Did you know it is OK for a type 2 to eat white bread and pasta?

[Northerner]

So is it unfair to criticise individual diabetic nurses if the information from above is woolly? (I guess I don't know the answer, just thinking outloud. And I suspect this has been debated at great length here before!)

As you say Nick, general advice assumes a healthy pancreas. Certainly, I would expect a nurse/dietician who has a specialism in diabetes to be fully aware of the impact of carbs, and many members have reported this to be the case. Problems with advice tend to come when a dietician is not aware of the specific problems associated with diabetes. As for Diabetes UK, they have been pilloried many times for adhering to the 'standard' dietary advice, although there is some evidence that they are starting to accept lower carb as being a better option, so there is hope on the horizon!

Of course, we tend to hear more of the individuals giving out bad advice than those giving out good, and it does go wider when you consider the 'do not test' advice standard for Type 2 from many healthcare professionals - these HCPs may genuinely believe they are giving the best advice based on their training, or they may simply think they know best even when presented with evidence from patients like many of the people here 🙄

 

[Ralph-YK]

A dsn and diabetes dietitican from a neighbouring NHS trust area say we need to manage carbohydrates.
Thing is, being in a neighbouring area, I don't normally get to use them.

 

[Pumper_Sue]

Sadly, some are still stuck in what was 'standard' advice many years ago There are some good dieticians, but unfortunately a lot who don't appear to update their knowledge

They must be extremely dated then as even in 1965 my mother was told to watch the amount of carbs I ate.
A few years back I saw a fabulous dietitian who said forget the eatwell plate it's totally unsuitable for people with diabetes and then proceeded to give me some very sound advice.

It's a great pity they we don't hear more comments from people who have had good advice.

The matter of testing for type2's though is NHS policy so they all have to sing from the same hymn sheet whether they agree with it or not.

 

[MikeTurin]

Yes, pretty similar to the advice I was given and still get from the nurse who specialises in diabetes. I now just nod and say nothing. Don't know what would have happened if I had not found the forum. She tells me that I can have up to two slices of cake a week. one biscuit a day plus four squares of chocolate and a bunch of grapes and a banana each day. 60% of meals should be carbohydrate based as these are the "building blocks of life" LOL 🙂

For me what worked first was reading paper books from library. All the books I have read are explicitly saying to switch to lower GI starchy foods, wholegrain pasta, and bread, sweet potatoes. What I am not following is to switch to skimmed dairy products, because they are tasting awfully. So I prefer eat less cheese, and buy less high quality one.
I know drinking alchool it's bad, so I reduce doses, and instead to buy some cheap diesle fule tasty whiskey at LIDL I boughr a 16 year aged Lagavulin, a year ago, for special treat. Still more than half full.
I eat some 73% or 88% chocholate squares some times and i put bitter cocoa powder in my milk but in small quantities, and even if I am a Type 2 I count the carbs and the calories.

For lunch I eaten wholewheat Spaghetti, garlic and hot peppers, a carrot and cabbage salad and a pear for a total of 50g of carbs and 600 calories, for instance. If you search a post from me from a week ago I have HBa1C that is firmly in the non-diabetic range. (Ah I am T2 not T1, no HCP told or explained me how to carb count)
Because I know that if I really like spaghetti I can eat them, but I can't make a second course with fried potatoes. and a slice of banana cake.
If I really want a slice of banana cake I'll eat only,say, a salad and a piece of roasted hen before.
I am actually following official guidelines on this

As you say Nick, general advice assumes a healthy pancreas. Certainly, I would expect a nurse/dietician who has a specialism in diabetes to be fully aware of the impact of carbs, and many members have reported this to be the case. Problems with advice tend to come when a dietician is not aware of the specific problems associated with diabetes. As for Diabetes UK, they have been pilloried many times for adhering to the 'standard' dietary advice, although there is some evidence that they are starting to accept lower carb as being a better option, so there is hope on the horizon!

Of course, we tend to hear more of the individuals giving out bad advice than those giving out good, and it does go wider when you consider the 'do not test' advice standard for Type 2 from many healthcare professionals - these HCPs may genuinely believe they are giving the best advice based on their training, or they may simply think they know best even when presented with evidence from patients like many of the people here 🙄

My idea is that the standard dietary advice is taught and understood wrong.
Not all people are willing to read about it and GP and HCP unfortunately are tending to give a really terse advice.
I think that on the diabetes UK website the advice could be a bit more stronger, like saying "you should really switch to whole wheat product, it's not forbidden to eat white bread or fried potatoes now and then but it's not advisable basing the diet on them" and the fact that starch is a carboyhdrate too and its found in rice, pasta, bread and most grains and derived.

