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trophywench said:
I remember the survey well Hannah - but - where are the results thereof? - or, when will they be available? Whether DUK are able to glean anything meaningful from them which might enable them to take any action, or not. We all know very well that if you bang your head on awall for long enough and hard enough - eventually a crack should appear. But we KNOW it won't be instant ! LOL

I mean - I just did a BEAT Diabetes survey about management of BP, today. At the end it asked me to give my email address if I wanted to know the results thereof. I did, so I gave it them. I can now confidently forget about it FTB and not waste time wondering what's happened, can't I?
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The survey closed early last week and we're currently analysing the results - once done, we will be publishing this on the website soon but I have passed on to the team the option to update people via email about the results, thanks for the suggestion! Our Policy Team will be going back to talk to NHS England about what they can do to improve access to strips and choice of meters. Fingers crossed, slowly and steadily, we can implement changes, but with all things of this nature, they rarely come quickly - although it is not unheard of...🙂
 
Hannah M said:
Our dietary advice is generally around healthy eating and balanced diets as its the most broadly beneficial diet and tends to be the option that people are likely to stick to long-term, however, saying that, we are fully supportive of any diets that individuals find to be beneficial to them. If anyone wishes to follow a low carb diet that’s absolutley fine, we'd just advise discussing it with their GP in advance. The only issue is that we don’t yet know the long term results of low-carb, and that's why we're continuing to fund a low calorie diet study. People need to find a diet that they can stick to long term. There are an awful lot of ‘evidence based diets’ now, yet the vast majority of studies all suggest that healthy balanced diets are the most likely to be sustained. Essentially, we support whatever works for individuals, be that low carb, low cal, or Mediterranean to name but a few.

Hope that makes sense! 🙂
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What you say makes sense...but it's completely at odds with the actual advice you give.

https://www.diabetes.org.uk/Guide-t...ith-diabetes/What-is-a-healthy-balanced-diet/

You define a 'balanced diet' as something that's based around starches and with little fat. I'm not sure you quite understand what I'm getting at - what I'm suggesting (and the evidence is suggesting) is that the standardised definition of 'healthy eating' and a 'balanced' diet is incorrect. There's nothing 'balanced' about a diet primarily based on starches with little fat, in the same way that there's nothing 'balanced' about a high fat, low carb diet either. 'Balance' would imply equal proportions of macro-nutrients which is not what anyone is truly advocating. I'm not sure why 'balance' is regarded as inherently good.

I would also question how much awareness there genuinely is of what constitutes a low-carb diet since you state that you're funding a low calorie study. Those are completely different things. If you were genuinely looking into the long-term results, you would be funding a low-carb, high fat diet study.

I agree that people need to find a diet to stick to in the long term but the arguement seems to be framed around the idea that the easiest one to stick to is also probably the worst one overall. There's no point following a diet that's easy to stick to if it makes managing your diabetes more difficult.
 
DeusXM said:
I agree that people need to find a diet to stick to in the long term but the argument seems to be framed around the idea that the easiest one to stick to is also probably the worst one overall. There's no point following a diet that's easy to stick to if it makes managing your diabetes more difficult.
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I prefer to look at my diet as a "Way of Eating".... Before I was diagnosed T2, I used to eat a "balanced" diet with lots of grains, pulses, beans & starch, now I don't, the result is that I have evolved how I eat into a sustainable LCHF diet that I enjoy. Sustainability is more about education than a cookie cutter approach to telling people what to eat.

I have seen so many times people caught up on calories rather than looking at carbs, hence a carb rich diet where a population is growing steadily more obese by the decade (with the attendant healthcare problems that that causes). Fats sate the appetite so portions are naturally smaller (hence less calories).
 
DeusXM said:
With Betavivo, is it necessarily wise for a producer of a product that is something like 50% carbohydrate to be involved with a charity dedicated to helping people who can't metabolise carbohydrates, and with their sponsorship of the Tomorrow's Leaders course, does their sponsorship by any chance extend to any of the materials used on the course? I'm interested to know if there's anything on this course about diet (and particularly, if there are any breakfast recommendations o_O)

Similarly, is it really a good idea to be involved with a yoghurt company that produces a yogurt that contains more carbs by weight than Coca-Cola? I'm all for taking money from corporations, but don't these on-pack promotions imply that these products are universally good/better choices for people with diabetes? I know everyone is different, your mileage may vary etc. but I can really easily see some of the perhaps less-well supported people with diabetes seeing the Diabetes UK pack promotion, and interpreting that as meaning they can eat these yogurts in place of regular ones and expect better long-term glucose control.

