Type 2 Diabetics on Diet or Metformin - Why this advice?

[wallycorker]

I posted this on another forum but got nowhere near receiving an answer to my question. Thought that I'd try on here - people may be more knowlegeable or wiser. Apologies to any members that use both forums.

It is nearly nine years since I was diagnosed as a Type 2 diabetic yet I am increasingly confused regarding the advice I have received from the health authorities on this matter – i.e. NHS, Food Standards Agency, Diabetes UK, my diabetic team.

On diagnosis I remember well that I was told that I needed to:

a) avoid sugar
b) adopt a low-fat diet
c) eat more regular meals throughout the day.
d) ensure that I ate starchy carbohydrate such as bread, potatoes, pasta and cereal at every meal e) Type 2 diabetics had no need to test blood glucose levels.
f) my long-term blood glucose level (HbA1c) would be tested every three months

I took this advice very seriously and did as I was told. For a long time nothing very much happened – my HbA1c readings fell below some apparently satisfactory target of 7.5%. It seemed that I had been given good advice and was doing the right thing. At least I thought so and I wasn’t told any different.

However, after seven years my Hba1c rose to 8.2% and then 9.4% - so my GP prescribed Metformin tablets. Initially, my level fell to 7.2% and then 6.7% and it looked as though things were back on track. However, one year after the prescription of Metformin my level then rose again to 8.5% - so the GP doubled my dose of Metformin.

It was looking to me as though I was heading quite quickly towards the stage where I would need to start injecting insulin – and I wasn’t looking forward to reaching that stage. Because of that, I decided that I ought to try to find out whether there was anything that I could do myself to improve my diabetic situation. I had always been an avid reader of every book, magazine, leaflet and whatever reading matter I could find on the subject of diabetes (mainly from Diabetes UK sources or at least Diabetes UK approved) and applied every bit of advice that I came across in the course of that reading.

Because of my worsening situation, as a new approach, I went to the on-line book store Amazon and searched for “diabetes”. In doing this I became aware of books that talked of “reversing” and even “curing” diabetes – all originating from the USA and written by US doctors. It was like entering into another world! The common message that I picked up from reading such books was that I needed to take control of the situation myself and begin testing (i.e. self-management) to establish what was causing my elevated blood glucose levels. This was in total conflict to the advice that I had been given from UK sources.

As soon as this message had sunk in, off I went to my well-respected GP and told him what I had read and that I wanted to start testing. “Not necessary” was his reply! I insisted that I had made my mind up and really did want to sort my situation out. He knew that I had started to adopt a dietary lifestyle change and had already lost around 10 kgs in weight and, moreover, my HbA1c had fallen to 6.8%. No matter what I said, the GP insisted that he was not willing to prescribe test strips. As far as he was concerned, it was sufficient to check my HbA1c every three months to see how good – or how bad – my blood glucose control had been over that period of time. He stressed that, if I wanted to start testing, I would need to find a different GP who would be willing to back my action plan or, alternatively, I would have to buy strips myself. I decided to do the latter – and, immediately, started to spend my hard-earned state pension on test strips!

As soon as I started testing, I could see that it seemed to be carbohydrate that was raising my blood glucose levels and by simply cutting back on this part of my diet – also by changing to low GI options, eating more fruit and vegetables over and above the oft quoted ‘five a day’ and coupled with my continued weight loss (currently down by nearly 25 kgs) – my HbA1c levels have dropped to a very healthy 5.7% and then 5.5% at the last time of reading.

Over the nine years since diagnosis, my wife had often asked me why I ate so much carbohydrate. I always told her - sometimes quite manically and certainly impatiently - that I had been told that I needed to eat plenty of starchy carbohydrate. Often telling her quite angrily “Stop asking – it’s important in dealing with my diabetic condition!” However, because I had started to doubt whether I had heard the message correctly, I have recently taken a look to see whether I had got the wrong message. Here are extracts relating to this matter from some of the health authorities on their current websites:

NHS

• Eat plenty of starchy carbohydrates

Foods Standards Agency

What should people with diabetes eat?

• high in starchy carbohydrate foods, such as bread, chapatti, rice, pasta and yams (these should form the base of meals) - choose wholegrain varieties when you can.

Diabetes UK

……meals including some starchy foods, such as bread, potatoes, cereals, pasta and rice.

