Carb counting course.

[helli]

Unfortunately I think most people don't even know that they CAN take charge, so they don't look for resources.

This is really really important.
Most people with diabetes are not on this forum, do not know about Bertie and many expect to get all they need from their doctor rather than the internet.
My MIL believes she is managing her diabetes because she takes Metformin every day and the GP tells her nothing more when she has her annual review.

 

[Lisa65]

This is really really important.
Most people with diabetes are not on this forum, do not know about Bertie and many expect to get all they need from their doctor rather than the internet.
My MIL believes she is managing her diabetes because she takes Metformin every day and the GP tells her nothing more when she has her annual review.

I once went with my mum to visit a friend of hers, when I declined a piece of cake she said "I'm diabetic too and as long as I take my tablets I can eat what I like" she was already practically blind!

 

[Inka]

That's the problem, but the solution is not that everyone must look for resources for themselves. There is far too much information available to digest at once immediately after diagnosis. Or for GPs and DNs to keep on top of.

I'd say the Department of Health and the NHS should commission authoritative, up to date, well presented 'Handy Guides' (for want of a better name) to Type 1, Type 2 and Prediabetes. These would fill the void identified by the posts in this thread. They would be a starting point for everyone, including HCPs.

I think they do still have some leaflets but the leaflets don’t cover carb-counting, which is crucial for Type 1.

 

[Leadinglights]

I once went with my mum to visit a friend of hers, when I declined a piece of cake she said "I'm diabetic too and as long as I take my tablets I can eat what I like" she was already practically blind!

More or less as with a friend who was telling me he had lost feeling in his feet, had to have his car converted to hand controls, had to get rid of his caravan and classic car and then piled his plate with sandwiches and cake and took the tablet.

 

[nonethewiser]

@nonethewiser
Yes, information overload - please see my post, the one before yours.

No, wasn't implying that it's a case of information overload, was merely saying that theres no need to be floundering around in the dark nowadays with so much info freely available to hand, as where decades before it wasn't.

 

[JITR]

No, wasn't implying that it's a case of information overload, was merely saying that theres no need to be floundering around in the dark nowadays with so much info freely available to hand, as where decades before it wasn't.

I realise that. There is so much information available nowadays that a newly diagnosed diabetic may find it difficult to know where to start. That is where authoritative guidance is needed.

There are many examples in this forum of people feeling left high and dry after phone calls and meetings with HCPs at one of the thousands of surgeries in this country.

A single source of authoritative guidance would fill that void. This would aim to help people who have to look after themselves and others.

This is not the same as NICE guidelines which are basically for professionals delivering treatment.

 

[Inka]

Diabetes U.K. does a good job at helping to fill that void @JITR Not just this forum but the numerous information pages on the website and the Careline 🙂 I know some HCPs suggest DUK.

 

[JITR]

The T1 chap was guessing most of his doses and didn't know he was "allowed" to adjust his basal if he needed to, and usually tried to go to bed at 15mmol so he didn't hypo during the night.

It’s probably all to do with time and money. When I was diagnosed with Type 1 30+ years ago, I had a visit in hospital from a consultant who explained things and answered questions. I then had a visit from a dietician who went over carbs and gave me an excellent leaflet with handy carb counts in. Now they seem to think that it makes it ‘easier’ to be told very little. It doesn’t, it just causes stress and confusion.

I hope you recommended they join this forum!

@Inka Yes DUK do a good job but I am addressing your unarguable point about 'stress and confusion' in your response, quoted above, to Lisa's OP about carb counting for those on insulin.

That some HCPs recommend DUK rather proves the point, given the absence of anything else.

My GPs were spot on with diagnosis, T2D and a liver complication. Their prescribed treatment followed NICE guidelines but was wrong for me through lack of knowledge about remission. The treatment for my liver and T2D proved to be one and the same.

Up to date authoritative guidance would have told me that, and my GPs as well.

Anyway enough said, methinks.

 

[louisew]

So today I went to the "carb awareness" half day course run by the diabetes department at my local hospital. There were only three attendees as a couple of people hadn't turned up.

The course was run by a young dietician, we introduced ourselves and talked about our reasons for wanting to do the course. The other people there were a late onset T1 and another insulin dependent T2 like me.

The lady went through the basics of how to carb count, suggested the carbs and cals book/app, got us to write down the kind of meals and snacks we ate and helped us to calculate the insulin needed, a bit about correction doses and insulin /carb ratios.

The other T2 fella was on huge amounts of insulin which must have made calculation of doses hard for him. The T1 chap was guessing most of his doses and didn't know he was "allowed" to adjust his basal if he needed to, and usually tried to go to bed at 15mmol so he didn't hypo during the night.

It makes me very sad that so many diabetics are essentially left to their own devices with little or no advice. Surely more guidance in the early stages would save the NHS money in the long run by not having to treat so many complications down the line?

I didn't learn anything I hadn't already read about, but it helped to see someone else explaining it and I feel a bit more confident about starting Trurapi now. She suggested I start with a 1:10 ratio with a correction dose of 1 unit to 2-3 mmol and see how it goes.

But it’s pretty easy to find this information on the internet now, including on sites like this. I’m a type 2 on insulin and was never offered any classes but my diabetic nurse recommended 60g carbs a day, suggested beginning doses of insulin and I’ve adjusted it to my needs. Carbs and calories is a helpful app, and just looking at nutritional values of food. I now very rarely need to look anything up, and can usually work out when to take extra insulin or when to eat extra carbs. I do self finance a libre which makes it very easy. Hope the class helps you and makes you more confident about your food choices

 

[mashedupmatt]

The BERTIE Course has been mentioned several times and it is a good starter to carb counting - it is designed for Type 1's but there's no reason why Type 2's (or any other type) couldn't access it and complete the carb counting section - it's free to do, and is all online

It can be found here: https://bertiediabetes.com/

 

[Inka]

@Inka Yes DUK do a good job but I am addressing your unarguable point about 'stress and confusion' in your response, quoted above, to Lisa's OP about carb counting for those on insulin.

That some HCPs recommend DUK rather proves the point, given the absence of anything else.

My GPs were spot on with diagnosis, T2D and a liver complication. Their prescribed treatment followed NICE guidelines but was wrong for me through lack of knowledge about remission. The treatment for my liver and T2D proved to be one and the same.

Up to date authoritative guidance would have told me that, and my GPs as well.

Anyway enough said, methinks.

In some HCPs attempts to ‘make things easier’ for newly diagnosed Type 1s, they omit to give the carb counting tools that are crucial to control. I think that’s the important bit.

I don’t know what leaflets my hospital has now, but I got a collection of them, including Sick Day Rules. However, I was in hospital, and if an older adult was diagnosed by a GP, they might not have access to the same leaflets. Even if they’re later seen in clinic, if they’ve been diagnosed a while people might not think to give them leaflets.

I’m sure we’re agreeing here 🙂