Type2 cases for different paths

[rebrascora]

Ian - I have avoided mentioning this at large for the last 49 years because it involves a very dark place which is not a good place to visit even briefly so we avoid it if we have any sense - being diagnosed T1 fairly instantly gives a person the wherewithal to cause serious health concerns (or worse ie death) to anyone they happen to wish to that day - ie Insulin and an injection device. So IMMEDIATELY as well as being 99.9% responsible for our own life - we have an unspoken but inbuilt greater SOCIAL responsibility than we ever imagined the day before.

So we take that on board overnight and immediately have to shove it to the back.

Do 99.9% of T2s have that automatic responsibility?

To be honest, I would say that most people on insulin don't even contemplate this "responsibility" to any great extent. Interestingly it occurred to me when I was out walking on my own late one night, not long after the Sarah Everard case, when there was mention of women walking home clutching their keys as a possible self defense weapon. Up until then it had never really occurred to me that insulin could be used as a weapon although I am aware that there have beenrare cases of murders where insulin was used. I think it just didn't occur to me on a person level that I was potentially carrying a lethal weapon myself. But then, just driving a car can be lethal and much more likely to result in killing someone but we don't dwell on it every time we get behind the wheel, so I really don't see my insulin as a weighty responsibility in that respect and possible an advantage if I was ever in an horrific situation like Sarah Everard, where I might use it in my own defense if my life depended on it.

 

[ianf0ster]

Hi Ian, I’ve wondered about restricting carbohydrates. What do diabetic vegetarians eat if Carbs are restricted or not to take them at all? Starve?

Vegetarians and vegans are extremely diverse, both in what they eat and in why they restrict their diet from being omnivores.
Apart from religious reasons or 'love of animals' there are 2 misunderstandings:
1. That veggie is somehow healthier. It isn't, in fact it is easier to have a diet full in all essential nutrients even going completely carnivore than going completely vegan. Also there is junk vegan food as well as junk omnivore food.

2. That farm animals are 'bad for the planet'. The reverse can be true (and is true in many parts of the world even on some ranches in the USA). Without herbivores all soil would lose most of its ability to store carbon. Fields of grass when grazed by herbivores store more carbon than do forests.
In spite of the addition of petrochemical fertilisers soil becomes less fertile without the excretions from animals.
Herbivores can turn cellulose into protein and fat and can do so by grazing in places unsuitable for growing crops.
They emit no net greenhouse gases - just recycle the carbon around between the vegetation and the atmosphere.

 

[trophywench]

All things involving animals are inclined to be emotive whatever it is. Any other T1s ever wonder when Banting Best & McLean were experimenting with insulin, why nobody recorded the names or even breeds of the doggies?

They're (one of) the only main reasons I can sit here typing - and I'd just like to know more about them and be able to thank them and sort of remember them better somehow. (Am I THAT unusual in this?)

 

[nonethewiser]

I was trying to phrase it in a way that acknowledged that not all Type 1's count carbs, but that those who want to do so have the full resources including meters. And they don't suffer the problems that people say Type 2's would get by doing so.

Different kettle of fish fella, can't compare dietary controlled type 2s to type 1s or type 2 using insulin, we need every bit of help to fine balance insulin food exercise to keep bg steady, wish there was more resources not less.

All people should have access to bg meters, but just don't get why someone well controlled by dietary methods would want to test so much, see this often even to extent that some wear libre sensors on permanent basis, bit OTT & wouldn't be me in their shoes, so there is an argument to back up hcp claim that some type 2s can come obsessive about bg testing.

 

[ianf0ster]

.......................................

All people should have access to bg meters, but just don't get why someone well controlled by dietary methods would want to test so much, see this often even to extent that some wear libre sensors on permanent basis, bit OTT & wouldn't be me in their shoes, so there is an argument to back up hcp claim that some type 2s can come obsessive about bg testing.

