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Diabetes U.K. webpage Vs Diabetes U.K. forum for T2

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This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.

Martin9

Well-Known Member
Relationship to Diabetes
Type 2
I have been a user of Diabetes U.K. forum just over 1.5 yrs now and have found it invaluable in maintaining my HbA1c in the mid to lower thirties over the past year or so. The main thrust of the advice in the forum being following the LCHF diet, upping exercise and losing excess weight ..
However when I goto the webpage I see what I would call the “eat well” diet being suggested such as bowl of cereal for breakfast or pasta salad for lunch in amongst other choices and wonder why the disparity between this wonderful forum and the Diabetes U.K. website..
Any comments ..?
 
Not everyone follows LCHF though, i don't. But on the flip side I wouldn't follow the eat well plate either. I do still have the occasional bowl of cereal for breakfast. But I know what ones I can eat.
 
Not everyone follows LCHF though, i don't. But on the flip side I wouldn't follow the eat well plate either. I do still have the occasional bowl of cereal for breakfast. But I know what ones I can eat.
Yes I realise, but the webpage doesn’t mention LCHF at all and perhaps needs to reflect what we all suspect to be true...for T2
Thanks for your answer @Stitch147
 
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Well, for most of its formation the Forum has had very little input from the charity in terms of dietary advice, hence most of the advice is gleaned from the life experiences of its many members over the years. Certainly for the first 6 or 7 years most areas of the charity were unaware that there even was a support forum supported by the charity. That has changed in more recent years, but I imagine that the charity's webpage is more constrained by official guidelines 🙂
 
Diabetes UK doesn't post on the forum (mostly). A tech forum I was on some time ago was run by a publisher of computer magazines (Computer Active etc). It was an extension of their magazines, with staff (marked as staff) answering questions in most threads. In effect, if you posted you were interacting with the publisher. (This was obvious from user names, style etc.) It was even used for material to go into the published magazines.
This forum isn't like that. It's whoever signs up to the sight that answers questions and comment in threads. The discussion are between The Public, as opposed to with the Organisation. (With the odd exception.)
Though I don't know what is happening in the background. 🙄o_O
 
That is the tech forum would be following the publishers (Ugh darn mush for brains, the words have gone... back???? *sighs*) editorial policies.
Here doesn't in the same way. (Though there is a couple, such as not naming people.)
 
I posted this because I’m on a FB group diabetes 2 group and one member of the group was poking fun at Diabetes U.K. webpage for being stuck in the 90s, I assured her that the Diabetic U.K. forum wasn’t but...
 
Diabetes UK website is a bit wishy washy on managing carbs, where you can find reference to it. Though there has been the odd piece that did kind of back it up.
 
They are probably waiting for the new legislation regarding diet, on the expert diabetes 2 course I attended run by NHS with Diabetes.org UK, they know low carb is better and acknowledge world health got it wrong regarding low fat. I suspect UK health generally are a bit embarrassed about steering the population wrong. Still many people and doctors think low fat is a good idea.

Was the person actually talking about diabetes.org.uk or diabetes.co.uk site, they are 2 different sites.

here is diabetes.org.uk link page on carbs https://www.diabetes.org.uk/search?q=carbohydrates&op=Search+Diabetes+UK
 
It is the difference between the colliery owners and the miners at the coalface.
 
Any information you read on here, be it dietary or otherwise, is the personal view of the individual based on their knowledge, experiences and preferences. What you read on the website is the official position of the charity based on expert opinion or NHS advice.
 
As a counter to this:

- BG isn't the be all & end all. Other risk factors are generally at least as important, including BP and cholesterol. Any responsible dietary guidance has to take this into account. This is one of the main drivers behind recs like "Eat Well", I believe. If you focus just on BG then you might risk getting not enough fibre, too much sat fat, too much salt, not a wide enough spread of micronutrients etc etc.

- Fibre is really important & this is the main reason for the wholegrains recs. The thinking is that people generally don't get enough fibre and a lot of what they do get is from grains. So recommend wholegrains. (Personally, as a seed fanatic, I think the answer to this one is pretty obvious: seeds are way more nutritious than grains, without the BG impact and with way more fibre.)

