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

[trinity0097]

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.

I agree op. And it's not just diabetes - I've been low carb (well, paleo, but I keep my carbs low) for 3 years and in that time it has staggered me how many stories i've read of peoples' chronic pain, autoimmune conditions, asthma, infertility, thyroid issues, skin complaints, heart problems etc etc etc being radically helped by this woe. I can't wrap my head around how much healthier many people would be if they switched to this and how much money the NHS would save. Sometimes it makes me very angry, but then what can you do? You can't make people try it. You can only keep talking about how much better it's made you.

Not meant to be patronising but you reaction reminds me of the almost aggressive opposition to dietary control among fellow suffers of my condition, despite their lack of alternatives. I have no idea about the specific ethics of medical trials but in the research papers I have read about my own condiction, ethics have been cited as the reason for lack of support of dietary trials. The AIP diet has been used as a guide to uncover the flare foods for many people - everyone is different and this adds to the complication. I flare with the supposedly safe food - coconut but I still found it useful - if you don't fair enough but everyone should be made aware that diet is a treatment option.

Interesting first link, MedSchoolRat.

Looking at the diets that lead to an improvement in glyaemic control, I wonder whether there's something in common between them, because on the face of it, they are a very different group of diets.

A lack of processed foods will always lead to a lower glycemic load. Not sure whether type 2 peeps react differently to foods. What I mean is do all foods have the same impact on everyone's blood sugar level? We all eat such weird combinations it's so hard to tell?

DD has T1. I despair of what I've been told by some health professionals.

The treatment of T1 diabetes hasn't got any better since I was a child imo. I get shockingly bad information from some health professionals. One nurse got deeply offended when I refused to add white potatoes to my diet on her suggestion.

Also the assumptions made can be dangerous. I had test strips removed from my prescription because I "clearly" had T2. Despite the fact I've been T1 since I was a kid. I happened to be a little bit overweight at the time because I was comfort eating due to depression. The difference in some health professionals when I said I was T1 was pretty shocking as well.

Not fair to slag off NHS-NICE if they can't find the evidence.

I suspect that the reason the low carb approach doesn't perform better than others is because most people's diets are so lousy poor quality. So any of those healthy diet options turn out to be huge improvements on avg. Plus, what is a "low carb" diet? There are so many versions. Which one is practical and best... who knows.

I meant to make the point that there are lots of aspects to managing diabetes well & reducing the risks, not just diet, it's a big uphill battle for NHS to try to make so much diverse advice practical & get people to act on any of it. Sorry if that wasn't clear.

Med have you got an auto immune condition? Have you tried dietary control?

Is it not possible to have a different opinion?
I think it more complicated than just saying low carb is the only way. I think there will need to be more research before the nhs which claims to be evidence-based.
Fwiiw many of the people I work with avoid medication through diet (increased activity, alcohol reduction) and yes the diet recommended is low fat, low sugar high fibre.
The big problem is motivation and long term up take of this advice it is hard work changing the way you have lived for years.

• take up this treatment option

Crucial thing about the diet is calorie reduction

Stately I'm not against modifying my diet. I'm not sure how you got that from my post. I have changed my diet, in line with proven research in my disease. I don't believe that going low carb and gluten free is the pinnacle of health that some people claim it to be. (Not saying you are saying this btw.) I just feel quite at people who lump all autoimmune diseases into one homogeneous group. Some diseases cause unpleasant symptoms that distrupt quality of life and some actively threaten life. There are a wide variety of diseases. Low carb for someone with severe Crohn's, for example, would be a nightmare. During flares, the advice is a low residue, high white carb diet. I have tried every diet over the years, every magnetic bracelet, every woo cure that I didn't believe in but ultimately, I am reliant on toxic medications, immunosuppressive injections and multiple significant surgeries. I find it quite upsetting when some people assume that patients like me wouldn't far rather give up bread than go through what we do.

Doggity at no point did I ever suggest you have not tried alternatives, your journey us your own. I know that loads of people have not found diet solutions effective as much as I know that many have. I get pissed off that people don't get the choice to find out which camp they belong in - to me that's unacceptable.
My condition came down to Crohn's or Hydradenitis Supputivia - not much fun to be had from either but after many years of pain dietary control has given me a pain free life again and that is something I obtained without scientific backing or the NHS - sentinels you just can't wait!!!

Imo there is a dietary solution to auto immune issues - find the solution yourself because unless you have s very forward thinking doctor no one is going to do it for you for quite a few years or don't and wait. I can't wait, I want to live life and I will explore any opportunity that presents rather than waiting on a massive organisation like the NHS to fill me in on what is good for my body!!! I know they need study upon study but life doesn't wait and change in diet is not such a big deal given how much better it makes you feel.

Stately I have psoriatic arthritis would a low carb diet be helpful?

Dr Unwin in Liverpool has been advocating low carb diets for about 4 years now and is at the forefront of it in treating diabetes, weight loss, etc... He has saved his practice £40k a year in diabetes medication (T2s not needing met forming etc and T1s needing less insulin) and if that was extrapolated nationwide they reckon that would amount to savings of £400 million a year.

You are right in saying what is low carb, I suspect that many trial low carb diets were not low carb enough. I aim for 20-30g a day, have achieved sustained weight loss I never managed on low fat diets (because on them you feel hungry!), stopped having diabetes complications (for which I had been needing NHS treatment/surgery) and have now reversed the diabetes. It might not be the only way, but it's a sure fire quick fix if done properly. The only real advocates of it are the diabetes.co.uk website/forum, where just about every t2 diabetic who has adopted the lifestyle has significantly improved their diabetes and reduced/come off medication.