From what I have learnt recently since I started self-testing, it would appear that I have been seriously misled!

Because of this I have decided that would like to try to establish why the various health authorities give the advice that they do to Type 2 diabetics on diet alone or Metformin medication (i.e. non-insulin injection or other medication) and particularly those who are are routinely discouraged from self-testing.

I think that I am able to understand why both Type 1 and Type 2 diabetics who are injecting insulin can cover the amount of carbohydrate that they eat by the amount of insulin that they use. Moreover, I am very well aware that there are fervent supporters of the “low-carb” approach to diabetes generally. I really do not want to start another war on that front. I am simply looking for a straightforward answer, from someone who knows why the health authorities give out the message to “eat plenty of starchy carbohydrates”. It would be nice to hear from someone who was – or better still is - involved in coming to the policy decision to give out this message. I do hope that this will be possible.

In this case, I really do respectfully ask that people respond to this thread only as it applies to Type 2 diabetics on diet alone or Metformin medication (i.e. non-insulin injection or other medication) – and particularly those who are are routinely discouraged from self-testing.

 

[Hazel]

As already mentioned, I am a T2 recently diagosed as requiring insulin injections following a steady rise in blood glucose levels that could no longer be maintained by tablets.

The hospital specialists advised me that I had done nothing wrong, it was just that my body needed help, and that meant insulin.

The one thing I was told though, that it is a MUST to eat carbohydrates, as it is mantory for T2s to maintain their energy levels.

I can only pass on what I have been told, but perhaps you could talk to your DSR at the hospital to walk you through any concerns you have..

I wish you good luck

Hazel

 

[mikep1979]

this advice is given due to it working. my mum and aunty are both type 2 and follow this advice and are on metformin and have fantastic hba1c's. i do believe it is down to you wally if you feel you can get better results from your own diet, however i would also stress that you cant always take what these guys write in the books at face value. some people will put anything in to seel some books.

 

[wallycorker]

As already mentioned, I am a T2 recently diagosed as requiring insulin injections following a steady rise in blood glucose levels that could no longer be maintained by tablets.

The hospital specialists advised me that I had done nothing wrong, it was just that my body needed help, and that meant insulin.

The one thing I was told though, that it is a MUST to eat carbohydrates, as it is mantory for T2s to maintain their energy levels.

I can only pass on what I have been told, but perhaps you could talk to your DSR at the hospital to walk you through any concerns you have..

I wish you good luck

Hazel

Hi Hazel,

They certainly told me that I NEEDED to eat starchy carbohydrates but never told me why. For a long time - nearly nine years until relatively recently - I did follow that advice - but since I've started testing my blood glucose levels it is making me question why.

You will have found from this forum and others that many people can only maintain acceptable levels by reducing their carbohydrate intake - if they don't then their situation just seems to deteriorate - perhaps at varying speeds but eventually they seem to need more and more tablets and eventually insulin injections.

What or who is my DSR? By the way, the treatment of my Type 2 doesn't take me hardly any where near the hospital.

Best Wishes - John

 

[wallycorker]

this advice is given due to it working. my mum and aunty are both type 2 and follow this advice and are on metformin and have fantastic hba1c's. i do believe it is down to you wally if you feel you can get better results from your own diet, however i would also stress that you cant always take what these guys write in the books at face value. some people will put anything in to seel some books.

Hi mikep1979,

For seven years I would have said the same as your mum and your aunt and that was without Metformin - just diet alone. However, it didn't work forever for me - I came to a stage where I needed Metformin and quickly arrived at a stage where the dosage needed to be doubled.

Despite the fact that I have reduced my carbohydrate intake, I'm certainly not on a low-carbohydrate diet. Moreover, apart from Dr Bernstein then I've not read that much that points in the direction of low-carbohydrate.

Now that I am on Metformin and decided myself to start testing, I can understand that the food that is increasing my blood glucose levels is carbohydrate intake. Moreover, from my blood strip testing, I can understand why people on this forum advocate low-carbohydrate approach.

What I have never seen is any reasoned argument for "eating plenty of starchy carbohydrate". With the benefit of hindsight, I think that was where I was going wrong - it can only have been the extra carbohydrate that caused my levels to go haywire after seven years because that was the only way that I was getting sugar into my body - cereals, bread, pasta, rice etc.

