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To think it's so sad/frustrating that most people in the nhs don't know how to treat t2 diabetes

(123 Posts)
trinity0097 Fri 12-Aug-16 16:26:55

Most nhs nurses (who do most of the treating if t2 diabetics) have no clue as to how to actually deal with the disease at little cost to the NHS, I.e. To go low carb.

Just moved, so annual check at a new surgery, nurse asked how I managed it as she saw I wasn't on medication. I said I did low carb, she was impressed. Ten I found out that she thinks that low carb means to eat a fistful of low GI carbs with EVERY meal. That will just make someone with diabetes get worse diabetes as it is carbs that are the problem!

So if the nurses follow the NHS advice they have to give patients 3 monthly blood tests (at cost), give them medication (at cost) and deal with their worsening symptoms (at cost), plus the patients don't lose weight.

Surely if it's as simple as eat hardly any carbs, you will lose weight and get back to normal sugar levels they need to see this and give this advice. If I had followed the NHS guidelines I would be the same weight and still be properly diabetic, not 5 stone lighter and with normal blood sugars.

April241 Fri 12-Aug-16 16:35:48

Sorry, do you mean it's sad/frustrating that most NHS nurses regardless of their place of work don't know how to treat T2DM or the nurses that work specifically with diabetic patients don't know how to treat them? confused

XiCi Fri 12-Aug-16 16:38:37

I know, it's so unbelievably frustrating. My mil has just been diagnosed and has been given shocking nutritional advice. The ignorance is unbelievable. I guess it comes from the decades of eat low fat, low Carb erroneous advice that we've had drummed into us.

specialsubject Fri 12-Aug-16 16:39:21

Those are the NHS guidelines which she has to follow. Diabetes UK also think that the NHS need to rethink this.

They recommend plenty of veg. Which of course contain carbohydrate so perhaps people just need to sort this out?

HumphreyCobblers Fri 12-Aug-16 16:41:53

I read Michael Mosely the other day saying that if his dad had been given better advice (low carb type diet) then he might still be here today. Instead he encouraged his dad to eat low fat, high carb. It is really sad.

I agree OP. It is most frustrating.

XiCi Fri 12-Aug-16 16:44:54

*high carb

trinity0097 Fri 12-Aug-16 16:47:21

Both April.

Last year I saw a nutritionist at the Royal Surrey, she said I would be unable to function following the low carb high fat diet I was successfully doing.

I then saw a specialist doctor who said ignore the nutritionist you are doing it right and it's what we now suggest to patients, only problem is that most type 2 share dealt with via the GP surgery and diabetic nurses not specialist doctors (I was diagnosed at a and e so got to see hospital doctors initially).

TellAStory Fri 12-Aug-16 16:48:07

When my father was diagnosed with Type 2 diabetes 35 years ago my parents did a lot of research and the advice then was to drastically limit carbs and my mum used to measure the carb content of food. My father has fantastic control and managed without medication for many years due to a good diet, he is on medication now but has not needed insulin and does not have any secondary complications such as poor eyesight, leg ulcers or circulation / nerve damage. Over the years my parents have been horrified by the nutritional advice given out to others and have continued to restrict carbs. I think the NHS has to review the advice given out but there will always be people who will not keep to it.

Statelychangers Fri 12-Aug-16 16:54:30

It's not just type 2 diabetics that could do with better advice to deal with their condition. Lots of people with autoimmune conditions find their symptoms improve enormously when they dramatically lower carbs and drop dairy - it's life changing stuff and yet to find anyone in the NHS to provide the advice and support on how to go about it is very challenging.

April241 Fri 12-Aug-16 17:10:41

Ahh, I absolutely agree that those who are in regular contact with diabetic patients and have clinics/check ups and the like should definitely be up to date on the current guidelines. Also believe that if they think the guidelines are wrong they should challenge them and it's useless to give out incorrect information which could be potentially harmful.

However if a nurse doesn't work in an area that deals with diabetic patients on a regular basis it's really difficult to ensure they're up to date and giving out correct information and they shouldn't be giving out information theyre not sure about. For example in my place of work I know about diabetes, I know why it happens and complications that can arise from it and I know how it can affect the patients I see on a daily basis and the complications that can arise. However I don't know anything about current treatments, about types of medication available or dietary advice etc so I wouldn't be giving out information to anyone and I'd really hope other nurses aren't doing the same.

There are so many guidelines that need updating, something I've found out in pregnancy after being given conflicting information and it is frustrating.

trinity0097 Fri 12-Aug-16 17:12:54

You would think in this age of budgets being stretched they could suck it up and admit their dietary advice is rubbish and promote the advice that costs the NHS nothing other the re-education.

stopgap Fri 12-Aug-16 17:13:29

Statelychangers, you're dead right. I have Hashimoto's and have been strictly gluten-free since diagnosis, and also limit my carbs to low levels. I was showing very early signs of prediabetes (HDL and LDL in reverse, among other things) and put things right back into place by eating no sugar, no alcohol etc for four months.

Now I can get by with a couple of pieces of dark chocolate per week, and some might say they'd rather live love to the fullest than live so puritanically, but I have the energy for hard workouts, raising two children etc. whereas many people with autoimmunity really struggle with pain, inflammation and fatigue. It isn't always smooth sailing, but cutting out sugar has done wonders for me.

stopgap Fri 12-Aug-16 17:14:49

*Live life!

