To refuse to see a dietician during pregnancy

[Battleshiphips]

I have type 2 diabetes but I am in very good control of it. My diabetic nurse was amazed at how low my HBAC1 was and every doctor that I have seen has said how well I am doing (I have also lost a load of weight) and that my diet (I follow a paleo one) is really healthy and to carry on as I am. I am now pregnant and intend to carry on with my way of eating. The midwife was really pleased and said there is absolutely no harm in losing weight during pregnancy and that she was very happy for me to carry on as I am as I eat very healthily. However when I saw the dietician and told her what my diet was she instantly said I wasn't having enough carbs and that I needed to eat more bread, pasta, rice and potatoes. I told her that if I have more of these carbs then my blood sugars would rise. She said "oh well we'll just have to give mother nature a boost and put you on insulin"! I was shocked, surely it's better for me to eat healthy and control my sugars that way. WIBU to refuse to see her again. I am definitely not going to add more carbs to my diet as I do not want to end up on insulin. I have been monitoring my sugar for the past few days and my readings are perfect.

Rather than refuse outright to see one could you not get a second opinion? Pregnancy with diabetes is risky and I am not sure that ignoring the advice healthcare professionals is necessarily a good idea.

But that midwife is not a dietician! It sounds like you're really doing the right thing. Go to the dietician and get it confirmed.

You know your body and. Your healthcare professionals are happy. Don't go again and also report back to your doctor that she is advising medically unnecessary insulin

Stumbled on your post by accident and have no relevant diabetes experience, but took dc to dietician and was horrified by her ignorance. Completely ignored everything she said (she was wrong) and sorted the problem myself.
It sounds like you know what you're are doing. So called professionals aren't always good at their job. Listen to your experienced midwives or GP if you have any doubts.

I have been told this by another dietician and followed her advice and ended up with blood sugars through the roof! At myy last appointment with the diabetic nurse I was told my diet was fantastic and to carry on as I was. All NHS dieticians seem to tell you to eat more carbs. My sugars are perfect and I am getting all I need from the healthy foods I do eat. I eat fish, meat, all fruit, all vegetables and nuts and seeds. A very healthy diet.

That sounds a bit crazy, there is no 'one size fits all' with insulin so you could spend your entire pregnancy trying to get your levels right when they already are. I think if your midwife is happy you and the baby are getting what you need it would be mad to change what you're doing, surely?

I am type 1 by the way and insulin can be hard work !

my sons dietitian told me to put him on coconut milk and other various strange milks the results were shit literally watery shit everywhere i refused to see her again and saw a paediatrician who radically told me to reintroduce milk and wheat now he was 12 months old he now has a normal diet

i wouldnt want to see a dietitian either

you probably should though they might have some good ideas and you might get a good one

congratulations by the way

I would be alarmed at any diet that could result in worse management of your diabetes.

Could you see the Diabetic Nurse for a second opinion? They are the experts and I'm sure they'd be concerned, Insulin for managing type 2 diabetes shouldn't be touted as something of no consequence.

judey my GP was shocked that I had been told to eat more carbs. He actually said that the dieticians needed to get up to date with their advice. I have added dairy back into my diet on her advice but I cannot see the benefit of adding the type of carbs she is recommending back into my diet only to end up on insulin. Has anyone ever turned down appointments such as this?

I followed the dieticians advice during my last pregnancy when I had gestational diabetes and ended up on insulin! I have to inject myself with a blood thinner from week 24 so I certainly don't want to have to inject insulin when it can be avoided! Seems like a few of you have had problems with dieticians. Thanks for your views ladies.

If your GP and the diabetic nurse are happy with the way you manage then that should be fine.

I declined dietician appointments in pregnancy-I had gestational diabetes but ds1 has type 1 so I knew what I needed to eat/avoid.My sugars were good all the way through and baby was fine.

My son sees dieticians occasionally-one was brilliant the other was crackers. Tis the luck of the draw I think.

I've been in exactly the same position, it's so frustrating! I think current health guidance is a good few years out of date and often (not always) the patient has better knowledge on what makes their diabetes worse than medical staff who they see every couple of weeks.

In my case I am eating more carbs than before because I'm craving them! But I regularly try to have no carb breakfasts and avoid starchy carbs because they're more trouble than they're worth blood sugar wise.

