because in my opinion the HCP's should have been held to account and the two examples had nothing to do with budgets etc. I don't even mind if you treat the two cases as hypothetical cases but I do believe that people in any arena should be held to account and who better to do it than their peers?

    That is the sum total of what I am asking for.

    ...oh and that low to moderate carbing should become the standard practice advice for Type 2's. If you have read any of my posts to new members I always offer a low to moderate level of carb advice based on what I believe to be the latest validated research.

    Please do not let us fall out over this. I recognise I am a pretty blunt speaker but that is the way I am. I find it gets things done :)
     
  6. borofergie

    borofergie Type 2 · Well-Known Member

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    Then you can have a big hairy "carb-managed" kiss.
     
  7. Dillinger

    Dillinger Type 1 · Well-Known Member

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    MODS!!!! THIS IS GETTING OUT OF HAND... :? :shock: :lol:

    Dillinger
     
  8. Unbeliever

    Unbeliever · Well-Known Member

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    I agree hat it is ot all about diet and that HCPs cannot really recommend one die more tha another in any event as we all know that each of us has to find our own way.

    When I was first diagnosed I was underweight and had always been so. I had followed a GI diet for years but it was obviously no longer enough.
    That Practice had a doctor with special responsibility for diabetes, He actually mentioned the GI diet o me but when I told him I already used it he had no further suggesion to make. except to comment that it was going to be difficult to ensure that I had enough to eat. I didnt understand that at the time but it is now obvitous to me that this was a reference to carbs.
    That doctor obviously knew a great deal about diabetes but did not believe that patients should be made privy to his knowledge.

    At that time and again now here appears to be a definite movement agains patients trying to take responsibility for the management of their own diabetes,. This is strange in a period where resources are limited and Drs think they are overworked. Surely it would make sense to give patients the tools and information to help themselves?

    I do not think the NHS should recommend any particular diet but just tell patients how others cope with the condition.
    What could be the harm in telling people about the GI diet , reducing portion size and reducing carbs? They could be told that these measures or a combination of them can help to control the condition but warned not to do any of these things to excess
    and not all together immediately but to take thngs slowly and see what works for them ,as this condition is for life?

    I know what would be wrong with that approach. It would not tick all the right boxes in the right order. Heaven forefend that diabetics should be reated as individuals.!

    That is the real problem. This is a complicated disease and probably, in many cases an umbrella term for many different conditions and disorders, Until this is recognised and admitted by the NHS I don't suppose things will or can improve.

    Catherine was quite correct in her comments about T2s having been older people until quite recently and I am sure this fact is at the root of many of the current problems. The enormous rise in the numbers being diagnosed brings many problems but it will also force many improvements also. In tthe meantime we are stuck with all sorts of anomalies and it would be good if we could find a "Voice"

    I think it is a great pity that these discussions have to become personal whe we are all basically on the same side. We can surely disagree without personal abuse. We need people to be able to state their opinions even if those opinions are not popular. Makes for a more interesting discussion. for one thing.
    It is a great piy when anyone feels offended or personally attacked.

    I am paricularly referring to catherinecherub and noblehead here. Both have been stalwarts of tthis forum for a long time and many posters including myself owe them a great deal. Surely we can all respect each other and discuss things civilly?
     
  9. viviennem

    viviennem Type 2 · Well-Known Member

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    I agree with you, Unbeliever, and have edited my post on page 3 in the hope of removing any patronising tone.

    I have also apologised to Catherinecherub, by PM, for any offence caused, which was certainly not my intention.

    Viv 8)
     
  10. noblehead

    noblehead Type 1 · Guru
    Retired Moderator

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  11. Grazer

    Grazer · Well-Known Member

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    Can't seem to "quote" sections on this stupid iPhone but +1 on Borofergie- NO ONE was talking about ULC. Merely the wish for HCPs to understand the effects of carbs the way we do. Not hard. And I also agree that NO T2s on diet/met can achieve good BGs without carb control. I'm lucky to handle a strict diet of 150 grams of carbs made up with shredded wheat and hobnobs (joking!) but others eat less. No big deal. That's the message to HCPs. Let each find their own level but show them how.
     
  12. xyzzy

    xyzzy Other · Well-Known Member

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    This maybe a really stupid question and completely off topic but is there any real evidence for an epidemic of Type 2 or is it just that nowadays it is tested for and found? Maybe 20, 30, 40 , 50 years ago people were Type 2 but remained largely undiagnosed.

    The link between smoking and cancer always existed but the statistics would only show people beginning to die of smoking related diseases once it had been accepted that smoking caused them.

    My instinctive belief is to say that Type 2 rates have risen dramatically over the last 10 years or so and that therefore something has caused that to happen. What causes / caused should imo be the focus of research and not necessarily a hunt for a cure. Prevention is always better.
     
  13. sdgray22

    sdgray22 · Well-Known Member

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    Well my type 2 is probably because I ate enough chocolate in the last few years to keep a few Cadbury employees in work!! Nobody has tested my blood sugar in years and so I did not know I was prediabetic at any time and just kept eating. I am sure that had somebody bothered to test (and I have high BP so am in a risk group and have blood tests each year beause of it - just no sugar test added to the list of tests)I may have avoided it, and I would imagine with our junk diet a lot more are in the same position and are just reaping the consequences.
    I think it is a bad diet of processed foods and junk food full of sugar fat and salt. How many of us in the past cooked our food from scratch and did not buy burgers, fish and chips ,cottage pies , curries and shop sandwiches etc, eat cakes pies pastries and chocolate? just think 50 years ago we were only just out of rationing, nutritionally balanced diets were the norm then junk food arrived!! As for undiagnosed in previous years, up to 20 years ago women at their well women clinics, as far as I know had a three yearly urine test which would show high sugar up (OK I know pretty high) but it was done, not now though. So a high proportion of women had tests in those days.
    Sharon
     
  14. Dillinger

    Dillinger Type 1 · Well-Known Member

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    My understanding is that that is correct- I don't have the figures though; I'm sure they're available via a quick google.