It's not once T2s are well controlled by diet that they need to test much. As I have mentioned in several threads (not sure if in blue or red forums or both) I hardly ever nee to test now ( I've used around 6 strips in the last 4 months). For the 1st week I tested every meal, for the 2nd week I tested every lunch and dinner. Then just meals I was unsure of - there is no point in testing when you already know what the result will be (unless you like your fingers pricked) . Some people are OCD, but there's no reason to think this is higher in Type 2's than in any other section of the population.

It's that without access to a BG meter we can't find the right types of carbs and the right quantities in order to personalise our diabetic control. Even within what's universally accepted to be low carb, for some that's around 130 gms per day and for others it has to be less than 20gms per day. Obviously when coming from a 'standard' i.e. high carb way of eating, 130gms per day is a lot easier = more sustainable than 20gms per day. Also some can eat 2 different foods with the same carb count and the same GI and get differing BG spikes from them. Our bodies process some carbs better than others.

Without testing before and after meals how the heck can we find that out? Without a BG meter how long would it take to find the right amount of the right type of carbs in order to get our BG back to 'normal'. I would suggest for many that would be impossible - very difficult even if having an HbA1C every week!

 

[Inka]

I was trying to phrase it in a way that acknowledged that not all Type 1's count carbs, but that those who want to do so have the full resources including meters. And they don't suffer the problems that people say Type 2's would get by doing so.

Even Type 1s that might be newly diagnosed and not counting carbs, get given a meter and strips for free, yes. But that’s because a) we might have a severe hypo and die; and b) because we need to test every time we drive. Its being on insulin that’s the thing.

You keep on and on not understanding Type 1 carb counting. We count the carbs only to calculate our insulin dose according to our individual ratios. We’re given the “full resources” of a blood glucose meter so we don’t die from a hypo or die from DKA.

 

[Deleted member 33972]

Just to be clear @ianf0ster Type 1s count carbs in order to calculate our insulin doses. So when a Type 1 asks a newly diagnosed Type 1 “Do you count carbs?” they mean something very specific and nothing to do with totting up daily carbs or limiting them or anything similar . They mean “Do you know your ratios?” So your first sentence makes no sense with regard to that statement.

My friend was Type 1 and gave talks on Diabes 1 she ate what I ate and adjusted her insulin. She had a box of sweets in the fridge. She had had a kidney tran

Eggs, cheese, tofu are all low/no carb protein sources. Meat isn’t the only form of protein. Vegetarians eat a variety of foods but don’t stick to a veggie version of meat, veg, potatoes. We’ll have chillies, curries, bakes, etc etc. It’s a different way of eating. It can have any amount of carbs you choose.

i can’t do a lot of meat. Hurts my digestive system badly. Have you seen smelly tofu being made? Lol

 

[Deleted member 33972]

I

It's not once T2s are well controlled by diet that they need to test much. As I have mentioned in several threads (not sure if in blue or red forums or both) I hardly ever nee to test now ( I've used around 6 strips in the last 4 months). For the 1st week I tested every meal, for the 2nd week I tested every lunch and dinner. Then just meals I was unsure of - there is no point in testing when you already know what the result will be (unless you like your fingers pricked) . Some people are OCD, but there's no reason to think this is higher in Type 2's than in any other section of the population.

It's that without access to a BG meter we can't find the right types of carbs and the right quantities in order to personalise our diabetic control. Even within what's universally accepted to be low carb, for some that's around 130 gms per day and for others it has to be less than 20gms per day. Obviously when coming from a 'standard' i.e. high carb way of eating, 130gms per day is a lot easier = more sustainable than 20gms per day. Also some can eat 2 different foods with the same carb count and the same GI and get differing BG spikes from them. Our bodies process some carbs better than others.

Without testing before and after meals how the heck can we find that out? Without a BG meter how long would it take to find the right amount of the right type of carbs in order to get our BG back to 'normal'. I would suggest for many that would be impossible - very difficult even if having an HbA1C every week!

just doing mornings. It’s expensive with strips and sticks

 

[ianf0ster]

I was trying to phrase it in a way that acknowledged that not all Type 1's count carbs, but that those who want to do so have the full resources including meters. And they don't suffer the problems that people say Type 2's would get by doing so.

