Twitter threads on why most GP's won't suggest low carb

[hankjam]

I agree. I have argued with another t2 at work several times now. He eats crisps fruit bread. Hell anything he likes. Tests his blood from time to time but according to him. Anything upto around 12 is fine, you need a bit of sugar to function. He has his met and that's him happy.
Unfortunately he suffers very little from any high sugar problems at the moment and his 1c is down 15points . Stii high 50s.

These are the people that make it hard for us.

Probably a matter of time..... sadly

 

[hankjam]

Not really a techie but OP could persuade me to go on Twitter.... would have to change my phone though... it's a brick.

 

[ickihun]

I ended up on betablockers for fast heartbeat on lchf but low carb, low protein, low fat, low caffeine and low artifical sugar works much better for me.
No fruit, no cheese and no nuts aids weight loss and lower bgs on high doses of background insulin for hormones from stress.

 

[HSSS]

Because they have their preference not too, currently.

Oh ok they don’t want to do things differently. That’s all ok then, no need to hope for progress

 

[bulkbiker]

I ended up on betablockers for fast heartbeat on lchf but low carb, low protein, low fat, low caffeine and low artifical sugar works much better for me.
No fruit, no cheese and no nuts aids weight loss and lower bgs on high doses of background insulin for hormones from stress.

Sounds pretty much like fasting...? Have any of your HCP's thought of that?

 

[HSSS]

I ended up on betablockers for fast heartbeat on lchf but low carb, low protein, low fat, low caffeine and low artifical sugar works much better for me.
No fruit, no cheese and no nuts aids weight loss and lower bgs on high doses of background insulin for hormones from stress.

Would you not agree that yours is not the typical or usual case and as such needs much more individualised plans than most? Policy has to be built around more usual presentations then have enough in built flexibility to cater for a minority that don’t fit within that.

 

[DCUKMod]

I get temperatures due to other medical conditions and paracetamol or ibuprofen isn't paid for by gp as cheaper if sourced myself.
So are meters and test strips.
Have those who struggle to pay for meter and strips tried for dwp PIP payments? They help workers pay for medical supplies.

The GP doesn't do everything nor know whether you'll be granted help. GP isn't Google.

I find this forum great for loads of things but it doesn't prescribe meds or order blood tests. I'd expect my diabetes team to do that.

Ickihun, I cannot think for a millisecond anyone struggling to pay for their meter and strips would qualify for PIP, on that basis. If I think what I understand the process to be, the potential claimant would fill in a form, then ask their GP to sign it off, then send it off. If the GP doesn't have to sign it before it goes off, they have to agree it at some stage?

I don't see a GP getting involved in this at all. If the GP thought testing was necessary, he/she'd prescribe the required supplies. If they don't believe the person needs to test, I can't see how he/she could possibly support and application for benefits, to supposedly pay for it.

If I'm way off on my vision of the application process, I apologise. I'm fortunate never to have made any such application.

Edited to correct a typo and clarify my opening statement regarding PIP qualification.

 

[librarising]

I think this is the kind of stuff that scares them, not hypos per se
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5669378/

"Multiple studies demonstrate that T1DM patients experience an average of 0.5 to 5 severe hypoglycemic events every year"
I've been on insulin (Novorapid/Levemir) for 2 1/2 years. I've never had a severe hypoglycemic event. I've read about them on this forum, but never experienced something I've needed to recover from, or which has affected me for hours/the rest of the day.
Are they down the line ?
Is it being LADA that helps ?
Currently I credit low carbing.
Geoff

 

[KK123]

I agree. I have argued with another t2 at work several times now. He eats crisps fruit bread. Hell anything he likes. Tests his blood from time to time but according to him. Anything upto around 12 is fine, you need a bit of sugar to function. He has his met and that's him happy.
Unfortunately he suffers very little from any high sugar problems at the moment and his 1c is down 15points . Stii high 50s.

These are the people that make it hard for us.

I would say fortunately he suffers very little from high sugar issues rather than unfortunately, that's a good thing and long may it continue. In my opinion there is no need to argue with him at all, that is HIS choice to make, I don't see how that makes it harder for anyone else. If he refuses to eat well for his condition, well, so be it. Maybe you can ask him why he thinks anything up to 12 is ok?, is that (bad) advice from his Dr?

