Hello fellow sufferer’s

[Cloughy]

I am John, had type 2 for about 20 years. Pretty well under control with an hba1c of 51. And fairly steady. 1 metformin and sensible (I think) eating.

 

[rebrascora]

Hi John and welcome.

What brings you to the forum after 20 years of diabetes? Sounds like you are doing great if you are managing with an HbA1c of 51 after so long and largely diet controlled? (1 Metformin is neither here nor there in the scheme of things)
Do you also exercise as well?
Do you test your BG levels at home or just rely on your HbA1c to monitor your progress?

If you have any questions please feel free to ask? Of perhaps just share any tips you have for successful Type 2 management!

 

[Cloughy]

Hi John and welcome.

What brings you to the forum after 20 years of diabetes? Sounds like you are doing great if you are managing with an HbA1c of 51 after so long and largely diet controlled? (1 Metformin is neither here nor there in the scheme of things)
Do you also exercise as well?
Do you test your BG levels at home or just rely on your HbA1c to monitor your progress?

If you have any questions please feel free to ask? Of perhaps just share any tips you have for successful Type 2 management!

Thanks Barbara. I do agree. Just thought I would investigate the forum and see if it is useful to me. A friend is similar but not as steady as my readings having been in the 80’s recently. Both of us get confused with understanding which food stuffs are best. I think we know and follow the fundamentals though. (but he could do better). We both think that having a book or leaflet which simplified choice for people would be useful. I know there are plenty of books but most are not specific. Most just say things like ‘anything in moderation’!

Reading through the recipie section on this forum really shows how delicately those with severe diabetes need to manage the condition and they all have my sympathy. For me, I just need to know what is good or bad so I know what to avoid and can improve my management.

Just a list of foodstuffs in categories but with traffic lights next to them.

Is there such a thing do you know?

I used to do finger pricks but just got continual slightly high readings, I don’t seem to peak at all. I now rely on the 6 month check.

I do little exercise as I have blood flow problems particularly to my legs, it put me in a wheelchair for a couple of years before an operation opened them up.


John

 

[Leadinglights]

Welcome John
You may benefit from reading through the Learning Zone to get a better understanding of the condition. Although you have been diabetic for some years some of the things you say suggest you are missing some basic knowledge.
Don't forget that the way people with Type 1 diabetes manage their condition is very different from people with Type 2 and even they are doing things in a variety of ways, diet only, diet and meds, diet, meds and insulin. You will see a whole range of foods and meals that people are able to tolerate which is why it is not so easy to give a simple list of foods and meals which people can have.
Many Type 2 people find that a low carbohydrate regime reduces and keeps their blood glucose stable but they will use strategic testing of foods and meals they as an individual can tolerate. A low carb regime would be less than 130g carb per day but some people do go lower than that. This is mainly achieved by reducing or cutting out many of the high carb foods like potatoes, bread, rice, pasta, cereals, pastry, tropical fruits, cakes and biscuits and high carb snacks and sugary drinks and basing meals on protein, healthy fats, eggs, cheese, vegetables, salads and some fruits like berries.
Unfortunately the traffic light system on food packaging is not helpful for diabetics as it shows sugar rather than TOTAL carbohydrate which is normally in the small print on the back.
It is that you need to look at as it is ALL carbs that convert to glucose and will increase blood glucose levels when the body cannot process them effectively.

 

[Cloughy]

Welcome John
You may benefit from reading through the Learning Zone to get a better understanding of the condition. Although you have been diabetic for some years some of the things you say suggest you are missing some basic knowledge.
Don't forget that the way people with Type 1 diabetes manage their condition is very different from people with Type 2 and even they are doing things in a variety of ways, diet only, diet and meds, diet, meds and insulin. You will see a whole range of foods and meals that people are able to tolerate which is why it is not so easy to give a simple list of foods and meals which people can have.
Many Type 2 people find that a low carbohydrate regime reduces and keeps their blood glucose stable but they will use strategic testing of foods and meals they as an individual can tolerate. A low carb regime would be less than 130g carb per day but some people do go lower than that. This is mainly achieved by reducing or cutting out many of the high carb foods like potatoes, bread, rice, pasta, cereals, pastry, tropical fruits, cakes and biscuits and high carb snacks and sugary drinks and basing meals on protein, healthy fats, eggs, cheese, vegetables, salads and some fruits like berries.
Unfortunately the traffic light system on food packaging is not helpful for diabetics as it shows sugar rather than TOTAL carbohydrate which is normally in the small print on the back.
It is that you need to look at as it is ALL carbs that convert to glucose and will increase blood glucose levels when the body cannot process them effectively.