GraceGildee Fri 12-Aug-16 17:44:15

Yep, I agree. My diabetic nurse is lovely but her diet advice is to eat lots of fruit and pasta etc. I do low carbing and have lost 35lb and got my blood sugar down.

RichardBucket Fri 12-Aug-16 17:50:49

Ha, try being Type 1. Non-diabetes-specialists know hardly anything about Type 1, and even so-called specialists can give very dodgy advice.

Don't get me started on the dieticians.

The only way to go with diabetes is to educate yourself online... which opens up a whole other set of problems if you're not a good critical thinker and/or not internet savvy.

FoggyMorn Fri 12-Aug-16 18:09:44


Dh and some of his GP partners, in defiance of standard NHS guidelines, recommend low carb to their patients with t2, and very importantly those with metabolic syndrome, fatty liver. Only some are receptive to ignoring official advice, but those who do often have spectacular results- not just weight but much more importantly long term blood sugar, cholesterol, and liver enzyme improvements. There are also good reasons why people with t1 (and indeed all of us) , should be eating fewer total carbs, particularly acellular ones ( ie things made of flours and other highly processed carbs). For those with t1, of course great care must be taken as a medication and carbs need to be managed in tandem.

Within the same practice, a couple of the GPs and all of the practice nurses contradict this and push carbs with every meal (usually saying "low sugar" at the same time!!!).
Change is coming! Diabetes uk has become interested in "low carb" although their low carb is about 150g a day - probably fine for healthy, active, normal bmi people but imo not nearly low enough for those people who are obese, inactive and metabolically challenged (I speak as one people of those btw- much weight lost and much health gained on low carb).

Current dietary guidelines are pretty much perfect... For making people fat and sick.

trinity0097 Fri 12-Aug-16 18:11:08

Well done gracegildee. I have lost 4.5 stone since diagnosis 18 months ago and my hba1c today was 33 (5.2), all through LCHF

Hedgehog80 Fri 12-Aug-16 18:14:27

It's the same with type 1. Our surgery are useless with it and twice in three months tried to CANCEL the prescription for test strips and glucose tablets !!! They said we were using too many and it was a cost issue

Sunnymeg Fri 12-Aug-16 18:19:48

Agree Richard Bucket DH is type 1 and they have no clue. He had a major operation last year and was visited by a diabetic nurse specialising in post operative recovery. He didn't agree with her advice but had to go along with it whilst in hospital. His blood sugars ended up all over the place and affected his wound healing.

trinity0097 Fri 12-Aug-16 18:56:49

When I was diagnosed with diabetes and given an NHS meal in hospital that evening (went in with a finger prick reading of 32 via an ambulance!) it was carb heavy and included not only a pudding but also sweet biscuits. Hardly the best way to start dealing with diabetes, give the person nearly in a diabetic coma loads of sugar!

Fruu Fri 12-Aug-16 19:03:47

I have PCOS but am thankfully not diabetic yet although I suspect I'm insulin resistant. The dietary advice I had from my GP was shocking - they wanted me to eat very low fat and high carb (even white bread and potatoes!) to lose weight. All the PCOS books and forums basically say to do the opposite, so I ignored my GP and for the first time in my adult life I'm managing to lose weight by low carbing. I pile on weight very quickly if I follow NHS healthy eating guidelines.

It's dreadful that the NHS can't get dietary advice right for people with medical conditions. They don't even have correct advice on their web pages for things like food allergies / intolerances (e.g. they listed peanut butter as a food containing milk on their page on lactose intolerance when I have never ever found a peanut butter that contains milk in the shops! I emailed them about that one.) You'd think they'd at least get their allergy information correct!

Statelychangers Fri 12-Aug-16 19:04:30

My post op food in hospital after a c section was a shocker - consultant told me not to eat it - good job my dh was around to feed me proper food.
NHS is fantastic for a lot of things but dietary advice is most definitely not one of them!
I really feel for the people who are suffering from auto immune conditions who don't know of the effectiveness of dietary control. Fair enough if you decide you can't/don't wish to choose this option but to not be informed by the so called experts is negligent. So you become a google expert - the very thing doctors tell you not to do - but you have no choice because the doctors seem to be convinced by either surgery or drugs - the third way - diet is completely dismissed but too many people report success for it to be the placebo effect alone - we have consultants and researchers who hang out in our Facebook group gathering evidence on how people control their condition. Apparently it would be unethical to run a trial involving restricted food they are relying on people self experimenting.

MedSchoolRat Fri 12-Aug-16 19:24:08

The standard advice is a Med-style diet, this works about as well as low-carb on avg. There is a systematic review showing that low carb diets have no advantages over standard advice for T2 diabetes.

Besides, most patients ignore the current official advice. Changing the official advice won't make them follow it better.
They don't count carbs.
They only reduce sugary foods temporarily.
They don't monitor blood sugar, or keep an eye on feet problems.
They don't take exercise.
They don't make an effort to lose weight.
They don't take medication as directed.

trinity0097 Fri 12-Aug-16 19:29:49

This is a fascinating read...

Statelychangers Fri 12-Aug-16 19:42:22

So most people are unable to follow the diet so there's no point in telling everyone - that's a bit of a shit approach!
When I was diagnosed my consultant offered me fairly ineffective meds - I asked her whether they would work long term and her reply was no, so I suggested the dietary approach - she agreed with me that it worked but not many could be bothered. Just as well I wasn't relying on a fecking expert for advice!

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