I expect, from what you say, that your mum and aunt are following down a well-trodden path and that they are likely to eventually progress to needing insulin. That is the way that I seemed to have been heading. Now, I'm trying to find out how to avoid getting to that stage and I seem to be having some success. I suspect that I could come off the Metformin and think that my GP may do that at my medication review which is due soon - i.e. my situation seems to have reversed.

I never take anything at face value - that isn't my style. In fact, that is why I'm trying to understand what is happening to my body. However, there is a lot of evidence on these forums from well-meaning people - who in the main are testing and because of that know more about what happens to their blood glucose levels - that the low-carbohydrate approach is very successful in a large number of cases.

By the way, do your mum and aunt test their blood glucose levels - or are they the same as I was for nearly nine years - i.e. having no idea what was happening apart from three-monthly HbA1c checks?

Best Wishes - John

 

[Hazel]

Hi John

Sorry, I should have explained - DSR is the diabetic specialist nurse. She is responsible for monitoring, in my case, my insulin dosage/usage, basically she is my sounding board. I have seen her 3 times in 8 weeks, but she phones me at least once a week to see how I am getting on

The DSR is part of the care team at my local hospital, which also includes the consultant, dietician, nurse who takes bloods, etc, podiatrist, and retinopathy check.

I had chosen to cut back/out carbs over a couple of days, and yes my blood glucose readings did come down, but I felt awful - but the dietician and DSR threw a wobbly - no way was I NOT eat the right amount of carbs. I was told that the muscles needed energy and that comes from carbs. The dietician was otherwise very happy with the food diary I had, but told me I was to strict with myself and picked up immediatly the couple of days I had no carbs.

I suppose since being prescribed insulin, I am very mindful of what I am being told to do and eat, as it is all new to me. This has to work.

The only issue I have now is that insulin can put weight on - which as an already overweight person, I have to agree with them that the lack of exercise that is now my issue and exercise is the only way I will lose weight.

So, I hope this has been of some help to you.

Keep in touch
Hazel

 

[Vanessa]

Good morning, John

You might find this link of interest

http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/carbohydrates-full-story/index.html

I use Walter Willett's work as he is a much respected nutritional expert from Harvard's public health medicine department who is campaigning to change the USA food pyramid. In the book "Eat, Drink and Weigh Less" (Katzen and Willett, 2006), the authors state

""Carbohydrates from grains, fruits and vegetables should indeed give you part of your daily calories - as much as 30-40 per cent. But it's important that the carbohydrates from grains come from whole grains [his emphasis] which help protect you against a range of chronic disease. In other words: Don't just cut carbohydrates" (p49)

Not wishing to be political but Katzen and Willetts also point out in their introduction that the USA's food pyramids

"... come from the United States Department of Agriculture, not the National Institutes of Health, the Institutes of Medicine, or the Food and Drug Administration. They're designing, in part, to promote American agriculture, and what's good for agricultural interests isn't necessarily good for your body." (p13)

In terms of the traditional advice to avoid sugar, then 9 years ago research on the glycaemic index was more in its infancy and the theory was that as diabetes is a disease of glucose then sugar would make it worse. It has now been shown that white flour converts to glucose more quickly than sugar and so the original theory was discredited. However, the myth continues

 

[Caroline]

While I think it is wise to avoid an excess of things like sugar and fat (and some fats are better than others), we need a balanced diet. A balanced diet includes fruit vege, dairy, protein, cereals. some fat and some sugar.

Being diabteic just means we need to be a little more watchfull of wht we eat and to take pills or insulin to cope better with the glucose our bodies produce.

If you test on a regular basis you will know which foods cause a high and help you balance your diet accordingly.

Although we need the experts, some of the best advice I've had has come from this forum and a couple of others I use. The people on these forums have had the practice of living with diabetes, some for many years.

There seem to be an incredible ammount of contradictions, like don't eat fruit because it has too much sugar in it, so I think we just need to apply common sense.