- Despite the buzz, many people actually do get their BG under control by following the general recommendations. To the extent they exist, credible studies suggest that any generally healthy way of eating works equally well, with a (vaguely defined) Mediterranean diet generally doing a bit better than LCHF, vegan, whatever in the medium term. This is because at the general T2D population level, the most important thing for getting BG under control is weight loss, much more important than macronutrient composition.

- Restricting carbs in the absence of weight loss generally isn't going to do much for fasting BG levels. There's no credible evidence that carb restriction does anything much to improve hepatic insulin resistance, which drives overactive gluconeogensis, the process by which he liver (mainly) produces glucose from amino acids, trigs etc - not carbs. This process is most apparent overnight and is supposed to be the most characteristic feature of T2D. What does generally work is sufficient weight loss to clear fat from the liver and thereby improve hepatic insulin sensitivity.

- On the other hand restricting carbs does have an obvious impact on post-prandial BG levels and this is important while in the early stages of getting T2D tamed. Things like "Eat Well" fall down to the extent they don't recognise and allow for this. The difficulty is that everybody is indeed different in their response to carbs and you can't make up useful specific rules. If you just say, "cut carbs as much as possible", then you risk people cutting too much fibre and micronutrients and adding too much sat fat, salt etc, and for many people it just won't be sustainable anyway. But if you want to make it more nuanced, you have to recognise that people will have to test often to work out what does what to them, which depending on jurisdiction may fly in the face of anti-SMBG policy and anyway runs into the inability or unwillingness of many T2's to self-test effectively.

- The latest update to the American Diabetes Association guidelines recognises these difficulties, and says in essence: "Eat healthy, and within this manage carbs in personalised consultation with a dietary expert". That's probably the best which can be done at the moment in terms of general guidance, but it's obviously not very satisfactory, for newbies looking for answers and without access to expert one-on-one guidance, or without SMBG support. The ADA commentary is hopeful about the recent high-profile personalised nutrition research - send a stool sample, get back a list of foods to try/avoid. But there aren't any sure-fire answers right now.
 
I was certainly pleased when Diabetes UK’s official guidance began to more clearly highlight the impact of carbohydrate on blood glucose levels - along with many in the wider HCP community.

Around 10 years ago official advice for PWD was to ‘base all meals around starchy carbohydrate’. So much so that I remember some people on arriving forums who had followed this advice, added far more carbohydrate into their diet than they had eaten before, and got themselves into a bit of a pickle both weight-wise and certainly BG-wise.

So by comparison, I see the current advice as moving in a much more positive, ‘carb aware’ direction.

eg
All the carbohydrates you eat and drink are broken down into glucose. The type, and amount, you consume can make a difference to your blood glucose levels and diabetes management.
And...

Everyone needs some carbohydrate-containing foods in their diet. The actual amount that you need to eat will depend on your age, activity levels and the goals you are trying to achieve. For example, one person trying to lose weight and manage their blood glucose levels on a low-carb diet would restrict their carb intake, while another person who is happy with their weight may decide to eat more healthy carbs. The total amount of carbohydrate eaten will have the biggest effect on your glucose levels after eating, so it is important to know how much you’re eating. However, not everyone with diabetes needs to restrict their carb intake.​

https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/carbohydrates-and-diabetes

which seems very much to align with forum experience. Carbs raise BG, and different people can cope with different amounts and types.
 
- On the other hand restricting carbs does have an obvious impact on post-prandial BG levels and this is important while in the early stages of getting T2D tamed. Things like "Eat Well" fall down to the extent they don't recognise and allow for this. The difficulty is that everybody is indeed different in their response to carbs and you can't make up useful specific rules. If you just say, "cut carbs as much as possible", then you risk people cutting too much fibre and micronutrients and adding too much sat fat, salt etc, and for many people it just won't be sustainable anyway. But if you want to make it more nuanced, you have to recognise that people will have to test often to work out what does what to them, which depending on jurisdiction may fly in the face of anti-SMBG policy and anyway runs into the inability or unwillingness of many T2's to self-test effectively.
I regularly recommend on here that people self test so they can see what affect things have. Unfortuneately self testing is dismissed and unsupported by HCP.
 