Sorry - I know that corporate donations are a bit of a case of dancing with the devil and things have certainly improved since the days when you had confectioners, international cereal manufacturers and statin producers as sponsors. But I know companies tend to sponsor charities with a view to getting some good PR in return and those who sponsor conferences etc. usually expect some sort of input into the presentation materials.[/USER]
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Yes @DeusXM - you're not wrong, there is some element of danger when working with Corporate Partners and the risks that can arise when developing partnerships are something that we do have to be aware of. Each corporate partner has to go through a Risk Assesssment with us, something that we know is particularly important when partnering with food & drink comapnies or pharmaceutical companies. Partners are developed with consideration and have to meet all the requirements in our 'Working with Funding Partners Policy' - an exciting read if you wish to have a look. 🙂

https://www.diabetes.org.uk/Documents/Corporate/FINAL Working with Companies Policy 2015 (updated November 2015).pdf[/USER]
 
Amberzak said:
I would also like to know about groups and support in place specifically for type 1's. I went to a support group once and I was the only type one there.
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Hi @Amberzak - Just thought I'd say that I passed on your comments to highlight your experience at the support group, but thought I'd mention that you may want to get in touch with your Regional Team - The managers know the groups in each area really well so they should be able to highlight any groups that are more focussed around type 1 or have more type 1 members, or any other things that may be happening at a more local level.
There is an additional online community for young adults through the #Type1uncut project as well. 🙂
 
DeusXM said:
What you say makes sense...but it's completely at odds with the actual advice you give.

https://www.diabetes.org.uk/Guide-t...ith-diabetes/What-is-a-healthy-balanced-diet/

You define a 'balanced diet' as something that's based around starches and with little fat. I'm not sure you quite understand what I'm getting at - what I'm suggesting (and the evidence is suggesting) is that the standardised definition of 'healthy eating' and a 'balanced' diet is incorrect. There's nothing 'balanced' about a diet primarily based on starches with little fat, in the same way that there's nothing 'balanced' about a high fat, low carb diet either. 'Balance' would imply equal proportions of macro-nutrients which is not what anyone is truly advocating. I'm not sure why 'balance' is regarded as inherently good.

I would also question how much awareness there genuinely is of what constitutes a low-carb diet since you state that you're funding a low calorie study. Those are completely different things. If you were genuinely looking into the long-term results, you would be funding a low-carb, high fat diet study.

I agree that people need to find a diet to stick to in the long term but the arguement seems to be framed around the idea that the easiest one to stick to is also probably the worst one overall. There's no point following a diet that's easy to stick to if it makes managing your diabetes more difficult.
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As you say, there are really promising results from the studies on low-carb diets - unfortunately, the studies are still very small and results tend to get cherry picked and so the evidence is not always reliable. It doesn't mean that there are no benefits to low-carb diets at all, it is just that the evidence is not yet enough for any fundamental changes in advice to be made. There has been a big response to the NOF report from experts, which you may find interesting - you can view here.

There can be a lot of confusion around what all the different diets mean. The DiRECT study which we're funding on low-calorie diets is in fact quite low in carbs too, however it is testing whether a low-calorie diet, made up of starchy veg and shakes, can put Type 2 into remission - so it’s slightly different to the diets we might recommend for managing T2. It would certainly be beneficial to fund some further studies into the low-carb diets which we are open to doing, however we don’t propose research projects ourselves, we review applications that come into us, so it is a case of someone submitting a viable research study.

In terms of a balanced diet, the term suggests that you need to consume from all of the main food groups, in order to get all the essential nutrients needed. The amount eaten from each group is not necessarily equal, but it is ensuring that you are not just eating from 1 or 2 food groups. It is about having a broad diet. Although other diet options may well be beneficial, current evidence supports the benefits of a healthy, balanced diet.
There is a more detailed account of our advice on this, in particular dieatary fats, which has been put together in consultation with the British Dietetic Association and may be of interest to you: https://www.diabetes.org.uk/Documents/Dietary%20Fat%20Consumption%20in%20the%20management%20of%20Type%202%20Diabetes.pdf

Dietary advice has changed a lot over the years and I'm sure it will continue to change as a result of continuous research studies and clinical trials, providing detailed evidence of the results.
 
Thanks Hannah - I have to say I found the expert response to the NOF fascinating, not least because the common criticism was we don't have any long term evidence (which begs the question of why isn't the low fat diet under the same scrutiny, and shouldn't we therefore be doing these long term tests?) and at least one of the NOF critics admits the studies they've done on cholesterol don't actually support the accepted wisdom.

Re DiRECT, as you say, there is a lot of confusion, not least because you say it's a low-carb diet...but then say it's based on starchy veg. I appreciate you're not a dietician but this is diabetes basics here.