 

[wallycorker]

Good morning, John

You might find this link of interest

http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/carbohydrates-full-story/index.html

I use Walter Willett's work as he is a much respected nutritional expert from Harvard's public health medicine department who is campaigning to change the USA food pyramid. In the book "Eat, Drink and Weigh Less" (Katzen and Willett, 2006), the authors state

""Carbohydrates from grains, fruits and vegetables should indeed give you part of your daily calories - as much as 30-40 per cent. But it's important that the carbohydrates from grains come from whole grains [his emphasis] which help protect you against a range of chronic disease. In other words: Don't just cut carbohydrates" (p49)

Not wishing to be political but Katzen and Willetts also point out in their introduction that the USA's food pyramids

"... come from the United States Department of Agriculture, not the National Institutes of Health, the Institutes of Medicine, or the Food and Drug Administration. They're designing, in part, to promote American agriculture, and what's good for agricultural interests isn't necessarily good for your body." (p13)

In terms of the traditional advice to avoid sugar, then 9 years ago research on the glycaemic index was more in its infancy and the theory was that as diabetes is a disease of glucose then sugar would make it worse. It has now been shown that white flour converts to glucose more quickly than sugar and so the original theory was discredited. However, the myth continues

Hi Vanessa - Thanks for that well-written summary - it's interesting and I am already aware of most of the detail. Basically, it's what I am doing.

Best Wishes - John

 

[paulnicholls]

Hi Wally.

I'm just at the stage where I'm possibly weeks off insulin. The next appointment makes the decision for me.

I'm on 4 Metformin, Glicazade and statins.

My situation is that I have a GP who outright refuses to prescribe lancets and strips, telling me it's 'pointless' and that monitoring is only needed for insulin purposes. I have a sneaking suspicion it's all about funding issues.

As a result of the advice given by my GP. my levels have been all over the place. On diagnosis I was 25.6 and admitted to hospital thinking I was having a stroke - this after 3 years of him telling me I wasn't diabetic, just 'stressed'.

The dietary advice I've been given is just incomprehensible - the nurse told me one thing, the Dr. another and the Dietician something else. Quite honestly I'm sick of it all. My levels at last GP testing were 13.8 and my GP surprised that the levels were so high. I can be 6.5 one day and 14 the next, things are just all over the place.

Fortunately it seems that many people on here get a great support from their surgery and what sems like a raft of diabetic specialist services. I don't. I'm not even sure if there's a diabetic team in my local area - it's all so frustrating.

Not being able to monitor unless I buy my own strips and lancets seems horrendously negligent, let alone uncaring.

Diabetes UK give out some great literature, but it's all so general and not terribly effective if you can't monitor. I also find the dietary advice in my area confusing and contradictory.

I'm sure I'm not alone in thinking that Type 2 is very much thought of as treated by chucking a few tablets our way, and told to exercise more and lose weight.

As bizarre as it sounds, I actually hope I'm given insulin so I get a better service and advice and stop feeling so generally c**p with multiple hypers / hypos each week.

Sadly it easy to feel quite resentful, concerned, confused and alone with such ineffective medical support.

I'm pleased to see your post in that I'm actually not simply being paranoid and that much of your concern resonates with me.

 

[wallycorker]

Hi Wally.

I'm just at the stage where I'm possibly weeks off insulin. The next appointment makes the decision for me.

I'm on 4 Metformin, Glicazade and statins.

My situation is that I have a GP who outright refuses to prescribe lancets and strips, telling me it's 'pointless' and that monitoring is only needed for insulin purposes. I have a sneaking suspicion it's all about funding issues.

As a result of the advice given by my GP. my levels have been all over the place. On diagnosis I was 25.6 and admitted to hospital thinking I was having a stroke - this after 3 years of him telling me I wasn't diabetic, just 'stressed'.

The dietary advice I've been given is just incomprehensible - the nurse told me one thing, the Dr. another and the Dietician something else. Quite honestly I'm sick of it all. My levels at last GP testing were 13.8 and my GP surprised that the levels were so high. I can be 6.5 one day and 14 the next, things are just all over the place.

Fortunately it seems that many people on here get a great support from their surgery and what sems like a raft of diabetic specialist services. I don't. I'm not even sure if there's a diabetic team in my local area - it's all so frustrating.

Not being able to monitor unless I buy my own strips and lancets seems horrendously negligent, let alone uncaring.

Diabetes UK give out some great literature, but it's all so general and not terribly effective if you can't monitor. I also find the dietary advice in my area confusing and contradictory.

I'm sure I'm not alone in thinking that Type 2 is very much thought of as treated by chucking a few tablets our way, and told to exercise more and lose weight.

