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Venting: diabetes education session

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Kernowal

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I had my local online T2 diabetes education session this morning. The two key messages were:

1) Eat whatever you like as long as it fits the half veg, quarter protein, quarter wholegrain profile.
2) Use Slimfast or the NHS meal replacement shakes programme for 20 weeks, then carry on with a low fat low cal diet.

The first approach, which is pushed by the NHS pre-diabetes Healthier You programme doesn't work, as evidenced by the number of people in the group who had moved from Healthier You into full blown diabetes over the last 18 months.

When asked which of a low carb, 5:2, low fat or low cal diet was best to put diabetes into remission, the dietician said none of the above, just eat using the diet plate.

Has anyone else found these sessions frustrating or is it only me? I may have been more grumpy as my local NHS only runs them during working hours on Tuesdays, so I had to take a day as holiday to attend.
 
Kernowal said:
I had my local online T2 diabetes education session this morning. The two key messages were:

1) Eat whatever you like as long as it fits the half veg, quarter protein, quarter wholegrain profile.
2) Use Slimfast or the NHS meal replacement shakes programme for 20 weeks, then carry on with a low fat low cal diet.

The first approach, which is pushed by the NHS pre-diabetes Healthier You programme doesn't work, as evidenced by the number of people in the group who had moved from Healthier You into full blown diabetes over the last 18 months.

When asked which of a low carb, 5:2, low fat or low cal diet was best to put diabetes into remission, the dietician said none of the above, just eat using the diet plate.

Has anyone else found these sessions frustrating or is it only me? I may have been more grumpy as my local NHS only runs them during working hours on Tuesdays, so I had to take a day as holiday to attend.
Click to expand...

You are definitely not alone. My local course, can’t remember the name pushed the Eatwell plate too, maybe ok for non diabetics but too high carb for us type 2s. I did the follow up course the following year to see if the advice had changed, but no it hadn’t. I eat low carb and GP and diabetes nurse think my results are great but don’t openly advise low carb. I’m glad you’ve found this forum!

Edit for typo
 
I believe that some time in the future these times, where those with blood glucose dysregulation are being told to eat wholegrains and quarter plates of carbs by governmental authorities, will be looked back on with horror and maybe even some humour - like we see now doctors smoking cigarettes during consultations back in the day. It really happened, it's horrifiying, you have to laugh? Although of course it isn't really funny.
 
The person giving the course info is probably in most cases not a diabetic. The GP who recommends it to you is also probably not diabetic. The bean counters in the back office that organise the funding for this venture are likewise not experiencing the joys of metabolic disregulation. Just smile sweetly and exit stage left. Do what works for you.

Just remember that most of their clients are either insulin users, or are well on the progression to insulin as proven by previous experience of this condition (evidence based).
 
Read through the booklets my mother received, a US hospital. It was actually not bad as they recommended lower carb.

I was diagnosed in Singapore, recommended to see a nutritionist, I declined and ended up here.

My doc says like 1 out a 100 actually stick with their plan. Wondering if that influences their care level.
 
Oldvatr said:
The person giving the course info is probably in most cases not a diabetic. The GP who recommends it to you is also probably not diabetic. The bean counters in the back office that organise the funding for this venture are likewise not experiencing the joys of metabolic disregulation.
Click to expand...
Male gynaecologists don't experience gynae problems but that doesn't mean they don't know what they are talking about.
Not experiencing a medical issue is no excuse for prescribing something that doesn't work.
However, as is often said, we are all different: our diabetes behaves differently, our lifestyles are different, we have different health issues, ... I believe the message should be to find the approach that works for you, your body, your life.
 
Kernowal, I feel your pain. Infuriating waste of time, and to have to take time off work as well! Thank goodness we know better, and have so much information from this forum.
 
If feel your frustration.
I've friends that are T2 for years, eating healthy Wheetabix or Shredded Wheat for breakfast as advised by their dietitian.
Proud of themselves for switching to brown rice & wholegrain breads.
But anyway, the Met & Glic is doing the trick & their A1cs are around 7.0% so their doctor is happy.
I'm the crackpot for suggesting rashers & eggs for breakfast.
 
Have you got a meter to measure your blood glucose levels ? I fully recommend that you test your blood glucose levels before a meal and then 2 hours after ,that way you can see what effect what you have eaten affects your blood glucose levels
Carol
 
Kernowal said:
I had my local online T2 diabetes education session this morning. The two key messages were:

1) Eat whatever you like as long as it fits the half veg, quarter protein, quarter wholegrain profile.
2) Use Slimfast or the NHS meal replacement shakes programme for 20 weeks, then carry on with a low fat low cal diet.

The first approach, which is pushed by the NHS pre-diabetes Healthier You programme doesn't work, as evidenced by the number of people in the group who had moved from Healthier You into full blown diabetes over the last 18 months.

When asked which of a low carb, 5:2, low fat or low cal diet was best to put diabetes into remission, the dietician said none of the above, just eat using the diet plate.

Has anyone else found these sessions frustrating or is it only me? I may have been more grumpy as my local NHS only runs them during working hours on Tuesdays, so I had to take a day as holiday to attend.
Click to expand...
The plan you are on is the ******* child of the Newcastle Diet from Prof Roy Taylor at al. The only vestige of that original work is the use of meal replacement shakes, but ND only did 8 weeks of meal replacement with supplemented veggies, BUT the NHS using 20 weeks instead shows it does not work. Even ND is now revamped to do 2 cycles of 8 weeks within 6 months since that may work better, The original ND plan was only something like 46% effective initially but drifted away from that after the plan ended.
 