Thank you leadinglights for the full answer. But I don’t have a misunderstanding that type 1 and type 2 are managed differently, and why. Though I admittedly, as not having type 1, I have not properly investigated type 1. But I don’t think you understood my point on traffic lights. I was not suggesting it should be simply sugar based. But a combination of ingredients which are known to adversely affect diabetics.

Are you suggesting that different foods affect different people differently. If so then traffic lights may not work. I do know that speaking to others with mild type 2 or those in danger of succumbing to it. That, discovering the right foods for them is not something generally understood in managing their condition or in prevention. For those people. I would suggest a simple method of shopping and diet is what is required. Which is very different from those for who detailed management is essential.

For example. I have 1 banana per day. My friend has been told bananas are the worst thing ever and to steer clear. The internet is varied in its opinion. For those experimenting to see what is right for them the will need to try and test.

For me who tests only 6 monthly this is not possible. For those who are borderline and rarely get tested but are told to watch what they eat, also not helpful.

I can see that traffic lights may be of less use to severe sufferers. But if the idea where possible, it would be very helpful, in my opinion. To the very many people with mild or borderline condition. And prevention is so important.


John

 

[Leadinglights]

I see what you are saying but it is not as simple as that. For example when people test regularly that is from a finger prick test using a home blood glucose monitor, they will test before they eat and after 2 hours. They would look for no more than a 2 mmol/l increase. Some people with the banana would see an increase of much more than 2 mmol/l so would choose not to have it but somebody else may find that increase is only 1mmol/l and would be happy to eat it but would probably not also have a bowl of cereal as well.
There are people who will keep their blood glucose stable by eating no more that 130g per day other people will find more than 50g per day will increase their levels.
The difference between people who are high up in the diabetic zone will need to do much more to get their blood glucose levels back to normal than those who are just into the diabetic zone or termed 'at risk' or prediabetic.
The foods people will generally be able to eat without pushing up glucose levels will be protein so meat and fish, healthy fats, cheese, eggs, green vegetables, salads. Foods with anything but minimal carbohydrate will different in how they will be tolerated by different people.

 

[Cloughy]

I see what you are saying but it is not as simple as that. For example when people test regularly that is from a finger prick test using a home blood glucose monitor, they will test before they eat and after 2 hours. They would look for no more than a 2 mmol/l increase. Some people with the banana would see an increase of much more than 2 mmol/l so would choose not to have it but somebody else may find that increase is only 1mmol/l and would be happy to eat it but would probably not also have a bowl of cereal as well.
There are people who will keep their blood glucose stable by eating no more that 130g per day other people will find more than 50g per day will increase their levels.
The difference between people who are high up in the diabetic zone will need to do much more to get their blood glucose levels back to normal than those who are just into the diabetic zone or termed 'at risk' or prediabetic.
The foods people will generally be able to eat without pushing up glucose levels will be protein so meat and fish, healthy fats, cheese, eggs, green vegetables, salads. Foods with anything but minimal carbohydrate will different in how they will be tolerated by different people.

Thanks. I think this is a matter of perspective. It must be very different for those with severe diabetes to those with mild symptoms or are prediabetic. Many of whom could be in denial or feeling well so not as concerned as perhaps they should be. In my mind, simplicity in some form, perhaps not traffic lights but more like the explanation you provided in your final paragraph. Would be useful.

Regarding your previous recommendation of the Learning Zone. This is intriguing, I will certainly investigate. I visited this site some years back and did not spot it, perhaps it’s new since then.

John

 

[grovesy]

I have been diagnosed as long as yourself, but have had to adapt what works for me for a number of times over the years.

 

[nonethewiser]

Never classed myself as sufferer dont know about others, never mind welcome anyway.

 

[trophywench]

Trouble is @Cloughy because every single one of us is different - so is our diabetes whatever its label is. Hence diet advice and requirements are as individual as the colour of our eyes, the length of our eyelashes, whether we embrace naturism, or whether we happen to play for/manage Derby County FC.