As bizarre as it sounds, I actually hope I'm given insulin so I get a better service and advice and stop feeling so generally c**p with multiple hypers / hypos each week.

Sadly it easy to feel quite resentful, concerned, confused and alone with such ineffective medical support.

I'm pleased to see your post in that I'm actually not simply being paranoid and that much of your concern resonates with me.

Hi paulnicholls - it's good to meet you.

Wow - I must say that your situation sounds extremely frustrating and poor even when I compare it with mine.

Your statement "The dietary advice I've been given is just incomprehensible - the nurse told me one thing, the Dr. another and the Dietician something else" reminds me that is exactly what I used to say to my wife after diagnosis. However, I had been detected early and my problem took seven years to start getting worse.

You have my greatest sympathy with your situation. I suggest you start looking for whatever other options you might have healthcare wise.

One thing that I can say is that my situation improved almost immediately just as soon as I started eating a different diet and combined this with eating less calories. Moreover, if you haven't done so already get some strips and start testing.

Your levels will still vary between depending as to whether you take them before or after a meal - but you will soon recognise a regular pattern that tells you a lot about what is happening. Use those lessons to make additional small changes and I expect that you will see an improvement.

The important message that I learnt was that I needed to take control of my own situation. I suggest that you start to do just that.

Good luck!

Best Wishes - John

 

[C*5_Dodger]

Dear wallycorker,

You write a good post, I only wish my command of the English language was as good as yours, but then I regard English as my second language! I have been trying to get Diabetes UK to at least acknowledge that a controlled carbohydrate approach should be offered in addition to their current advice, but they have completely ignored the paper I wrote setting out why a controlled carbohydrate approach is viable. If you study the chemistry behind a controlled carbohydrate approach then it easy to see why eating “plenty of carbs at each meal” must mean that diabetic medications must be used – and even then the seminal study UKPDS showed that over the long term fasting plasma glucose and HbA1c just got worse and and worse. Usually, when type 2s are first diagnosed the pancreas still produces enough insulin so that carbohydrate tolerance is quite high – so diet only – even on the diabetes UK diet works. However, as the years pass the pancreas deteriorates and so first oral drugs and then finally insulin are needed. If and when a controlled carbohydrate approach is initiated you can feel dreadful for a week or so, while your body changes from utilising glucose to utilising fat. However, the notion that you need at least 130gms of carbohydrates a day is just not so – the human body CAN do with much less carbohydrate. A good example of this (in addition to myself – I am very active and NEVER short of energy) is the traditional hunter gathers, the Inuit. They live solely on fat and protein and in fact believe that carbohydrates are only fit for animals! The paper I referred to earlier showed that if you eat two teaspoons of sugar (10gms of Sucrose), the average person's blood sugar can rise by up to 5.8mmol/L. The actual amount of rise depends on how far along the path to complete beta-cell failure you are. This explains why following the Diabetes UK diet MUST mean you need medications – at least after a few years. It seems that you have arrived at this point now. As to why Diabetes UK offers the advice it does, I can only speculate: They believe that fat causes heart disease - hence the low fat diet. This ofcourse means that it must contain plenty of carbohydrates. I think that they think they are choosing the lesser of two evils. I can't believe that they do not believe that the more carbohydrates you eat the more difficult it can be to control your blood sugar.

Regards Dodger

 

[wallycorker]

