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What would be your ideal care model for the NHS with your Type 2 Diabetes?
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<blockquote data-quote="Celeriac" data-source="post: 989249" data-attributes="member: 188243"><p>The NHS gives out crazy advice to people with diabetes. </p><p></p><p>Firstly, to eat carbohydrates which they know (or SHOULD know) become glucose in the body, thus raising blood glucose. Advising people to cut processed carbohydrates rather than stuff starchy carbs at every meal would save the NHS millions. Ancel Keys and his Diet-Heart Hypothesis should be consigned to the dustbin of history. Before oral medications, Type Twos were treated by low carb diet. It's disingenuous of the medical profession to say that low carb diets are the great unknown.</p><p></p><p>If you tell someone: " Your HbA1c is 13%" it means nothing to someone newly diagnosed who doesn't know what normal is. Show that person an infographic or a graph, it will sink in better. </p><p></p><p>The NHS tells patients not to do XYZ, but doesn't follow through with the reasoning behind that, often enough. Explanation Explanation Explanation !</p><p></p><p>It's not reassuring to stressed patients when the HCP goes off the deep end about amputations, for a minor problem. The patient IS taking the problem seriously, otherwise s/he wouldn't be there. Frightening and bullying patients into compliance is not a reasonable tactic.</p><p></p><p>Patients are often made to feel that their questions are unimportant. It should be easier for patients to ask them somehow and not get the standard NHS Direct 'Go to A&E' response or the Eat Well Plate rubbish. </p><p></p><p>IMO engaged patients are invested in their health, they are more likely to do well, so help them. </p><p></p><p>Second piece of crazy advice, is not to test blood glucose. If I hadn't tested my BG, I would be on insulin by now. Patients should be given the means to discover which foods spike their BG, and to find out whether they have the Dawn Phenomenon i.e. an early morning liver dump of glycogen which sends BG up. Patients with a meter, find out that exercise can help them lower BG. They see their efforts to eat low carb, rewarded with better BG numbers. Motivation. Better BG = fewer complications = saves the NHS money. Billions probably as in fewer drugs, fewer surgeries.</p><p></p><p>Patients are individuals not statistics. If studies say X people with diabetes get Y, that's a statistic not a given. Giving drugs with bad side effects to healthy people or people with impaired health on the basis that it MIGHT help them avoid a statistic they don't have, does seem bizarre to many patients. HCPs probably look more at Big Pharma marketing than studies. It's the Absolute Risk that matters not the massaged to look good figures.</p><p></p><p>The NHS demotivates patients with T2DM by telling them that they will inevitably get worse and end up on insulin, with complications, dying prematurely. That's not a certainty. Not if someone has good control of their BG. I know that ACCORD and UKPDS studies showed that good control didn't have much effect, but the NHS guidelines for BG are higher than those that people without diabetes have.</p><p></p><p> Secondly, any pursuit of good control which results in rollercoaster BG highs and lows is a bad thing for some bits of the body e.g. eyes. This happens particularly for people on insulin and could indicate that the NHS just doesn't train people how to use insulin properly perhaps.</p><p></p><p>Giving bad advice which conflicts with the reality that BG meters show us, really undermines the NHS. I think that's the first thing that needs to be done. To at least acknowledge that cutting carbs reduces BG for the majority of people with diabetes. </p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p>Sent from the <a href="http://www.diabetes.co.uk/app/?utm_source=sig&utm_medium=txt&utm_campaign=appsig" target="_blank">Diabetes Forum App</a></p></blockquote><p></p>
[QUOTE="Celeriac, post: 989249, member: 188243"] The NHS gives out crazy advice to people with diabetes. Firstly, to eat carbohydrates which they know (or SHOULD know) become glucose in the body, thus raising blood glucose. Advising people to cut processed carbohydrates rather than stuff starchy carbs at every meal would save the NHS millions. Ancel Keys and his Diet-Heart Hypothesis should be consigned to the dustbin of history. Before oral medications, Type Twos were treated by low carb diet. It's disingenuous of the medical profession to say that low carb diets are the great unknown. If you tell someone: " Your HbA1c is 13%" it means nothing to someone newly diagnosed who doesn't know what normal is. Show that person an infographic or a graph, it will sink in better. The NHS tells patients not to do XYZ, but doesn't follow through with the reasoning behind that, often enough. Explanation Explanation Explanation ! It's not reassuring to stressed patients when the HCP goes off the deep end about amputations, for a minor problem. The patient IS taking the problem seriously, otherwise s/he wouldn't be there. Frightening and bullying patients into compliance is not a reasonable tactic. Patients are often made to feel that their questions are unimportant. It should be easier for patients to ask them somehow and not get the standard NHS Direct 'Go to A&E' response or the Eat Well Plate rubbish. IMO engaged patients are invested in their health, they are more likely to do well, so help them. Second piece of crazy advice, is not to test blood glucose. If I hadn't tested my BG, I would be on insulin by now. Patients should be given the means to discover which foods spike their BG, and to find out whether they have the Dawn Phenomenon i.e. an early morning liver dump of glycogen which sends BG up. Patients with a meter, find out that exercise can help them lower BG. They see their efforts to eat low carb, rewarded with better BG numbers. Motivation. Better BG = fewer complications = saves the NHS money. Billions probably as in fewer drugs, fewer surgeries. Patients are individuals not statistics. If studies say X people with diabetes get Y, that's a statistic not a given. Giving drugs with bad side effects to healthy people or people with impaired health on the basis that it MIGHT help them avoid a statistic they don't have, does seem bizarre to many patients. HCPs probably look more at Big Pharma marketing than studies. It's the Absolute Risk that matters not the massaged to look good figures. The NHS demotivates patients with T2DM by telling them that they will inevitably get worse and end up on insulin, with complications, dying prematurely. That's not a certainty. Not if someone has good control of their BG. I know that ACCORD and UKPDS studies showed that good control didn't have much effect, but the NHS guidelines for BG are higher than those that people without diabetes have. Secondly, any pursuit of good control which results in rollercoaster BG highs and lows is a bad thing for some bits of the body e.g. eyes. This happens particularly for people on insulin and could indicate that the NHS just doesn't train people how to use insulin properly perhaps. Giving bad advice which conflicts with the reality that BG meters show us, really undermines the NHS. I think that's the first thing that needs to be done. To at least acknowledge that cutting carbs reduces BG for the majority of people with diabetes. Sent from the [url=http://www.diabetes.co.uk/app/?utm_source=sig&utm_medium=txt&utm_campaign=appsig]Diabetes Forum App[/url] [/QUOTE]
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