 

[Cloughy]

Trouble is @Cloughy because every single one of us is different - so is our diabetes whatever its label is. Hence diet advice and requirements are as individual as the colour of our eyes, the length of our eyelashes, whether we embrace naturism, or whether we happen to play for/manage Derby County FC.

I am sorry if my apparent to ignorance has angered you. But I really think you are missing the point I, and friends of mine and acquaintances from diabetic meetings are making.

I fully understand what you are saying. And have also been saying the same above. However. My point is that that advice is of little use to prediabetics or, to the very many diagnosed diabetics, like me, who have to rely on common sense and logical/simple direction.

Experimenting with foods without the feedback from regular testing is simply not possible. (Or is it? If so how?)

That logical simple direction is not available. IMHO

I wonder, that if it were, then less of the population may pass over the threshold.

John

 

[Leadinglights]

I am sorry if my apparent to ignorance has angered you. But I really think you are missing the point I, and friends of mine and acquaintances from diabetic meetings are making.

I fully understand what you are saying. And have also been saying the same above. However. My point is that that advice is of little use to prediabetics or, to the very many diagnosed diabetics, like me, who have to rely on common sense and logical/simple direction.

Experimenting with foods without the feedback from regular testing is simply not possible. (Or is it? If so how?)

That logical simple direction is not available. IMHO

I wonder, that if it were, then less of the population may pass over the threshold.

John

Experimenting with foods without the feedback from regular testing is simply not possible. (Or is it? If so how?)

This is something very possible and can be done irrespective of whether you are prediabetic, or diagnosed and that is what very many people do to take control of their condition. They will purchase a home blood glucose monitor and strips and establish a testing regime as described to see what food and meals they can tolerate. Many people regard this as being key to managing not to progress to diabetic of in that prediabetes zone or bringing levels down when diagnosed.
It is just a pity that this is still not regarded as an essential strategy by the NHS and which is why people choose to self fund but find it is one of the best investments they can make to improve their diet.

If you read some of the posts then that is exactly what people have done so they can make an informed decision not to have certain foods or they are fine with other things or they are OK with 1 slice toast but not 2, a small potato is fine but pasta is not.

 

[Cloughy]

Experimenting with foods without the feedback from regular testing is simply not possible. (Or is it? If so how?)

This is something very possible and can be done irrespective of whether you are prediabetic, or diagnosed and that is what very many people do to take control of their condition. They will purchase a home blood glucose monitor and strips and establish a testing regime as described to see what food and meals they can tolerate. Many people regard this as being key to managing not to progress to diabetic of in that prediabetes zone or bringing levels down when diagnosed.
It is just a pity that this is still not regarded as an essential strategy by the NHS and which is why people choose to self fund but find it is one of the best investments they can make to improve their diet.

If you read some of the posts then that is exactly what people have done so they can make an informed decision not to have certain foods or they are fine with other things or they are OK with 1 slice toast but not 2, a small potato is fine but pasta is not.

Thanks, that makes total sense. However. It did not work for me. First I never had any advice to do this from the ‘experts’. So as you say, not supported as an essential strategy by the NHS. Nevertheless, I worked that out for myself and did exactly as you said for some time. I have no way of knowing if my reactions are normal or out of the ordinary, but as I do not spike as such, and any change to my readings happen over a course of days, trying to get a corilation to which food causes any issues is not possible. For me at least.

Furthermore. Is that really a suitable strategy for prediabetics, particularly if they are unaware. I suspect it probably is. And is something hitch should be encouraged.

I fully understand that I am approaching the problem from my own experience and perspective. Which is bound to be very different to someone with a severe condition.

I am far from obese, just a little overweight. And I believe I would never have been warned I could be a candidate for diabetes until other blood tests showed I was and still am.

Sorry to say this. But so far I get the impression, first from my diabetic nurse, that as a mild sufferer I should not be concerned. And sadly, so far on this forum, which seems to assume that as a mild sufferer I do not really know what it’s about.

That simply is not the case.

John

 

[Leadinglights]

Thanks, that makes total sense. However. It did not work for me. First I never had any advice to do this from the ‘experts’. So as you say, not supported as an essential strategy by the NHS. Nevertheless, I worked that out for myself and did exactly as you said for some time. I have no way of knowing if my reactions are normal or out of the ordinary, but as I do not spike as such, and any change to my readings happen over a course of days, trying to get a corilation to which food causes any issues is not possible. For me at least.