They are probably waiting for the new legislation regarding diet, on the expert diabetes 2 course I attended run by NHS with Diabetes.org UK, they know low carb is better and acknowledge world health got it wrong regarding low fat. I suspect UK health generally are a bit embarrassed about steering the population wrong. Still many people and doctors think low fat is a good idea.

Was the person actually talking about diabetes.org.uk or diabetes.co.uk site, they are 2 different sites.

here is diabetes.org.uk link page on carbs https://www.diabetes.org.uk/search?q=carbohydrates&op=Search+Diabetes+UK
It’s was the Diabetes .org.uk site they were on about specifically in relation to T2 diabetes and diet advice...
 
As a counter to this:

- BG isn't the be all & end all. Other risk factors are generally at least as important, including BP and cholesterol. Any responsible dietary guidance has to take this into account. This is one of the main drivers behind recs like "Eat Well", I believe. If you focus just on BG then you might risk getting not enough fibre, too much sat fat, too much salt, not a wide enough spread of micronutrients etc etc.

- Fibre is really important & this is the main reason for the wholegrains recs. The thinking is that people generally don't get enough fibre and a lot of what they do get is from grains. So recommend wholegrains. (Personally, as a seed fanatic, I think the answer to this one is pretty obvious: seeds are way more nutritious than grains, without the BG impact and with way more fibre.)

- Despite the buzz, many people actually do get their BG under control by following the general recommendations. To the extent they exist, credible studies suggest that any generally healthy way of eating works equally well, with a (vaguely defined) Mediterranean diet generally doing a bit better than LCHF, vegan, whatever in the medium term. This is because at the general T2D population level, the most important thing for getting BG under control is weight loss, much more important than macronutrient composition.

- Restricting carbs in the absence of weight loss generally isn't going to do much for fasting BG levels. There's no credible evidence that carb restriction does anything much to improve hepatic insulin resistance, which drives overactive gluconeogensis, the process by which he liver (mainly) produces glucose from amino acids, trigs etc - not carbs. This process is most apparent overnight and is supposed to be the most characteristic feature of T2D. What does generally work is sufficient weight loss to clear fat from the liver and thereby improve hepatic insulin sensitivity.

- On the other hand restricting carbs does have an obvious impact on post-prandial BG levels and this is important while in the early stages of getting T2D tamed. Things like "Eat Well" fall down to the extent they don't recognise and allow for this. The difficulty is that everybody is indeed different in their response to carbs and you can't make up useful specific rules. If you just say, "cut carbs as much as possible", then you risk people cutting too much fibre and micronutrients and adding too much sat fat, salt etc, and for many people it just won't be sustainable anyway. But if you want to make it more nuanced, you have to recognise that people will have to test often to work out what does what to them, which depending on jurisdiction may fly in the face of anti-SMBG policy and anyway runs into the inability or unwillingness of many T2's to self-test effectively.

- The latest update to the American Diabetes Association guidelines recognises these difficulties, and says in essence: "Eat healthy, and within this manage carbs in personalised consultation with a dietary expert". That's probably the best which can be done at the moment in terms of general guidance, but it's obviously not very satisfactory, for newbies looking for answers and without access to expert one-on-one guidance, or without SMBG support. The ADA commentary is hopeful about the recent high-profile personalised nutrition research - send a stool sample, get back a list of foods to try/avoid. But there aren't any sure-fire answers right now.
Some great points there, much to think about...!
 
This is the "key takeaways" from the ADA update I mentioned above: https://www.diabetes.org/sites/default/files/2019-10/ADV_2019_Consumer_Nutrition_One Pager.pdf

It's all good & worthy IMO but if I was a newbie looking for answers I could find it pretty frustrating - damn you, give me more rules!

There is no “diabetes diet.” Really. Talk to your doctor and get a referral to a registered dietitian nutritionist (RDN) who can help you figure out what eating plan makes the most sense for you and your treatment goals.

You have choices—lots. Many different eating patterns can help you manage your diabetes—from Mediterranean to low-carbohydrate to vegetarian. Whatever you choose, be sure to include lots of non-starchy vegetables, minimize added sugars and refined grains, and choose whole, minimally processed foods.