Dear wallycorker,

You write a good post, I only wish my command of the English language was as good as yours, but then I regard English as my second language! I have been trying to get Diabetes UK to at least acknowledge that a controlled carbohydrate approach should be offered in addition to their current advice, but they have completely ignored the paper I wrote setting out why a controlled carbohydrate approach is viable. If you study the chemistry behind a controlled carbohydrate approach then it easy to see why eating ?plenty of carbs at each meal? must mean that diabetic medications must be used ? and even then the seminal study UKPDS showed that over the long term fasting plasma glucose and HbA1c just got worse and and worse. Usually, when type 2s are first diagnosed the pancreas still produces enough insulin so that carbohydrate tolerance is quite high ? so diet only ? even on the diabetes UK diet works. However, as the years pass the pancreas deteriorates and so first oral drugs and then finally insulin are needed. If and when a controlled carbohydrate approach is initiated you can feel dreadful for a week or so, while your body changes from utilising glucose to utilising fat. However, the notion that you need at least 130gms of carbohydrates a day is just not so ? the human body CAN do with much less carbohydrate. A good example of this (in addition to myself ? I am very active and NEVER short of energy) is the traditional hunter gathers, the Inuit. They live solely on fat and protein and in fact believe that carbohydrates are only fit for animals! The paper I referred to earlier showed that if you eat two teaspoons of sugar (10gms of Sucrose), the average person's blood sugar can rise by up to 5.8mmol/L. The actual amount of rise depends on how far along the path to complete beta-cell failure you are. This explains why following the Diabetes UK diet MUST mean you need medications ? at least after a few years. It seems that you have arrived at this point now. As to why Diabetes UK offers the advice it does, I can only speculate: They believe that fat causes heart disease - hence the low fat diet. This ofcourse means that it must contain plenty of carbohydrates. I think that they think they are choosing the lesser of two evils. I can't believe that they do not believe that the more carbohydrates you eat the more difficult it can be to control your blood sugar.

Regards Dodger

Hi again Dodger,

I can relate to all that!

It is about the conclusion that I have arrived at after starting testing.

I have said elsewhere that at present I am eating a low-fat diet (definitely that) and I've started to reduce my carbohydrate intake also - increasingly so very recently.

However, you are quite clearly much deeper and knowledgeable about the entire thing than I am.

You say that "I have been trying to get Diabetes UK to at least acknowledge that a controlled carbohydrate approach should be offered in addition to their current advice, but they have completely ignored the paper I wrote setting out why a controlled carbohydrate approach is viable". May I ask, in what capacity have you been doing that? Simply as another diabetic - or in some official representative capacity?

I intend asking more questions myself and using my experiences to campaign against the advice that we are being given. I have started to ask serious questions at a local level - Diabetic Support groups, NHS, PCTs, GPs, Dietitians etc - but so far not receiving any meaningful answers. Hence the reason for me starting to ask on these forums (which I have only recently started using) to try to find out the experiences of others.

Have you ever used the online 10 Downing Street petition process for pushing your message? I've recently looked and was surprised to find very few petitions with a diabetic content. Perhaps, this is something that people on these forums could use more extensively to push the message. We should be able to drum up a lot of support on these forums. I don't put the facility forward as being the way towards an instant change but at least it gets the message out there and, more importantly, it is likely to get the Government asking questions of the powers to be heading the various health authorities.

By the way, thanks for the compliments but please do not denigrate your linguistic abilities. Your post was very clear and well written. Why might you think otherwise?

Best Wishes - John

 

[C*5_Dodger]

Hi again Dodger,

I can relate to all that!

It is about the conclusion that I have arrived at after starting testing.

I have said elsewhere that at present I am eating a low-fat diet (definitely that) and I've started to reduce my carbohydrate intake also - increasingly so very recently.

However, you are quite clearly much deeper and knowledgeable about the entire thing than I am.

You say that "I have been trying to get Diabetes UK to at least acknowledge that a controlled carbohydrate approach should be offered in addition to their current advice, but they have completely ignored the paper I wrote setting out why a controlled carbohydrate approach is viable". May I ask, in what capacity have you been doing that? Simply as another diabetic - or in some official representative capacity?

I intend asking more questions myself and using my experiences to campaign against the advice that we are being given. I have started to ask serious questions at a local level - Diabetic Support groups, NHS, PCTs, GPs, Dietitians etc - but so far not receiving any meaningful answers. Hence the reason for me starting to ask on these forums (which I have only recently started using) to try to find out the experiences of others.

Have you ever used the online 10 Downing Street petition process for pushing your message? I've recently looked and was surprised to find very few petitions with a diabetic content. Perhaps, this is something that people on these forums could use more extensively to push the message. We should be able to drum up a lot of support on these forums. I don't put the facility forward as being the way towards an instant change but at least it gets the message out there and, more importantly, it is likely to get the Government asking questions of the powers to be heading the various health authorities.

By the way, thanks for the compliments but please do not denigrate your linguistic abilities. Your post was very clear and well written. Why might you think otherwise?