Even Type 1s that might be newly diagnosed and not counting carbs, get given a meter and strips for free, yes. But that’s because a) we might have a severe hypo and die; and b) because we need to test every time we drive. Its being on insulin that’s the thing.

You keep on and on not understanding Type 1 carb counting. We count the carbs only to calculate our insulin dose according to our individual ratios. We’re given the “full resources” of a blood glucose meter so we don’t die from a hypo or die from DKA.

On the contrary, I understand very well why Type 1's count carbs (or not in the case of my friend Peter who lives a little dangerously). I think it's you who is deliberately downplaying the longer term health reasons why Type 2's count carbs. The effects of long term hyper glycemia, the side effects of SGLT2's the possibility of 'killing' beta cells due to prolonged overproduction of natural insulin, the growing insulin resistance requiring stronger medications which in turn make the insulin resistance worse.
But are you really unaware of those, or are you just playing at it for sake of a good discussion?

 

[Inka]

No, Ian, I’m not playing at anything. I’m trying to understand the point you’re making - genuinely trying. You still haven’t explained what you meant. If you simply mean Type 2s should get glucose meters as well as Type 1s - yes, I agree, as I’ve said many times before, both here and in other posts.

The point I’m making is that Type 1s aren’t given glucose meters so they can count carbs. They’re given them because they’re on insulin.

You said:
“Yes, but you still count them and you have BG meters to aid you. Dietary controlled type 2's just have a slightly different reason for counting them - so why is it considered so bad for us to do such that we are told not to and not to measure our BG. Or are most Type1's suffering mental distress from carb counting, whilst obviously also happy to be alive.”

The two things aren’t comparable. Yes, I agree Type 2s should be aware of the carbs they’re eating and I very much agree they should test before meals and after meals to see how certain foods affect their blood sugar. But why has that got anything to do with a Type 1 carb-counting to calculate an insulin dose? The two things are different.

I think I might understand better what you’re saying now, but I think you could have made your point - that Type2s should test and get glucose meters for the benefits it brings them as Type 2s - without bringing Type 1s into it.

It’s important to clarify that carb-counting means something very specific for Type 1s. There has been confusion before and they’ll continue to be. That’s why I made my initial post.

 

[ianf0ster]

I brought Type 1's into this because it is mainly Type 1's (though also some misguided Type 2's) who claim that Type 2's should just eat in moderation and not count carbs. I cut/paste the reasons they give:
1. They claim it upsets Type 2's and causes poor mental health.
2. They say that 'eating less and moving more' is enough.
3. They agree with the NHS, GPs (and( apparently Diabetes,org.uk) that Blood Glucose meters are not required for Type 2's unless they deteriorate such as to have to use strong (potential hypo causing) medication.

 

[Robin]

I brought Type 1's into this because it is mainly Type 1's (though also some misguided Type 2's) who claim that Type 2's should just eat in moderation and not count carbs. I cut/paste the reasons they give:
1. They claim it upsets Type 2's and causes poor mental health.
2. They say that 'eating less and moving more' is enough.
3. They agree with the NHS, GPs (and( apparently Diabetes,org.uk) that Blood Glucose meters are not required for Type 2's unless they deteriorate such as to have to use strong (potential hypo causing) medication.

Thank you for the clarification. That’s how I'd first interpreted your post, but I then reread it and felt I might have misinterpreted it, and you were referring to people in general. Apparently not. Please leave me out of your generalisation.

 

[JJay]

Please leave me out of your generalisation.

And me!

 

[everydayupsanddowns]

I brought Type 1's into this because it is mainly Type 1's (though also some misguided Type 2's) who claim that Type 2's should just eat in moderation and not count carbs.