Re: 'balanced' diets, again, I appreciate you aren't the right person for this but I'm having tremendous difficulty understanding how 'a balanced diet includes a bit of everything you need ' translates to 'lots of carbs, a bit of protein and minimise fat' but not 'minimise carbs, a bit of protein and lots of fat'. Again this is what I'm trying to get at, that the assumption that fat is bad and therefore not up for discussion is dubious at best.

I take on board your point about research and I have to say, I'm a bit shocked. Obviously im no expert on how funding works but am I reading this right, that Diabetes UK waits for people to come to them for funding? You're supposed to our advocate. You're supposed to represent us. Why isn't there a medical board saying 'hey, we need to know more about this approach?' and then advertising that funding is available? Otherwise, we're all just going to be sat here hoping done postgrad happens to research something that's helpful. Surely this is a fundamental basic part of the charity's purpose? It's your job to propose research, surely?
 
I think the universities usually have to decide what they are interested in researching - it's not up to individual funders. I think they take it in turns - Warwick Uni did shedloads of diabetes work for donkeys years - and then stopped !
 
Sometimes whole research teams move from one institution to another. I know it's not diabetes related, but it's an example of which I have personal knowledge: several years ago, Sea Mammal Research Unit moved from British Antarctic Survey HQ in Cambridge to St Andrews University.
 
trophywench said:
I think the universities usually have to decide what they are interested in researching - it's not up to individual funders. I think they take it in turns - Warwick Uni did shedloads of diabetes work for donkeys years - and then stopped !
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I get that, but surely any charity looking to find the best answers for people with diabetes should be playing a leadership role in research?

A case in point; there's obviously debate over the impact of particular diets. Surely it makes sense for Diabetes UK to have a research board that then flags up 'hey, we will make £500k available for an institution to research the impact of diets x, y and z on people with diabetes'? It seems insane that the main funding body for diabetes-related research should be a purely passive association that sits there hoping that eventually someone decides to research something that's a common concern. Again, it's simply not good enough to look at one particular diet and shrug that we don't know enough about the long-term impact. Research the long-term impact then! If you've got multiple GPs reporting in dramatic improvements based on doing the opposite of the official recommendations, hasn't that motivated anyone at Diabetes UK to try investigating further?

These decisions should NOT be left to universities to decide what they want to research. Diabetes research should be driven, above all, by people with diabetes and their representatives, because they are the ones who actually know what questions need to be answered.
 
But - Uni research depts. are all attached to their hospitals aren't they? so unless the hospital needs the students (and therefore their future consultants) to become expert in some area - they are not going to want to plough all that many resources into it all, Deus. Each dept of each Uni has to show - not profit - but a good return on the investment. There is no great benevolence at work anywhere here - only if there is either kudos or acclaim; proof of them being good at whatever they happen to be good at, to attract students and money.

Recruiting the patients to take part in the trials ? You'd think that would be easy - not so! The paperwork the researchers have to provide for the professionals they want to pitch this to, is enormous and equally costly and takes ages because of all the hoops it has to jump through before it's able to go Live.

I was lucky enough to be a member of the specialist Diabetes Group that was set up at Warwick Uni Medical School to work alongside the Researchers and Dons there. At the time it was set up, none of those people could see how much lay diabetics could help them.

How many times have you perused or taken part in some survey that some student is doing at some Uni, as part of their Ph D - and how many times have you or someone else said or thought 'Well - if he wants to find THAT out - he's asking the wrong blooming questions!' or 'Why isn't there an option for some other alternative here - nobody these days still does the things you have a choice of as answers!' Exactly! - it's because diabetics are not informing them before they start!

WE trained THEM - and eventually Warwick Ethics Committee refused to entertain proposals that had or could have any involvement of people with diabetes unless we'd seen it first and approved it! The research student used to come with whoever their Prof was and present their proposal and we'd all talk about it quite openly with them, around a very large table LOL Consensus was always reached and there was usually quite a bit of laughter involved. This is one of the reasons why they were so good at it all, in the finish.

Other Unis have learned from the Warwick blueprint - but not all of them as yet - hence we still get the survey monkeys with the daft questions!
 
There's a really handy little diagram on the website that explains the process of selecting research proposals, just at the bottom of this page: https://www.diabetes.org.uk/Research/Our-approach-to-research/

Some of the research propsals are from universities - we receive hundreds of propsals every year, which we narrow down and fund on a rolling, 6 month basis. The applicants range from small scale trials, up to large scale propsals from experts in their field. Each one goes through the same process to establish if it is scientifically viable and whether it will benefit those living with diabetes. There's close consultation with scientists and healthcare professionals, but we do also work closely with people living with diabetes (our Grants Advisory Panel), who help us in the shortlisting process to establish which projects to fund.