 

[rosco 2]

At the risk of boring you all, may I tell you a story about vested interest?
Ok, think mid 90s. I regularly attended a monthly senior hospital meeting as the senior nurse in community (the head of dept was very nurse friendly). New drug - viagra - was causing concern to budget bunnies as it £7 per pill and we are sexual health. Discussion by medic colleagues who can see our budget being gobbled by demand for this drug. The prof calmed everyone, we have time to work out the money, after all NICE takes at least 18months to agree a drug can be prescribed.
I sat there considering whether to be polite...but decided truth was best. I pointed out that NICE was largely composed of older guys whose willies probably didn’t work so well and that I thought this drug would be okayed pretty fast due to vested interest. The docs largely just laughed. Viagra was added to menu 3 months later. The prof emailed me to congratulate!

 

[Guzzler]

I think the tweeter has it spot on, Dr's/Consultants ARE scared of hypo's. So scared in fact, that they would rather we all ended up with complications caused by hyper's. There is one easy way to minimise the risk of hypo's though, give us all a Libre. There you go, problem solved, now they can give out advice that works, ie eat fewer carbs.

Aye, and then target blame for huge costs to the NHS for treatment of said complications due to their fears. It makes absolutely no sense. Prevention is better (and cheaper) than cure.

 

[HSSS]

At the risk of boring you all, may I tell you a story about vested interest?
Ok, think mid 90s. I regularly attended a monthly senior hospital meeting as the senior nurse in community (the head of dept was very nurse friendly). New drug - viagra - was causing concern to budget bunnies as it £7 per pill and we are sexual health. Discussion by medic colleagues who can see our budget being gobbled by demand for this drug. The prof calmed everyone, we have time to work out the money, after all NICE takes at least 18months to agree a drug can be prescribed.
I sat there considering whether to be polite...but decided truth was best. I pointed out that NICE was largely composed of older guys whose willies probably didn’t work so well and that I thought this drug would be okayed pretty fast due to vested interest. The docs largely just laughed. Viagra was added to menu 3 months later. The prof emailed me to congratulate!

So we need NICE and the cabinet deciding funding issues to be comprised of diabetics? I’m sure any health affected demographic wishes the same, but sadly not even all diabetics care that as the above case told by spl@ shows and the diabetic pm doesn’t seem to be pushing the case as she’s a little busy trying to hold a disintegrating government together.

 

[rosco 2]

Health promotion was always the gold standard from our NHS perspective. Funding was often largely lip service and there is always the ‘horse to water’ issues. More recently public health and the budget was moved from NHS to local authority but no ring fencing!! So if your borough prefers to spend the public health / promotion ££ on potholes or street lighting you can’t do a thing about it other than ask difficult QQs at council meetings.

 

[HSSS]

Aye, and then target blame for huge costs to the NHS for treatment of said complications due to their fears. It makes absolutely no sense. Prevention is better (and cheaper) than cure.

I don’t think budgets take account of long term complication, just the cost of short term prevention. I’m curious what testing kits, for example, cost verses the first line meds eg metformin and other non insulin drugs

 

[Jaylee]

"Multiple studies demonstrate that T1DM patients experience an average of 0.5 to 5 severe hypoglycemic events every year"
I've been on insulin (Novorapid/Levemir) for 2 1/2 years. I've never had a severe hypoglycemic event. I've read about them on this forum, but never experienced something I've needed to recover from, or which has affected me for hours/the rest of the day.
Are they down the line ?
Is it being LADA that helps ?
Currently I credit low carbing.
Geoff

Hi Geoff,

Hmmm. "Down the line." If it's any consolation from me...?

I've been diabetic for just over 42 years now. (Diagnosed on my 8th birthday.) & never needed 3rd party assistance with treating. Apart from an episode on the old animal stuff when I was about ten years old, when I had to fight convulsions (oddly, just in the legs.) to find the kitchen & get some "scram" down my own neck. Still managed only just to self treat. (Since then, I don't leave home without something in my pocket.)
I personally can treat & keep going.. But it's the luck of the draw on how lows affect an individual. (Metabolism.)