 

[grovesy]

They must be extremely dated then as even in 1965 my mother was told to watch the amount of carbs I ate.
A few years back I saw a fabulous dietitian who said forget the eatwell plate it's totally unsuitable for people with diabetes and then proceeded to give me some very sound advice.

It's a great pity they we don't hear more comments from people who have had good advice.

The matter of testing for type2's though is NHS policy so they all have to sing from the same hymn sheet whether they agree with it or not.

I think the change came in the 70/80s when the advice was everyone should eat a healthy diet. As a student nurse in the early 70s we did Carbohydrate exchanges for Diabetic diets.

 

[Northerner]

The matter of testing for type2's though is NHS policy so they all have to sing from the same hymn sheet whether they agree with it or not.

Not quite, they are supposed to decide on an individual basis, in consultation with the patient, there is supposed to be a degree of flexibility in the decision..

 

[Amigo]

They must be extremely dated then as even in 1965 my mother was told to watch the amount of carbs I ate.
A few years back I saw a fabulous dietitian who said forget the eatwell plate it's totally unsuitable for people with diabetes and then proceeded to give me some very sound advice.

It's a great pity they we don't hear more comments from people who have had good advice.

The matter of testing for type2's though is NHS policy so they all have to sing from the same hymn sheet whether they agree with it or not.

My GP surgery isn’t singing from the same hymn sheet Sue. I receive adequate testing strips even though I’m not at risk of hypos and it is challengeable if grounds can be established.

 

[Pumper_Sue]

I think the change came in the 70/80s when the advice was everyone should eat a healthy diet. As a student nurse in the early 70s we did Carbohydrate exchanges for Diabetic diets.

The reason it all changed was due to the introduction of so called human insulin. It was perceived that as it was human then people with diabetes could eat as much as they wanted as long as they injected. Obviously that not so fantastic idea didn't and hasn't worked.

 

[Pumper_Sue]

Not quite, they are supposed to decide on an individual basis, in consultation with the patient, there is supposed to be a degree of flexibility in the decision..

Supposed is the operative word.

 

[Northerner]

Supposed is the operative word.

Quite 🙄

 

[grovesy]

The reason it all changed was due to the introduction of so called human insulin. It was perceived that as it was human then people with diabetes could eat as much as they wanted as long as they injected. Obviously that not so fantastic idea didn't and hasn't worked.

I never connected the 2 before.Though it makes sense to me now.

 

[Matt Cycle]

I don't think the change in dietary advice was purely down to the introduction of human insulin as I started on fixed doses of twice daily Humulin I in 1986 with fixed amount of carbs and was taught carbohydrate exchanges. The introduction of MDI was the key point with 'quick acting' insulin - Actrapid. When I went on this in 1987 I was still on fixed doses until I worked out how to adjust it. I clearly remember the shift by the BDA in dietary advice in the late 80's with their dietitian Azmina Govindji in Balance and the move from low sugar/low carb to a balanced, healthy diet.

 

[Greymouser]

Really very sad Greymouser. Did you attempt to se the record straight at all? Share your own experiences and results?

I tried to share my experiences, but she was not interested, she even told me to not worry too much about my weight, but did say it was good I had lost three stones, not for the benefit of my diabetes, but to reduce my risk of a heart attack. She was a very large lady so I did not want to upset her, by explaining the major problem of huge amounts of fat around your organs. Not that she would have listened anyway, I think. She also knew nothing about me, could not access my records, only having a copy of the referral letter, so I had to explain my story from the start. I found the whole thing annoying and as you said: sad.

I agree with others too, when they say it is not so surprising that there has been a massive rise in the number of diabetics in the UK. With what I have seen from the various health professionals in the last three months, I cannot see things improving either. I must say though that the specialist Endocrinologist I saw was very good, though I find it amazing that many do not get to see one. This forum is a far more important resource for new diabetics, than the NHS; which is pathetic really isn't it?

 

[trophywench]

Well I agree it's pathetic - and as a founder member of a diabetes forum that pre-dates this one - you now know why we were so blooming keen to START one in the first place - and why we're equally keen on keeping them going and trying to promulgate PROPER advice to those who seek it!