And of course, we do research beforehand, to see what people would like to see being funded, like the survey that Northener has mentioned and probably some of the survey monkeys you will see floating around with daft questions 😉 We will keep pestering you to find out what you'd like so please do get involved! You are very welcome to email the research team too, they are happy to answer questions or take feedback - research@diabetes.org.uk 🙂
 
Not all publically funded research is done by universities. For example, a few years ago, I worked for MRC Epidemiology Unit, which carried out research relating to type 2 diabetes, among other things. Some members of academic staff held joint posts with universities (usually Cambridge University, as main base of unit was in Cambridge, with satelite units at Ely and Wisbech), and all clinicians who came into contact with research volunteers, also held honorary NHS posts. MRC = Medical Research Unit, which has been funded by British Government since 1913. MRC Epidemiology Unit isn't nearly as old as MRC.
 
There's a really handy little diagram on the website that explains the process of selecting research proposals, just at the bottom of this page: https://www.diabetes.org.uk/Research/Our-approach-to-research/
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Which unfortunately confirms my worst fears. Your funding strategy is reactive, not proactive. That's appalling for an organisation that is supposed to be taking a leadership role.

Look, I get the whole point that universities research what is in their commercial interest. That's why I'm frankly horrified that Diabetes UK's research strategy is reactive. It is precisely because researchers are motivated by concerns beyond scientific discovery, that the leading charity for diabetes advocacy should be creating the conditions where the right diabetes research is of benefit to the researching university. I can think of several research questions off the top of my head that probably wouldn't be commercially interesting/deliver prestige to a uni in their own right but would be incredibly valuable for people with diabetes - and surely that's the reason we have a charity?

It's a really simple question: why isn't Diabetes UK leading and co-ordinating the UK diabetes research agenda? Why are we allowing private institutions with no particular stake in diabetes to effectively determine what gets researched?
 
Hannah M said:
Our dietary advice is generally around healthy eating and balanced diets as its the most broadly beneficial diet and tends to be the option that people are likely to stick to long-term, however, saying that, we are fully supportive of any diets that individuals find to be beneficial to them. If anyone wishes to follow a low carb diet that’s absolutley fine, we'd just advise discussing it with their GP in advance. The only issue is that we don’t yet know the long term results of low-carb, and that's why we're continuing to fund a low calorie diet study. People need to find a diet that they can stick to long term. There are an awful lot of ‘evidence based diets’ now, yet the vast majority of studies all suggest that healthy balanced diets are the most likely to be sustained. Essentially, we support whatever works for individuals, be that low carb, low cal, or Mediterranean to name but a few.

Hope that makes sense! 🙂
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ADA goes a step further and as from 2013, actually recommends a Mediterranean diet as an effective alternative to a lower-fat, higher-carbohydrate eating pattern

ADA Position Statement
http://care.diabetesjournals.org/content/36/11/3821.full.pdf+html?with-ds=yes

Fat Evidence is inconclusive for an ideal amount of total fat intake for people with diabetes;
therefore, goals should be individualized; fat quality appears to be far more important than quantity.

In people with type 2 diabetes, a Mediterranean-style, MUFA-rich [mono fat-rich] eating pattern may benefit glycemic control and CVD risk factors and can therefore be recommended as an effective alternative to a lower-fat, higher-carbohydrate eating pattern.


Carbohydrates Evidence is inconclusive for an ideal amount of carbohydrate intake for people with diabetes. Therefore, collaborative goals should be developed with the individual with diabetes.

The amount of carbohydrates and available insulin may be the most important factor influencing glycemic response after eating and should be considered when developing the eating plan.

Monitoring carbohydrate intake, whether by carbohydrate counting or experience-based estimation remains a key strategy in achieving glycemic control.
 
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Hannah M said:
Hello everyone, as Northerner has kindly mentioned, I’m here to answer any niggling questions you may have about Diabetes UK, pass on your views or thoughts and offer insight to things happening in the organisations. I’m really looking forward to getting to know you all and become part of this very supportive community. 🙂:D
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Hi I would like to know if any 1 get red boil type marks on there body was just wondering if it was related to diabetes
 
Hannah M said:
at you may want to get in touch with your Regional Team - The managers know the groups in each area really well so they should be able to highlight any groups that are more focussed around type 1 or have more type 1 members, or any other things that may be happening at a more local level.
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Hi Hannah
Although the regional offices may know about the local groups that does not magically create a group that is more focused on Type 1. There may be T1 groups in large cities , especially university towns, but there are very few in the more rural areas, which is why like Amberzack, I am interested in DUK addressing the needs of adults with T1, as well as the needs for people up to the age of 30.
 
Linda63 said:
Hi I would like to know if any 1 get red boil type marks on there body was just wondering if it was related to diabetes
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Welcome to the forum, Linda63. Youy'll probably get more answers if you start your own thread in Newbies or General Messageboard.
 
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