Carb or not to carb ?

[Bill Stewardson]

Thank you for your concern. I really do appreciate it, and I am increasingly aware that advice may be of different value depending on the source.

My concern is a result of receiving orthodox advice some years ago, and following it precisely, but with moderate results and very limited monitoring. I have tried to obtain information about HbA1c results prior to 2016, but these and other records seem to be unavailable. I was not told anything except in the vaguest terms. At the time I did see a GP who was himself diabetic, and found him to be persuasively informed and sympathetic to recording BGs regularly. The present staff at the surgery appear to regard regular observance of BGs as a bit excessive, unnecessary and undesirable. When I said that one reason for maintaining a close scrutiny was to allow myself a slightly more varied diet I got a decidedly condescending response from DSN "T", who is "not a dietitian", but who supposed that "it depends on how much you have". And indeed it does, although I may add that I am not in the habit of preparing breakfast in a bucket. But as she had already expressed the opinion that there was no purpose in meeting, and that it was a "waste of time", asked a question about Gliclazide, and contradicted a reply I had not made... I have to agree with her: it was a waste of time.

So... HbA1c last year of 125, and I have the attention of a GP. With a succession leading to a January HbA1c of 43, and I am listed as "no further action needed", no interest in whether this was pure chance, or perhaps the application of a suitable strategy, and I am now regarded as an inconvenient and somewhat obsessive waster of the time of a DSN I had not seen in years.

Although the pyramid of expertise exists within the NHS, the obstructions to access also exist. And I do find it questionable that a medication with a stated 1 in 10 possibility of having an adverse effect on BGs has not been reviewed in a decade. As a responsible adult with a capacity for making informed decisions as well as ill conceived judgments I am in the curious position of having few responsibilities to others.

It is good to know that there are others taking an interest.

Ask your Qs in writing, give a set time to respond, aim you letter high and see what happens,

What harm can it do ?

 

[the blue wildebeest]

Indeed. That may be a way to go. I may even get to know who is really making the decisions...in a room, stroking a white cat...
😉

 

[Martin Canty]

My thoughts are that being LCHF forces us into another way of preparing food, i.e. make from scratch which is where I am at.... The advantages are that made from scratch makes our meals minimally processed, allows us to use quality ingredients (including the fat we use in our cooking). This even extends to the various rubs & flavorings that I use; I tend to concoct them myself or obtain from trusted sources.

I was turned onto this (Pre DX) after a discussion with a Restaurant owner who made everything from scratch every day using organic ingredients; he was not a large man but he had lost 30lb since coming to his epithany ... Post DX I was at a cooking demonstration in Crete where they were saying that the traditional Cretan diet produced low levels of heart problems, diabetes & cancer among the population until "western" diets were introduced & now these problems are on the rise.

 

[Plinkton]

Be interested to hear the results...obviously the professor has never witnessed the DESMOND Course...I've been on one Bill...most awful load of nonsense I've ever heard...patronising...condescending...useless...bit like being in a Mike Leigh production...Gathering Nuts & May springs to mind.

This is good to know. They have been trying to get me to go on one and I have been refusing mainly based on the information they have given me when I was diagnosed (pretty basic and mostly useless).

 

[Bubbsie]

This is good to know. They have been trying to get me to go on one and I have been refusing mainly based on the information they have given me when I was diagnosed (pretty basic and mostly useless).

Pinkton...some have found the course gave them some basic information...so it may have been useful if I'd gone on it soon after my DX (diagnosis)...alsoI have heard it can depend on the 'educators'...after labouring through the first half...I spoke to one of the presenters...who said 'I think you're a little more advanced than the others'...so I left at lunchtime...they have a structure...they plough through it regardless...do not really answer individual questions...said no need for a meter...no need to test your blood...out came the notorious 'eat well' plate...knew at that stage it wasn't for me...I'd been testing since joining the forum months before...knew high carbs didn't work for me...I gained nothing from it...other courses may be better.

 

[Plinkton]

Pinkton...some have found the course gave them some basic information...so it may have been useful if I'd gone on it soon after my DX (diagnosis)...alsoI have heard it can depend on the 'educators'...after labouring through the first half...I spoke to one of the presenters...who said 'I think you're a little more advanced than the others'...so I left at lunchtime...they have a structure...they plough through it regardless...do not really answer individual questions...said no need for a meter...no need to test your blood...out came the notorious 'eat well' plate...knew at that stage it wasn't for me...I'd been testing since joining the forum months before...knew high carbs didn't work for me...I gained nothing from it...other courses may be better.

Thanks. The educator in my case was my adviser, who had an interest in getting as many to attend as possible. They have recently left the practice and I will be seeing a new one next week for my recent tests results. At this stage I think I am past the basic information and the only thing I may gain from it is talking to the other attendees.

Thanks again for your insight 🙂

 

[Bill Stewardson]

When I worked in the NHS ( seven years from 06) Time and Motion studies were all the rage. They came out with figures for everything, a cost was worked out for a wheelchair not being used etc, it all made perfect sense to them. What it actually did was trigger all sorts of desperate attempts to make 2+2 equal about 37.
So, this causes me to wonder, what is the cost to the NHS of all these clearly ineffective corses etc ? Surely there would be a cost saving in doing them correctly and possibly actually helping to avert complications for those with D further down the line ?!

 

[Bubbsie]

When I worked in the NHS ( seven years from 06) Time and Motion studies were all the rage. They came out with figures for everything, a cost was worked out for a wheelchair not being used etc, it all made perfect sense to them. What it actually did was trigger all sorts of desperate attempts to make 2+2 equal about 37.
So, this causes me to wonder, what is the cost to the NHS of all these clearly ineffective corses etc ? Surely there would be a cost saving in doing them correctly and possibly actually helping to avert complications for those with D further down the line ?!

The problem is they have a protocol to follow Bill...they apply it regardless...we know that diet is very much an individual matter for types 2's ( most diabetics whether 1 or 2)...however...the 'eat well' plate re-appears time after time...they advise you should eat carbs with every meal...at least a third of your food should be carbs...whilst that may work for some of us...knew it didn't work for me...until they present alternatives...consider the benefits of different approaches...stop dismissing the need to test (if not on hypo medication)...then I cannot see it getting any better...I took a friend with me on the DESMOND course...she is type 2...never given much support...not managed her condition...on ever increasing amounts of meds...finally on large amounts of insulin...told me how 'the specialist' brought in by her practice treated her (dismissive...put her straight on insulin)...explained nothing...to my horror...her 'specialist' was one of the educators presenting the course...my friend has to accept some responsibility...she could have read...researched...she accepted the advice given...relied on the 'experts' and now is in the most horrendous mess...seems to me diabetes (and other conditions) has become a 'business'...while there's a fast buck to be made...any real progress is far far far away.