I‘m not sure that’s a helpful assumption, and have no idea what information you might have used to reach that conclusion, except perhaps your own experience. And if so, then I think that’s unfortunate. Most T1s here, and mist T1s I know anywhere don’t think that at all.

There is certainly a minority view that ‘the other lot’ (from either side of the same fence) have it easy, and it’s completely unfair - but that’s certainly not a view I see expressed by any members here, and if it were I’m sure it would be called out by the many members here who think that access to appropriate technology and education should be equitable whatever classification one has - so that each person with diabetes has the best chance of building their own ‘diabetes toolkit’ and a personalised approach to eating and managing their blood glucose in a way that works for them.

I am aware though that regular forum contributors, visitors, readers and lurkers (hello!) are not necessarily average patients. Seeking out a forum and accessing its content suggests a degree of self-motovation and an interest to be actively involved in your own care.

I am led to believe by medical professionals and diabetes specialists that these are fairly rare attributes in the diabetes population as a whole. I think there are many many people with diabetes, who for all sorts of different reasons, simply do not want to, feel able to, or are able to use those more intensive glucose management strategies.

And the more people we can connect with, encourage and support on the forum the better as far as I am concerned. So that each person can find their own way through the maze of options.

 

[nonethewiser]

It's not once T2s are well controlled by diet that they need to test much. As I have mentioned in several threads (not sure if in blue or red forums or both) I hardly ever nee to test now ( I've used around 6 strips in the last 4 months). For the 1st week I tested every meal, for the 2nd week I tested every lunch and dinner. Then just meals I was unsure of - there is no point in testing when you already know what the result will be (unless you like your fingers pricked) . Some people are OCD, but there's no reason to think this is higher in Type 2's than in any other section of the population.

It's that without access to a BG meter we can't find the right types of carbs and the right quantities in order to personalise our diabetic control. Even within what's universally accepted to be low carb, for some that's around 130 gms per day and for others it has to be less than 20gms per day. Obviously when coming from a 'standard' i.e. high carb way of eating, 130gms per day is a lot easier = more sustainable than 20gms per day. Also some can eat 2 different foods with the same carb count and the same GI and get differing BG spikes from them. Our bodies process some carbs better than others.

Without testing before and after meals how the heck can we find that out? Without a BG meter how long would it take to find the right amount of the right type of carbs in order to get our BG back to 'normal'. I would suggest for many that would be impossible - very difficult even if having an HbA1C every week!

You forget one important thing, of population of people with diabetes you'll be lucky if 1% join forums, in other words who knows how many type 2s get given bg meters.

Example, wife was diagnosed pre diabetic after long period of steroids & lack of activity having being unwell, she put on lot of weight so knew what to do after I told her about Prof Taylor's work, nurse at gp practice give her bg meter & encouraged her to test, she didn't test that much but went about losing weight, 5 stone in total & managed to reverse diagnosis & has since had normal blood results, in total she used 10 strips that came with meter & about 10 from pot of 50 which dr prescribed.

 

[Leadinglights]

You are right it is only the people who are motivated who will come onto forums like this. I was quite critical that G Ps just seemed to hand out medications rather than advise about dietary changes but talking to my daughter and son in law, both doctors they say that they get a feel for the people who will engage with lifestyle changes and those who will actually rebel against any suggestion they need to change their diet and basically do nothing so they sadly see people deteriorate to the point where their eyesight and limbs are suffering.
Many people have no basic understanding of nutrition and foods or even how to cook. I think that is a sad reflection of todays society.
It is not helped by the fact that high carb foods are cheap whereas good quality healthy foods are more expensive. But it requires some ingenuity to make the best of affordable foods.