    One view (see Gary Taubes - Why We Get Fat) is that the low fat diet 'world view' that developed from around 1980 means people have increased their carbohydrate consumption, and in particular high fructose corn syrup consumption (in the US at least), which has lead to a sort of hyper-insulin epidemic; which means more Type 2 diabetes and other metabolic syndromes expressing themselves. That is somewhat controversial but I find it makes absolute sense.

    Dillinger
     
  15. xyzzy

    xyzzy Other · Well-Known Member

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    That's an interesting theory Dillinger. There is obviously some genetic component going on as well imo. For example in my immediate family (wife, me, 3 sons, 1 daughter). Eldest son is Type 1, second son and wife are only slightly overweight official pre diabetic Type 2's (both now "really" low carb < 120g / day to stop their progression), daughter has IBS but rock solid BG's, youngest son seems ok so far but has slightly raised BG's. Me medium overweight but never obese Type 2.

    We would consider ourselves to have eaten healthily since the 1980's, cooked from fresh food for 99% of all meals, sweets and chocolate were a once a week treat for us and the kids, never had puddings except as treats, only occasional junk food or takeaway consumers, 5 a day followers BUT our meals were probably biased towards the starchy carb end. If we had a problem I would describe it as a quantity not quality of food problem. We bought low fat where ever possible, sunflower marg etc, you get the type.

    In my extended family my nephew is LADA Type 1 (diagnosed in his 40's) as was my grandfather (as I might be for all I know if I could persuade them to do the c-peptide test / GAD test). On my wife's side her sister and brother are both Type 2 as was her father.

    My point being is that there must be 000's of similar families out there who ate or eat a roughly similar diet yet they haven't been blighted by diabetes so the extent we have. So maybe its a genetic predisposition + high carbs (or something else).
     
  16. phoenix

    phoenix Type 1 · Expert

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    But does it apply to the UK?
    The high fructose glucose syrup hypothesis doesn't work outside the US (certainly not in the EU where there is a cap on the amount that can be used )
    see: The Australian Paradox: A Substantial Decline in Sugars Intake over the Same Timeframe that Overweight and Obesity Have Increased
    http://www.mdpi.com/2072-6643/3/4/491/

    In the UK it is the proportion of fat, rather than carbohydrates that has risen.In the 1940s each kJ of carbohydrate in the diet was associated with 0 6 kJ of fat and in the 1990s with 0.9 kJ of fat, an increase of 50%
    http://www.ncbi.nlm.nih.gov/pmc/article ... 5-0041.pdf
    And does it apply to the US?


    see graph towards end of article (actually read article, detailed and informed criitique of the carbohydrate hypothesis.
    http://wholehealthsource.blogspot.com/2 ... besity.htm
    edit: to add missed link
     
  17. Eilean13

    Eilean13 Type 2 · Active Member

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    Having followed this thread I'm not sure if my twopennorth is related but here goes... I went on a Desmond course last week, which was ok but, I felt, quite limited in the information supplied in a beautiful plastic binder to take away. One of the ice breakers was to say what caused T2. The two specialist facilitators concluded it was due to obesity. That might be their simplistic opinion.

    The focus was largely on sugar intake with respect to dietary guidelines with another exercise being to estimate how many sugar cubes were in certain types of food. Quite interesting if that's what rocks your boat. There was mention about needing to control portion sizes but no guidance given. A handful of something obviously differs if you have hands like mine which are as big as shovels! There was mention made of the need to eat a good level of starchy carbs, nothing said about managing quantities of carbs or guidelines as to how much was a good level.

    The two very pleasant nurses who led the day were allegedly up to date with the latest information, we were told, so I just give up.

    One good thing was that I was given the results of my initial Hba test and on the sheet my cholesterol level was low 4's so I feel quite justified in having refused the statins, for now.

    Not sure if the course was a good thing or a bad thing. I had to laugh when one rather generously sized gentleman said his DSN had told him if he wanted to each a cream cake it was okay as it would stop him craving them ..........

    Diane
     
  18. xyzzy

    xyzzy Other · Well-Known Member

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    That's very interesting Phoenix. The link between activity (rather than what people eat) and obesity seems to be pretty key as is the link between social class and obesity and TV viewing hours and obesity!.

    I'll agree we weren't the most active of families despite eating ok!

    To me the key mystery looked to be the social class / obesity link as I can't believe that the rich are that much more active than the poor. Granted they may do different things apart from watch TV but are they that much more active that it would make all the difference? Which leads you back to diet but as the links point out the problem exists across different society's with different carb / fat balances.
     
  19. borofergie

    borofergie Type 2 · Well-Known Member

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    Not disagreeing with either of you, but I think you are lumping in Robert Lustig (the anti-high-fructose-corn-syrup-guy) with Gary Taubes (the-carbs-make-you-fat guy).

    I think that, while Taubes appears to agree with Lustig on HFCS (http://www.nytimes.com/2011/04/17/magaz ... wanted=all), it isn't part of his core argument in "Why We Get Fat".
     
  20. xyzzy

    xyzzy Other · Well-Known Member

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    Just biting my tongue today Eilean13 :silent:
     
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