 

[Martin Canty]

massive rise in the number of diabetics in the UK

I think that one of the biggest problems is the food we are consuming, I read an awful lot about people consuming highly refined pre-packaged meals (including diet products), not the way we used to eat in the 70's & 80's where, certainly in my household, most food was made from scratch.
Cookies were a treat rather than a daily occurrence, cake was reserved for visits to Nan's who loved to bake..... Over the years I have been guilty of resorting to processed foods as a shortcut in cooking, that & a high carb diet...Add genetic predisposition & I'm where I am today!!!

 

[Ditto]

Now if I was into conspiracy theories I'd be thinking they're trying to kill off all us peasants! 😉

 

[trophywench]

In 1972 everyone in the NHS sang from the hymnsheet which said that ALL diabetics (whatever type) MUST limit or at least, closely watch, their carb consumption.

Roll forward about 15 years. I am told not to count carbs but purely guess how much insulin to have for meals. I ignored it, but it was still guessing. In 1998 I am told by a DSN very very angrily that if she ever catches me carb counting I will have to answer to her. I ignored her.

In the early 2000s I am screamed at by a Type 1 surgery nurse after answering the question 'What do you have for breakfast?' with one Weetabix and milk and I freely confess about a quarter of a teaspoon of sugar, cos otherwise 2u insulin is too much (no half unit pens then) The tiddly bit of sugar rounds the carbs up nicely to match the insulin. 'You've been diabetic longer than me - you must know very well we can never, never, NEVER ever eat any sugar ever in our lives!!'

I laughed and told her not to be so daft - after all everyone says we can these days.

Who ARE these people? Tell me their names immediately and I'll be certain to put them right!!

Oh OK if you feel you must. Professor John M, my previous consultant, he's a teaching diabetologist at the Queen Elizabeth Hospital/B'ham Uni Medical School - then a list of diabetes consultants and their current whereabouts, then I said and of course, the powers that be at Diabetes UK but I'm terribly sorry I can't tell you any actual names off the top of my head!

She just glared at me, and I proceeded to ignore her from then on too.

If people demonstrate that they do know what they're talking about, of course I listen - but if they don't demonstrate that I won't - I start to cross examine them. My current consultant is quite young and insisted I have to take statins. Well I won't - they caused me horrific loss of memory and I'm not doing it. So I started asking him to prove to me HOW taking them would magically unscale my already furred-up arteries - I know I have them as I have intermittent claudication but I somehow think having smoked for 50-odd years might have something to do with that, rather than just the diabetes. I obviously do have a high risk of CVD - but Hey!! - we all have to die of something don't we - and I'd rather do it with my marbles, thanks! Anyway, he got angry with me and said quite nastily 'I'm a diabetes consultant not a cardiologist!' to which I replied best stick to what you do know about then, I should! He absolutely doesn't accept my decision on that and thinks I ought to allow him to impose his will upon me - purely because the NHS says he must.

I think not ....... LOL

 

[Northerner]

Well said Jenny 🙂 You do have to challenge these people sometimes, because they often aren't used to it and then find it difficult to justify themselves. At one of my annual reviews I saw a GPSI (GP with special interest in diabetes) instead of my usual consultant. He noticed that I had stopped the statins and tried to tell me that I should be taking them as my cholesterol was 4.6. He ignored the excellent ratio I had. I asked him why I needed to lower my chol, given that I had no risk factors for CVD and had been told by a cardiologist that I was lower risk than the majority of the population. His response was that a study had shown that a tribe in Northern China all had low cholesterol levels and virtually no CVD. I pointed out to him that there are probably significant differences in genetic heritage, diet and lifestyle to my own. He mumbled some sort of grunt and we moved on 🙂 He was also the person who, when I told him I had stopped needing basal insulin about 2 months earlier, said I would inevitably need it again in a few weeks - that was over 5 years ago...! 🙄

 

[Lilian]

These 'specialists' know carbs raise blood sugar. It's common knowledge. It's how the human body works. Carbs convert to glucose. These 'specialists' are causing a strain on the NHS by giving diabetics bad advice!😡

I am a "medicine champion" for my local surgery and the first meeting of other medicine champions and the local CCG is next Wednesday. This is to bring ideas as to how and where money is wasted and money can be saved in the NHS from what we have seen, heard, discussed etc. This is one of the subjects I intend to raise.

 

[Ljc]

I am a "medicine champion" for my local surgery and the first meeting of other medicine champions and the local CCG is next Wednesday. This is to bring ideas as to how and where money is wasted and money can be saved in the NHS from what we have seen, heard, discussed etc. This is one of the subjects I intend to raise.

Thank you. I wish you the best of luck in this and in your role of a medicine champion.