 

[nonethewiser]

You are right it is only the people who are motivated who will come onto forums like this. I was quite critical that G Ps just seemed to hand out medications rather than advise about dietary changes but talking to my daughter and son in law, both doctors they say that they get a feel for the people who will engage with lifestyle changes and those who will actually rebel against any suggestion they need to change their diet and basically do nothing so they sadly see people deteriorate to the point where their eyesight and limbs are suffering.
Many people have no basic understanding of nutrition and foods or even how to cook. I think that is a sad reflection of todays society.
It is not helped by the fact that high carb foods are cheap whereas good quality healthy foods are more expensive. But it requires some ingenuity to make the best of affordable foods.

Pick up on couple of points in your reply. Really making wrong assumption that only those who are motivated join forums, met many people both type 1 & 2 who are well controlled but wouldnt come anywhere near diabetes forums, mainly red one mind, so its matter of choice to join or not.

Quality food need not be expensive, we mainly shop in Aldi who sell fruit veg meats at reasonable prices, likes of Sainsbury are price matching Aldi on lot of produce so another option there.

 

[Leadinglights]

Pick up on couple of points in your reply. Really making wrong assumption that only those who are motivated join forums, met many people both type 1 & 2 who are well controlled but wouldnt come anywhere near diabetes forums, mainly red one mind, so its matter of choice to join or not.

Quality food need not be expensive, we mainly shop in Aldi who sell fruit veg meats at reasonable prices, likes of Sainsbury are price matching Aldi on lot of produce so another option there.

Point taken. I suppose we only see a small snapshot of people here and there are thousands out there who have brilliant support from their diabetic support team and family so it is easy to get a biased view.

 

[trophywench]

I think a lot of PWD still get a lot of odd ideas and impressions from a certain forum (which had the damn cheek to use DUK's logo at first - to try and make people think it was connected to our charity, presumably - and as a member - I made damn sure I wrote to DUK to ensure they were aware of it) And yes even though I was perfectly happy using DSF, I did join the one I'm talking about to try and see what they were up to. I got banned quite soon - now decades ago - for saying on a thread 'Hang on there - there are other less drastic ways of dealing with Type 2 than everyone having to severely curtail their carb intake instantly.'

At that time a load of childish bullies, go along with what we say else we won't speak to you or let you speak to anyone.

Oh look, I don't seem to have lost out. Plus I now know a lot more about many things including diabetes than I did when I turned to Diabetes Insight (the fore runner of DSF) for help with mine in the first place.

I didn't know very much at all about Type 2 at that time - it was something you got if you were either old or fat - then I got chatting to an - elderly! but not fat - man in the GP waiting room in about 1974. I learned that he was T2 but treated only by insulin apparently (Now that was a surprise) and that he was a farmer from the other side of Stourport turned carriage racer, had just been competing at Badminton and was telling me how lovely the Queen and Prince Philip were. Any wonder I still remember that - or that a lot of things 'since discovered' eg LADA(!) - have come as no great surprise to me? Just more pieces of the broken up jigsaw stored in my brain, suddenly coming together. Got quite a bit of the sky finished now. (I think it's possibly a pic of The Haywain - but we'll all have to wait until more of it is done)

Hence - I do not fit with your assumption of 'what T1s think about T2s', either. Kindly remember the adage about the word assume !

 

[Deleted member 33972]

You are right it is only the people who are motivated who will come onto forums like this. I was quite critical that G Ps just seemed to hand out medications rather than advise about dietary changes but talking to my daughter and son in law, both doctors they say that they get a feel for the people who will engage with lifestyle changes and those who will actually rebel against any suggestion they need to change their diet and basically do nothing so they sadly see people deteriorate to the point where their eyesight and limbs are suffering.
Many people have no basic understanding of nutrition and foods or even how to cook. I think that is a sad reflection of todays society.
It is not helped by the fact that high carb foods are cheap whereas good quality healthy foods are more expensive. But it requires some ingenuity to make the best of affordable foods.

I’m always grateful that my mother taught me how to cook from an early age. I agree that there’s a lot of people who can’t or won’t cook or know about nutritional values. I feel some people brag that they can’t cook as if it gives them some kind of special status. The area I live in has cookery classes and they’re well attended by adult members of the community