It's time for more that just one lone doctor in Liverpool to take note! At least he has found the time to do some peer reviewed papers in proper medical journals, so the word is starting to get out, but the sad truth of the matter is that the medical profession do not want to go back on what they have been spouting as the truth for years, I,e, low fat high carb diets.

I don't know seven is it auto immune?
Doggity loads of people manage crohn's through diet.
I started this healing diet malarky 18months ago. I was a bit cynical - tried it for a month, my condition actually got worse and I declared it to be snake oil..for me. Then I suffered more pain and in desperation tried another diet - this time I stuck to it and after 6 weeks I could see it starting to work, it was very extreme and long term despite healing I couldn't stick with it.
Eventually my condition returned and got worse and just kept getting worse, till I had no choice - it was either diet or be in ever increasing amounts of pain for life. It took 6 weeks again (seems to be my healing time) for me to feel confident I was healing and some days I had my doubts healing was very slow but this time I was committed to the long haul. I no longer doubt - a slip up in my diet either causes a flare or informs me a food is ok.
No allergy test will say I'm allergic to sugar but it gives me blisters on my hands around 12 hours after eating it.
It's hard to believe at first and it takes ages for some people to feel better, others do almost immediately and that can be very frustrating. Finding your flare foods can be like searching for a needle in a haystack which is why you need support and help from others. Facebook groups can be amazing for this - you need to find the one that suits you. As I said earlier the AIP - Auto Immune Protocol diet is a good place to start. The Wahls protocol and Terry Wahls herself is very inspirational - she does a Ted talk about how she successfully manages her MS which had her wheelchair bound when she started. Some people start with Paleo, some start with low carb.

My personal goals are eating a good variety of foods, loads of fresh veg, meat and fish. No diary, no wheat, no sugar. Get enough Vitamin D3. Prioitise sleep. Minimise stress and get strong and fit.
The science may not back me up....yet! They don't know what they don't know but my body and the results I and many others have achieved do. If my condition worsens the medical options I have are pretty horrible immuno suppressant drugs - of teen don't work or major surgery with 6-12 months recovery, with the condition likely to return elsewhere on my body - doesn't sound very appealing.

I have a friend who despite following the low fat high carb diet, being fit and size 8, had very high cholesterol - family history. Her doctor started talking statins. I pointed her towards Paleo/low carb - told her to read up on it if she wanted another option.
So she decided to give it a go but she didn't tell her doctor and for her first two monthly check ups her cholesterol got increasingly worse - she was a bit panicked but decided she'd give it one more month and good job she did - her doctor phoned her - he was so excited by her impressive fall in cholesterol - told her to keep doing what she was doing and then asked what was she doing differently, when she told him he was horrified and tried to convince her to stop! She has been eating like this for 3 years now and her blood results continue to look great.

Which low carb diet are you guys following or trying?

The diabetes.co.uk website is plastered with ads for low-carbing, so presumably everyone under 40 will feel encouraged to try it.

For me the most unappealing feature of low carb would be heavy reliance on animal meat, which doesn't seem to be the healthiest option either.

Yes, low carb is the only way to go to prevent t2 diabetes getting worse, I have it so feel qualified to know!

Diabetes is a disorder of carbohydrate metabolism. Giving someone more of what they can't handle won't help. And whilst low GI carbs are better than high GI carbs it's all carbs at the end of the day.... it will all be broken down to sugar in the gut and have to be dealt with, which is exactly what diabetics have trouble with.

My personal philosophy is to low carb until the evening then inject a little extra insulin to have a couple of treats, that way I don't feel I am missing out, but I can only do that because i am on insulin in addition to meds, which most t2 aren't.

Nowt too wrong with animal meat, Medschoolrat, but then again it won't make me go blind if I eat too much of it, which carbs will (and almost did), so that tends to be my guiding principle now when deciding what to eat or not.

Those of you who are T2 diabetic & on low carb diets, do you still count your daily carbs or do you just follow low carb diet principles & not actually precisely count your carbs? Which version should NHS tell patients?

Obviously this doesn't apply to anyone on thread... :) but T2 diabetes is higher risk among people with lower numeracy skills. Many struggle with precise counting and calculating carbs in portions they just ate, etc.

GPs surgerys get a financial incentive to diagnose and have diabetic patients on their register.....so i dont truly believe all people diagnosed as type 2 diabetic are......i think sorting your own diet out, losing weight and eating healthily is beneficial.....saying that i know a 'diabetic' who keeps chocolate in her bag for when she feels 'funny'.....she eats all the wrong things and is very overweight...she tells her doctor she sticks to her 'diet', but lies about it...there lies the problem!

I think its always a bit misguided to suggest that most people in the NHs don't know how to treat T2DM when this is usually based on an individual's experience of one small portion of the service.
You have your good and bad out of date practitioners everywhere.

Seven, I have PsA (yes stately, it is autoimmune) and I have ibs. I have eaten low carb for quite a while, and though it helps my ibs massively, it doesn't make my joints (or psoriasis) any better.

However, I know that (apparently) nightshades and dairy are big bads for PsA too, but I have not tried cutting them alongside LCHF (though I have separately), as I like having something to eat apart from meat and lettuce!! That may well make me a horrible person wasting nhs resources on the toxic meds I would happily not take, but look at all the shits i give.....