Macronutrients may vary. We wish we could tell you the perfect percentage of calories from carbs, protein, and fat that you need, but the truth is the percentages can and should be individualized.

Carbs are not one-size-fits-all. While there is growing evidence to show that low-carbohydrate eating patterns can benefit people with diabetes and prediabetes, there is no one definition for “low carb.” For some, following an eating pattern lower in carbs (26–45% of total calories from carbohydrate) showed better blood sugars and a reduction in diabetes medications, among other benefits. Work closely with your doctor and RDN if you choose a lower carb approach to minimize risks (such as hypoglycemia) and maximize success

Weight loss works. Losing modest amounts of weight (start with 5%) can improve your blood sugars and other diabetes outcomes in both type 1 and type 2 diabetes.

Tweaking your food choices can help reduce risk factors for complications. Food swaps are easy ways for people with diabetes to reduce their risk for cardiovascular disease and kidney disease. For example, consider replacing foods high in saturated fat, such as butter and fatty beef, with foods rich in unsaturated fats, like olive oil and fish.
 
Yes I realise, but the webpage doesn’t mention LCHF at all and perhaps needs to reflect what we all suspect to be true...for T2
Thanks for your answer @Stitch147
The Carbs and Cals book reflects very much concerning carbs and portion size. Did you check out any of the links on the page posted above, I think you will find there is lots of information about carbs.

One of those links was :- (check out title How much Carbs)
https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/carbohydrates-and-diabetes

It is optional whether people go no, low, very low, or reduced carbs in their diet of course, what suits one will not always be suitable for another.

Who actually has the beef about diabetes.or.uk not giving the info ? Its no biggy either way, people will follow what diet they wish with all the information that is out there, including what is on this site and any other site for that matter or web page for that matter.

Have you check out diabetesScotland pages Martin I notice they have education and training pages too 🙂 http://www.diabetesinscotland.org.uk/
 
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The Carbs and Cals book reflects very much concerning carbs and portion size. Did you check out any of the links on the page posted above, I think you will find there is lots of information about carbs.

One of those links was :- (check out title How much Carbs)
https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/carbohydrates-and-diabetes

It is optional whether people go no, low, very low, or reduced carbs in their diet of course, what suits one will not always be suitable for another.

Who actually has the beef about diabetes.or.uk not giving the info ? Its no biggy either way, people will follow what diet they wish with all the information that is out there, including what is on this site and any other site for that matter or web page for that matter.

Have you check out diabetesScotland pages Martin I notice they have education and training pages too 🙂 http://www.diabetesinscotland.org.uk/

Jodee , I’m sure if you look around hard enough on the webpage you might find references to LCHF , but as a T2 first joiner you will get directed towards an eat well diet.
If you asking ‘ who has the beef’ , well it was me who originally asked on here following a comment on a FB group for U.K. diabetes T2 , saying the webpage was stuck in the 90s..
I asked as a discussion point only , but for you seems emotionally charged, hope you well take care with whatever diet you chose..
 
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Jodee , I’m sure if you look around hard enough on the webpage you might find references to LCHF , but as a T2 first joiner you will get directed towards an eat well diet.
If you asking ‘ who has the beef’ , well it was me who originally asked on here following a comment on a FB group for U.K. diabetes T2 , saying the webpage was stuck in the 90s..
I asked as a discussion point only , but for you seems emotionally charged, hope you well take care with whatever diet you chose..
~Ditto Martin I don't expect you will see the initials LCHF on that page but it does pretty well explain what carbs do.
High* Fat is dependent if you are going no carbs I believe as the body needs more animal fat / protein when on a no to very low carbs diet. Of course for folks wanting to loose some weight (which also helps tremendously in bringing the blood glucose down) high fat may not be so good, its good for anyone changing their diet when newly diagnosed to take advantage of the ~DESMOND or Expert course or just chat with their doctor, each person will have a different dietary requirement.

*High fat as in excessive consumption. Full fat as in normal diet (not excessive) portion size of all if looking to loose some lbs and to help the blood glucose levels in addition to reduced / low carbs.
 
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