Furthermore. Is that really a suitable strategy for prediabetics, particularly if they are unaware. I suspect it probably is. And is something hitch should be encouraged.

I fully understand that I am approaching the problem from my own experience and perspective. Which is bound to be very different to someone with a severe condition.

I am far from obese, just a little overweight. And I believe I would never have been warned I could be a candidate for diabetes until other blood tests showed I was and still am.

Sorry to say this. But so far I get the impression, first from my diabetic nurse, that as a mild sufferer I should not be concerned. And sadly, so far on this forum, which seems to assume that as a mild sufferer I do not really know what it’s about.

That simply is not the case.

John

I suppose the difference between people who are not diabetic is they can eat carbohydrates and their body will produce enough insulin to deal with what they are eating and for somebody non diabetic their blood glucose levels will go up and down throughout the day sometimes by quite large amounts than would not be good for somebody diabetic.
It is when that system fails for whatever reason that problems occur.

What is it about a testing regime as mentioned that does not work for you?

 

[trophywench]

We are all already singing from the same hymnsheet as you on here - but there is unlikely to be any change in the NHS stance on meters so if anybody wants to look after themselves by testing reviewing and adjusting they'll need to fund it themselves exactly as we all had to in the 1970s before the NHS started prescribing the strips anyway - they did that, but you had to have bought your own meter to begin with.

What I do have difficulty comprehending is why you keep mentioning 'degrees' of diabetes. Anyone's diabetes is likely to become a problem to them, if they don't actually take the trouble to look after it themselves. 20 ish years ago, so I'd been T1 for 30 ish years by then, a DSN I hadn't ever met before was chatting to me and asked 'Who treats your diabetes, Jen?' and I was a bit surprised - it was the first day of a 'carb counting and insulin dose adjusting course' which although all arranged through my Hospital trust (Coventry), was actually held at and run by, the other hospital within the same Trust (Rugby) - but surely to goodness they had had access to my NHS file ? - so I started reeling off my GP, and consultant's names adding at the end '.... and I reckon just at the moment, anyway, yourselves'. She then said with a wry grin, 'Well yeah - but don't you have any impact on it anywhere, Jen?' We both giggled. Of course I did, only every hour of every day 365 days of the year ..... She said then, and I have always said since, YOU have to treat YOUR own diabetes YOURSELF. The only thing anyone else can do whether medically trained or not, is provide the info and the wherewithal for you to do that successfully.

The 'better info' bit is what forums like this, try to provide to fellow PWD - and it is always a moving feast as new pros and cons emerge so eg. The Learning Zone didn't exist several years ago, as you have noted, but it is well worth plodding through however long you've had diabetes - and a lot of GP surgeries are now signposting patients to Diabetes UK via the internet. At long last the NHS at large have embraced using the resources of DUK properly! (The snag IMHO had always been that the printed info available in the past had to be paid for .......) Plus DUK have a Helpline so just like eg Prostate Cancer UK etc you can get advice on where to go/what to do next for whatever prob you may have with whatever medical condition you have.

You would actually get better info from a GP surgery were you diagnosed with D today - but filling in any gaps in your knowledge for the rest of your life, is entirely down to yourself.

 

[rebrascora]

The testing regime mentioned, when used in conjunction with a food diary and recording pairs of BG readings from just before and 2 hours after each meal is a very tried and tested strategy here on the forum for tailoring your diet and has been extremely successful for people with pre- diabetes, low level HbA1c diabetes and extremely high HbA1c levels.

My guess is that in your situation, if you cut your daily banana from your diet and kept everything else the same you might manage an HbA1c in the prediabetes range. That 15-20g extra of carbs per day from the banana could be what is holding you at 51. Or it could be that eating one less slice of bread a day might be enough to do it instead or there may be other areas of your diet which might be easier to strip a few carbs off. Sometimes it doesn't take much on a daily basis to tip the balance back in your favour and push your levels below 48, particularly when you are already just over the red line. It depends how you want to manage it and where you feel there is a good balance between managing it and enjoying your life/not feeling too restricted.