Good luck.

I wrnt to a diabetic maternity clinic and a couple of consultants the diabeties one an maternity one as well as a midwife was looked after the diabetic ladies. I was told to cut down on carbs full stop. Does your area have a diabetic maternity clinic, its been a few years but i thought this was an accross the country practice?

My daughter is type 1 and I always go on the advice of the diabetic specialists, the ignorance towards diabetes from health care professionals is shocking! Maybe ask your DSN for her advice then if you see the dietician you can tell her what you've been advised.

Grrrr! I am a recently diagnosed type 1 and I have to say the NHS still don't seem to realise that low carb = good blood glucose control. Whether it's coming from bread or chocolate, Carbs raise your BG levels. This is often more important for type 2's than Type1 as of course we can counter the carbs with insulin but even so, lots of carbs do make it harder to control BG no matter what type you are.
I would most definitely ignore the dietician, if you increase your carbs then you WILL end up on insulin not the other way round FGS!

Please come and have a look at the diabetes.co.uk forum, there's a whole section on pregnancy on the forum with plenty of good advice.

eatyou this is the diabetic antenatal in the hospital where I'll give birth. She also told me off for eating nuts and when I said the NHS website said I can she kind of ignored me and said no I can't. She then gave me a handout for pregnant women that said nuts are a good source of protein for pregnant women I think I will be turning down future appointments with her. Thanks for all the replies.

Thanks wicks I'll have a look on there.

I know someone who was referred to a dietician for general weight loss help and she was told to eat 6-8 portions of starchy carbs a day on top of her fruit/veg carbs. I was baffled that a trained professional would advocate that!

Keep doing what you're doing, it obviously works for you.

I think they tend to be keen on portion control and keeping all food groups in the diet.

I would ignore her advice but I think it might be better for OP to just go along to app and keep doing what she's doing. OR tell someone she's not happy with dieticians advice. If she just misses appointments it will get the alarm bells going and she's get extra app with consultants and what not.

ottilia I have no intention of just missing the appointments. I will be telling the diabetic midwife that I no longer wish to see the dietician because I don't feel her advice is beneficial to me personally. Hopefully my monitoring should show her that I am in good control.

It seems most dieticians are still following the NHS 'healthy plate' advice which is far too high in carbs for most diabetics. I declined to see one when I was diagnosed with type 2 in April and have reduced my HBA1c from 53 down to 38 (which for those who don't know is into non-diabetic figures) through eating low carb.

If I had followed the NHS dietician advice, as I did when I had gestational diabetes 2 years ago I would be on medication. I had to take insulin during pregnancy as I couldn't control blood glucose. Hardly surprising when none of the diabetic specialists or the dietician told me to significantly cut down carbs!

Congratulations on your pregnancy, and for maintaining an excellent HbA1c!

Re the dietician, YANBU. She doesn't seem to know what she's talking about. You can certainly refuse to see her again.

On the other hand, there might be legitimate reasons why a small increase in carb consumption is necessary in pregnancy, and that good control is just one part of the equation.

I'm not an expert on this kind of thing, but I was told by a doctor once that a fetus needs carb for brain development - however, it was many years ago and may no longer be the current thinking.

Nevertheless, a low carb diet is not the norm in pregnancy (since most pregnant women aren't diabetic). So in your shoes I'd want to know if there might be any adverse effects of a low carb diet, despite the positive effect of good control.

If I were you I'd ask the GP about getting access to research / information about nutrition and fetal development - maybe a referral to a consultant who specialises in diabetes and pregnancy?

Really sorry if this isn't helpful, and feel free to ignore me completely if this isn't the sort of thing you want to hear about.

I agree with both you and Sorcha, op. NHS pushes (low gi) carbs for diabetics even though most people do better on very low carb diets.
But I do wonder if restricting carbs in pregnancy might have other effects than just lowering blood sugar and I would want expert advice on that.
I would skip the dietician though and ask your consultant at your next appointment.

poster and sorcha I do understand what you are saying but I eat plenty of carbs. Fruit and vegetables give you plenty of carbs and I don't restrict them. I eat all fruit and veg apart from potatoes. I will look into how carbs effect an embryo though. Thanks for your input.