Best Wishes - John

Dear John,

Thanks for your reply, I have approached Diabetes UK simply as a Type 2 Diabetic. They are very polite and, I suspect, well-meaning, but they just ignore my requests to at least comment on the paper (it is only 2 pages long!). Thanks for your suggestion re: Downing Street petition process- I might just give it a try! I have always had difficulty with the written and spoken word, it took me three attempts to get 'O' Level English (I'm 69) - my first language is mathematics.

Regards Dodger (Phil)

 

[wallycorker]

Dear John,

Thanks for your reply, I have approached Diabetes UK simply as a Type 2 Diabetic. They are very polite and, I suspect, well-meaning, but they just ignore my requests to at least comment on the paper (it is only 2 pages long!). Thanks for your suggestion re: Downing Street petition process- I might just give it a try! I have always had difficulty with the written and spoken word, it took me three attempts to get 'O' Level English (I'm 69) - my first language is mathematics.

Regards Dodger (Phil)

Hi again Phil,

I'm having the same experiences as you - i.e. not getting anyone whatsoever in authority to answer any of my questions. I haven't tried approaching Diabetes UK but I did telephone the Foods Standard Agency and I got the same response as you - i.e. none. I shall certainly keep trying and hope that you will too.

If you do lodge a petition with 10 Downing Street then let us all know because I'm certain that you will get plenty of support from people on these forums.

I'm very much a mathematical type myself but quite a lot younger than you - a four years is a very large age gap isn't it? 🙄

Best Wishes - John

 

[Sparky Sue]

Hi Folks, I know what you mean about conflicting advice. I would recommend the book "The Glycemic Load Diet" by Rob Thompson MD. It looks at the science of insulin resistance and the issues of carbohydrates not just regarding their glycemic index but their glycemic load which is different and gives a better understanding of their effect on digestion. It made sense to me. Just a thought hope it helps.

 

[grovesy]

Hi Folks, I know what you mean about conflicting advice. I would recommend the book "The Glycemic Load Diet" by Rob Thompson MD. It looks at the science of insulin resistance and the issues of carbohydrates not just regarding their glycemic index but their glycemic load which is different and gives a better understanding of their effect on digestion. It made sense to me. Just a thought hope it helps.

You have posted on a thread that is over 10 years old, so you may not get any of the osters reply.

 

[Leadinglights]

However, not a lot seems to have changed in the Standard NHS advice. Thank goodness for this site and people's experiences to help the newly diagnosed.

 

[Becka]

The problem, on both sides, is there is no single answer that is right for everyone. However, notwithstanding the age of the thread, the answer to the question of "why this advice" can be found from page 56 of the PDF available from this page:

SACN Carbohydrates and Health Report

The Scientific Advisory Committee on Nutrition recommendations on carbohydrates, including sugars and fibre

www.gov.uk

And that advice is currently being reviewed:

Lower carbohydrate diets for adults with type 2 diabetes: draft report

We are seeking scientific comments on SACN’s draft report: ‘Lower carbohydrate diets for adults with type 2 diabetes’.

www.gov.uk

 

[Deleted member 25429]

Hi John

Sorry, I should have explained - DSR is the diabetic specialist nurse. She is responsible for monitoring, in my case, my insulin dosage/usage, basically she is my sounding board. I have seen her 3 times in 8 weeks, but she phones me at least once a week to see how I am getting on

The DSR is part of the care team at my local hospital, which also includes the consultant, dietician, nurse who takes bloods, etc, podiatrist, and retinopathy check.

I had chosen to cut back/out carbs over a couple of days, and yes my blood glucose readings did come down, but I felt awful - but the dietician and DSR threw a wobbly - no way was I NOT eat the right amount of carbs. I was told that the muscles needed energy and that comes from carbs. The dietician was otherwise very happy with the food diary I had, but told me I was to strict with myself and picked up immediatly the couple of days I had no carbs.

I suppose since being prescribed insulin, I am very mindful of what I am being told to do and eat, as it is all new to me. This has to work.

The only issue I have now is that insulin can put weight on - which as an already overweight person, I have to agree with them that the lack of exercise that is now my issue and exercise is the only way I will lose weight.

So, I hope this has been of some help to you.

Keep in touch
Hazel

You can still loose weight if you’re on insulin. You just inject the amount you need for your meal . I quite often only need 1/2 a unit when I’m having a salad . I lost about 3 stone after my type 1 diagnosis.