If you wanted a very simple rule of thumb which would probably improve every Type 2 diabetic's results you could suggest not eating any food item with a carbohydrate content of more than 10%...... but that would be incredibly restrictive. It would be a very simple rule, but means no bread, rice, pasta, potatoes, pastry, batter, most fruits, cakes biscuits, sweets, chocolate (apart from extremely dark 90%+). Very few people would manage to follow such guidance and it is unnecessary for many to be so restrictive. Even if you say to restrict any foods with 20% carbs, you still rule out any grains and grain products like flour and foods made from them, potatoes, etc. This is why there is so much confusion about dietary advice for diabetes, because tastes differ, willpower differs, metabolism and gut biome differs, exercise levels and mobility differ, stress levels, good sleep, hormones ..... etc. There are something like 42 factors which impact BG levels so the best way that we have found here on the forum, is to use a BG meter to see how our body works and tailor our personal diet to that as well as our tastes, food choices and circumstances.

It would be great if there was a simple answer, but there isn't. The current NHS advice and food traffic light system also does not help. It would take a massive overhaul of food labelling from the government and that is not going to happen because the food industry have a vested interest in feeding us cheap carbs as there are huge profits involved.... and most people don't want to give up their carbs because they love them and in some cases are addicted to them (I was)....Mental health/comfort eating/eating disorders are all involved... Certainly the high levels of sugar in foods has caused many to gain a sweet tooth which is very hard to overcome.

Just so that I don't end this post on a negative tone, I just want to say that I love my low carb high fat way of eating. It has given me control over my eating disorder and better management of my diabetes/BG levels. I feel younger and fitter and healthier than I have for years eating this way and my BG meter (Libre sensor now too) tells me that it is working.

 

[rebrascora]

PS. Like @nonethewiser I don't feel like I "a sufferer" as mentioned in your title. It's just a condition that I manage.

 

[Cloughy]

The testing regime mentioned, when used in conjunction with a food diary and recording pairs of BG readings from just before and 2 hours after each meal is a very tried and tested strategy here on the forum for tailoring your diet and has been extremely successful for people with pre- diabetes, low level HbA1c diabetes and extremely high HbA1c levels.

My guess is that in your situation, if you cut your daily banana from your diet and kept everything else the same you might manage an HbA1c in the prediabetes range. That 15-20g extra of carbs per day from the banana could be what is holding you at 51. Or it could be that eating one less slice of bread a day might be enough to do it instead or there may be other areas of your diet which might be easier to strip a few carbs off. Sometimes it doesn't take much on a daily basis to tip the balance back in your favour and push your levels below 48, particularly when you are already just over the red line. It depends how you want to manage it and where you feel there is a good balance between managing it and enjoying your life/not feeling too restricted.

If you wanted a very simple rule of thumb which would probably improve every Type 2 diabetic's results you could suggest not eating any food item with a carbohydrate content of more than 10%...... but that would be incredibly restrictive. It would be a very simple rule, but means no bread, rice, pasta, potatoes, pastry, batter, most fruits, cakes biscuits, sweets, chocolate (apart from extremely dark 90%+). Very few people would manage to follow such guidance and it is unnecessary for many to be so restrictive. Even if you say to restrict any foods with 20% carbs, you still rule out any grains and grain products like flour and foods made from them, potatoes, etc. This is why there is so much confusion about dietary advice for diabetes, because tastes differ, willpower differs, metabolism and gut biome differs, exercise levels and mobility differ, stress levels, good sleep, hormones ..... etc. There are something like 42 factors which impact BG levels so the best way that we have found here on the forum, is to use a BG meter to see how our body works and tailor our personal diet to that as well as our tastes, food choices and circumstances.

It would be great if there was a simple answer, but there isn't. The current NHS advice and food traffic light system also does not help. It would take a massive overhaul of food labelling from the government and that is not going to happen because the food industry have a vested interest in feeding us cheap carbs as there are huge profits involved.... and most people don't want to give up their carbs because they love them and in some cases are addicted to them (I was)....Mental health/comfort eating/eating disorders are all involved... Certainly the high levels of sugar in foods has caused many to gain a sweet tooth which is very hard to overcome.

Just so that I don't end this post on a negative tone, I just want to say that I love my low carb high fat way of eating. It has given me control over my eating disorder and better management of my diabetes/BG levels. I feel younger and fitter and healthier than I have for years eating this way and my BG meter (Libre sensor now too) tells me that it is working.

Very wise words. I am impressed with this site. And as you say, if I was diagnosed today things may be very different regarding advice. My initial diagnosis was poor. Having said that. I totally agree that managing my diabetes is MY responsibility. I hope I did not previously suggest differently. I believe that I do reasonably successfully. And I agree with you. If I tried a little harder I may even reverse matters.