Though, I wouldn't disagree lower bolusing for a lower carb count on MDI would minimise the severity in comparison to a higher bolus to carb.
It's all pending on timing of the bolus coupled with the type of carbs ingested. The working profile of novorapid (on "paper") doesn't always work in "harmony" with certain carbs & fats slowing the digestion. Or even speeding up & causing a large spike before it settles...

When I was a kid? The answer was. (From D HCPs at the time.) "Eat a snack to counteract the low mid morning or afternoon." One can only eat so much.

 

[Spl@]

I would say fortunately he suffers very little from high sugar issues rather than unfortunately, that's a good thing and long may it continue. In my opinion there is no need to argue with him at all, that is HIS choice to make, I don't see how that makes it harder for anyone else. If he refuses to eat well for his condition, well, so be it. Maybe you can ask him why he thinks anything up to 12 is ok?, is that (bad) advice from his Dr?

The argument comes from him telling Me I am wasting my time and should tell my doc to give me meds.
Believe me I DO know my bg is up. I feel like Parc (anagram) when I eat more than 70 to 80 g

 

[Guzzler]

I don’t think budgets take account of long term complication, just the cost of short term prevention. I’m curious what testing kits, for example, cost verses the first line meds eg metformin and other non insulin drugs

As far as I remember, Metformin is as cheap as chips (no pun intended) I have no idea about the costs of stronger meds/insulin but I do know that the cost I bear for strips are worth every penny to me and as a knock on effect has lowered the bill for my personal cost to the NHS. However, there are now approaching 4 million people with Diabetes in UK so a funding source would (I'm sure) be needed perhaps separate from NHS general funding to enable every T2 to be prescribed monitors and rep scripts for strips. This money would (alongside education) be recouped in better patient health outcomes long term but the way society now views T2 would mean that any government proposing such extra funding through taxation would become very unpopular very quickly.

 

[Ian_Laye]

Just think how NHS services would improve if the reported £1bn spend on diabetic medication plus the costs of amputations etc were drastically reduced by the adoption by NICE of the LCHF diet for type 2 diabetics. But obviously the drug companies who fund a most of the research have a £1bn vested interest in keeping the guidelines as they are.

 

[Bluetit1802]

As far as I remember, Metformin is as cheap as chips (no pun intended) I have no idea about the costs of stronger meds/insulin but I do know that the cost I bear for strips are worth every penny to me and as a knock on effect has lowered the bill for my personal cost to the NHS. However, there are now approaching 4 million people with Diabetes in UK so a funding source would (I'm sure) be needed perhaps separate from NHS general funding to enable every T2 to be prescribed monitors and rep scripts for strips. This money would (alongside education) be recouped in better patient health outcomes long term but the way society now views T2 would mean that any government proposing such extra funding through taxation would become very unpopular very quickly.

In the "old days" meters and strips were given to all T2s. Apparently, according to my knowledgeable nurse who has been there a long time, the vast, vast majority did not use them properly, or not at all. Probably because they nhadn't been shown how to use them to test out meals. Most likely told to take a fasting and/or after dinner reading. As this taught nthem nothing, they ndidn't work. In fact, when I told my nurse about testing before and after meals to test it out she had never heard of this method of testing. She was impressed. There are some folk on here that have reported having been given meters in the dim and distant past.

Please excuse typos and spelling. Am on holiday using ancient tablet with tiny, tiny keys!!

 

[Guzzler]

In the "old days" meters and strips were given to all T2s. Apparently, according to my knowledgeable nurse who has been there a long time, the vast, vast majority did not use them properly, or not at all. Probably because they nhadn't been shown how to use them to test out meals. Most likely told to take a fasting and/or after dinner reading. As this taught nthem nothing, they ndidn't work. In fact, when I told my nurse about testing before and after meals to test it out she had never heard of this method of testing. She was impressed. There are some folk on here that have reported having been given meters in the dim and distant past.

Please excuse typos and spelling. Am on holiday using ancient tablet with tiny, tiny keys!!

Aye, it is the same type of thing as when my son asked me if I wanted one of those Alexa things. Very handy for busy people but I declined because I knew I would not have the patience to learn how to use it to its full worth so it would end up in a drawer or being an expensive ornament. Poor analogy, I know but this was the reason it took me a few weeks to order a glucometer and start testing.