My course was much the same. Fortunately there was a dietitian who was very pro-low carb, but he was working alongside a diabetic nurse (not best informed, had not heard of dawn phenomenon) who pushed the "Eatwell" plate constantly. The two simply contradicted each other - "you have to base all your meals around starchy carbohydrate" versus "carbs are totally inessential and too many will make your T2 worse".

I was pre-warned via these forums, so was OK, apart from the arguments with the nurse: but at least three quarters of the class were hopelessly confused. I understand that the NHS target is to run the courses, not to achieve any change as a result.
 
This situation has been the case for many, many years. I find it incredible that we have so-called professionals recommending diets for diabetes that can lead to amputations, organ failure and early death. I have always advised on this forum to avoid dieticians, nutritionists and similar as they don't do their own research but mostly just profer this nonsense such as the Eatwell Plate. It's a disgrace that the NHS goes along with it. All we can do is try to make the facts available to as many as we can on this forum.
 
Kernowal said:
Thank you all. Nice to know it's not just me. I went to Wagamama for lunch, low carbing without eating a noodle!
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Glad you went in armed with some knowledge ! Sorry that you wasted a day of your life for the wrong message.
I run a low carb course over 8 weeks and think the biggest success tactic we've had is getting people to check their blood glucose ideally via a Free Style Libre (Abbott) sensor which we were able to give some free supplies of as it really brought home the fact that the low carb approach does work. It is nice to be able to offer some weekly support because it can be tricky to unlearn the low fat/healthy carbs lessons that have been learnt and there are lots of complications (gallstones, stressful carb munching partners and lactose intolerance , eating out, holidays) that need ongoing support.
The Diabetic 'Educators' you met can only get an NHS contract by pushing the low gi, low fat Eatwell Plate nonsense or the clinically approved 800 kcal shakes option so it isn't their fault. I also very much doubt their results get evaluated much in terms of the efficacy of their advice which is why we keep going with a failed approach and frustrated patients who need more help than is being offered currently.
The bean counters will tick off that stat on their 'dashboard' re numbers o f patients referred to and attended the education course.
If you feel strongly enough then I'd suggest checking out the Public Health Collaboration to see if they have an ambassador in your area and might run a low carb/real food course in your area.
https://phcuk.org/ambassadors/
 
The GI index is irrelevant, it's still carbs and will spike your blood, but slower.
 
The same food can have different effects on different people or at different times of day.
But having said that, if you want a guesstimate then just look up the net carbohydrates pre 100gm.
I completely avoid anything that exceeds 15gms carbs per 100gms (except for spices etc which are only used in very small quantities). I restrict those between 15 and 10gms per 100gms (which for me includes Lindt 85%cocoa chocolate at 14gms) and I slightly limit those between 5gms and 10gms per 100gms. Under 5gms per 100gms I don't restrict, I just actively try to eat more of those that are around zero carbs.

But the way to do it properly is to be fasted, test your BG with a glucometer, eat a set amount of a carb containing food in a way that you normally would, then test again 2hrs afterward to see if the BG has spiked more than 2mmol at that stage. If it has look at eating smaller portions, or swapping the for something with lower carbs.
This takes time and most tend to do it one meal at a time, but frankly if you like eggs you can skip testing for breakfast since you can just eat any style of egg (but no bread, or juice). Likewise eat as much meat, fish or cheese as you like for breakfast.
 
I loosely gave up on the gi index. I cannot eat strawberries at all or apples, berries or cashew nuts. With tomatoes I have one slice on a homemade burger and can only have the tomato during the day otherwise it will spike I can eat pumpkin seeds and sunflower seeds but not after 6/7 as snacks as they will spike my bg. I try not to eat after 6.7pm now as it keeps my bg on track apart from the dp. If I am hungry and its a big if - I will eat cucumbers. I have a garden which has cucumber plants in so its win win!
 
ajbod said:
The GI index is irrelevant, it's still carbs and will spike your blood, but slower.
Click to expand...
Actually, the GI and GL tables are not irrelevant for T2D. If you are producing your own insulin then T2D condition is that either you do not produce enough, or alternatively, your insulin resistance makes it ineffective. Thus a T2D will have a limit of how much insulin can be released to use or store glucose in the blood. GI is an indication of how quickly a food item will turn into blood glucose. Simple carbs are quickly converted, complex carbs take longer. Therefore the rate of buildup in the blood is indirectly related to the GI values. High GI= fast (<10 minutes) and Low GI takes up to 2 hours. So the height of the peak will depend on the difference between glucose creation vs insulin activity. The pancreas actually oscillates on/off in secreting insulin and adjusts to the level of glucose left in the blood until it is able to disengage at homeostasis.

So eating low GI will give lower peak values but for longer time. But it is the height of the peak that seems to cause the damage. High density of glucose in the blood increases inflammation and the higher osmotic pressure forces more glycation of the hemoglobin. Not exactly a win win solution.
 
I've been asked to go on a half day thing run by an independent company - info from my GP surgery - 4 hours on Microsoft Teams.... they say 2 hours of news about how I can die in different ways (maybe not literally but that's how it came over)... and then 2 hours of diet, exercise stuff...... I'm not doing it till the 16th Aug, but they've already started to email me every day - 'reminding' me - I keep saying 'yes' I'll be there, but it's obviously not enough..... Like some of you, I'm tired already of the nagging...... I' ll do the session and feedback the info......
 
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