I have learnt a lot from this discussion, even though I feel that some have missed my point. (Possibly my fault). Of course, as I keep being reminded, we are all different. But that is part and parcel of my point. I strongly sympathise with anyone who needs to micro manage their condition. But for me. With a fairly constant, slightly high reading. I need to do what suits me. And, as said already, a testing regime which shows little variation, tells me nothing as it does not correlate directly to what I have recently eaten.

I understand what you say about the difficulties involved in producing a simple traffic light solution to guide people into what is best to eat or avoid. However. Both yourself and leadinglight, made comments which simplified food choice somewhat. So, perhaps achieving the simplistic traffic light system I put forward is cloud cuckoo land. But both of your comments would be (I feel), of use to the groups I am talking about. And, if such dietary advice was more readily available, who knows, it may save many more succumbing.

PS. Like @nonethewiser I don't feel like I "a sufferer" as mentioned in your title. It's just a condition that I manage.

Appologies to both of you. I take your point.

I suppose the difference between people who are not diabetic is they can eat carbohydrates and their body will produce enough insulin to deal with what they are eating and for somebody non diabetic their blood glucose levels will go up and down throughout the day sometimes by quite large amounts than would not be good for somebody diabetic.
It is when that system fails for whatever reason that problems occur.

What is it about a testing regime as mentioned that does not work for you?

What is it about a testing regime as mentioned that does not work for you?

Like you said re glucose levels going up and down. Mine don’t very much. Therefore if I test, I don’t get usable feedback.



John

 

[helli]

Welcome to the forum @Cloughy
It's interesting to read your thoughts and ideas and treatment for your diabetes.
We are all different in terms of lifestyle and diabetes so what works for one or many may not work for others as you have explained.

With Type 1, testing is a very important of managing my condition - as important as insulin for me.
Like others, I do not consider myself as a sufferer or that I have severe diabetes.

 

[rebrascora]

I am pleased that you are finding the discussion useful. There are courses like DESMOND available through the NHS but they mostly promote the old NHS "eatwell plate" advice which isn't enough of a carb reduction for most people to gain control of their diabetes through diet and the LOW FAT mantra is so integrated into that advice, you would think that fat increased our BG levels, when in fact, of the 3 food groups, fat has the least impact our diabetes. I think the NHS makes it more difficult to manage diabetes through diet because of that advice and that leads quite often to the notion that Type 2 diabetes is progressive when it doesn't need to be. I do also think that many people diagnosed with diabetes are not motivated to change their diet and/or lifestyle, particularly when it comes to giving up or restricting foods they really like and the whole food industry is just pushing us to eat more.
We also see quite a few people who come to the forum having buried their head in the sand for months or years because they don't have any symptoms of diabetes, despite diagnosis. Some take the medication but don't make any lifestyle changes, others don't even take the medication, especially if it upsets their stomach as Metformin can so often do. Sadly once complications start to exhibit, the damage is sometimes irreversible but at least the risk of further damage can be reduced by taking control at that stage. Diabetes is a very easy condition to ignore until it's too late and quite difficult for health care professionals to motivate people to change their lifestyle.... The very easy and cheap availability of high carb foods and heavy advertising does nothing to help. I had no idea how powerful advertising was until I cut my carb consumption right down and was really trying not to be tempted and my eyes suddenly opened to the constant bombardment we face on TV, bill boards, magazines and internet pop ups. It is a huge multibillion pound industry tempting us to eat unhealthy foods and until you are trying to resist it, you don't even notice! It is everywhere!! Of course this time of year, it becomes even worse. It doesn't bother me any more as I have broken the cycle of craving those foods and found other low carb foods which I enjoy, but it was incredibly hard to ignore it in the early stages of changing my diet. I live on my own so I can restrict what is in the house to avoid temptation. Many people with families will find it much more difficult, although changing their children's eating habits is also important because there is a genetic aspect to it and creating better eating habits in children is the way to reverse the current diabetes epidemic. It's just that the official dietary advice needs to be right and at the moment it isn't.

Anyway, I hope you were not offended at my suggestion that you could "do better" with your diabetes management.... We could almost certainly all "do better", so it was not intended to be personal and it is important to remember that life needs to be worth living and diabetes has to live with us, not us be a slave to it, which is why I think your Hba1c of 51 after 20 years is really great.