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.

Totally agree. It's ridiculous. It's not just about cutting out sweets and puddings. Carbs are lethal. Even more so for a gestational diabetic. Try explaining that to MIL though. The added bonus of low carb high fat high protein is that the weight will fall off which also helps lessen the severity of t2. Win win.

But you could consult with patients about their preferred approach - some patients just want drugs - others may prefer to deal with it through dietary restriction - we should at least be informed about both options.

Ducky, why can't you adopt that as the official NHS treatment? Other conditions cut out carbs eg severe epilepsy in children is treated with a ketogenic (severe low carb) approach. What about coeliacs - they are 'treated' by advising them not to eat gluten for example.

Of course, it is up to each individual what treatment plan they actually want to follow, but the medical advice is simply that - advice - whether to follow it or not is down to the patient.

I think that nutritional advice is gradually coming round to the view that fat is not bad for you (except hydrogenated fats) and that the real problem is refined carbs.

Hopefully this will filter through to diabetes advice soon. For a diabetic refined carbs are dreadful and fat can actually be helpful as it raises the GI of foods. (For example cheese on toast has a lower GI than a slice of toast on its own, so less likely to cause a blood sugar spike).

I had GD and am now petrified of developing T2. I cut out almost all refined sugars and carbs and stuffed myself with nuts and cheese and fish etc - it is so hard when you dislike meat and most fish and tofu intensely, as what the hell do you eat?! - and felt like I was eating loads. But by the time DD was born I had only gained 15lbs in the entire pregnancy, of which she was 7.4. So I think I would have lost weight had I not been pregnant.

I am gaining weight like the greedy out of control sow that I am now that she's safely here, so I think I am going to do the 8 weeks at 800 cals to try and give me a mental break before easing back into healthy eating with mostly veg and some fish.

Mini pie, it's not just refined carbs, all carbs are a problem. A 30g slice of brown bread raises blood sugar the same as 3 teaspoons of sugar - a fact I saw the other day, yet people perceive brown bread to be healthy, yet know that 3 teaspoons of sugar is bad.

Brown bread is refined carbs though trinity! Anything made with flour is.

Agree all carbs are a problem for blood sugar but some are worse than others, and carbs that have been refined, processed or broken down in some way (like bread and obviously sugar) are much worse than carbs in their natural form (like raw veg or lightly cooked pulses).

I'm confused!

What is a good list for low carb diet?

I like quinoa, brown rice, bulgur wheat, oats, sweet and boiled potatoes. Should I not eat them?
I like full fat hard cheese and unsweetened Greek style yoghurt, should I not eat this?
I like fish, but don't like meat... How do I eat a high protein diet if I like lentils and chickpeas? Aren't they carbs?

I like cherries, bananas, pears, blueberries, grapes and apples, can I eat them?

It seems to be one week you can eat something and the next they're off the menu.

Anyone have an idea where I can get a comprehensive list of low carb foods. And does low carbing mean ketosis? Is it the same thing? Is this just aitkins.2?

TIA

The diet doctor website explains it all in detail.

Thanks trinity. I'll have a look at that now.

Any contraindications for kidney stones with all this green leafy veg and protein?

Anyone on this diet with kidney stones? and how do you stop yourself from getting them. Do you limit oxalate rich spinach, asparagus, cabbage, sprouts, red meats and drink 3L water a day? What do you eat instead of these iron / oxalate rich low carb foods.

TIA

I don't know much (anything) about diabetes, but when I was very young I remember my dgf weighing out his potato and measuring all his carbs each day. He also had to inject insulin, but measuring carbs was a huge part of his managment of the disease.

That was about 35 years ago, so surley the advice must have been low carb even in those days? Is that not what the NHS are advising now?

Henry part of taking insulin is knowing how much to take this done by carb counting (not all insulin users do this) it can be really useful to do for people prone to hypoglycaemic episodes. It's not that they can't eat carbs or that they have to restrict.
Venus I would say if you have a history of kidney stones that you really should seek professional advice about changing your diet.

Henry, I suspect your relative had type 1 diabetes where carb counting is what has to be done, although relatively few advocate reducing carbs although this can help those with type 1 to have to need to take less insulin. A colleague of mine with t1 reduced carbs after I started low carbing and found he improved his control of his t1 diabetes as a result and felt much better.

Thanks Trinity, that's interesting. I was only young at the time. It is one of my overriding memories of my grandfather. It always made us all laugh because my grandmother always took charge and told him if he could have another potaoe or not. I don't know if it was type 1 or type 2. He got it later in life, but was not over weight, in fact,he was v skinny.

OP, I agree with you.
My MIL is under NHS care for lifestyle related type2 diabetes. She is also about 4 stone overweight.

They tell her she must eat carbs with every meal. She also eats loads of fruit on the grounds that 'you have to have your 5 a day', but she honestly has about 15 a day and never goes more than an hour without eating.
She thinks she is following the instructions. The clinic think she is too. But she is not healthy and they keep upping the medication.
I despair :(

Thanks ivy and foggy

ivy, would you mind reposting that link as that one just goes to the guardian's website? Thank you

www.theguardian.com/science/2006/dec/10/medicineandhealth.health
Hopefully correct link this time

I've just switched to LCHF and I'm eating (following dr schofield) and in eating EXACTLY the same as two friends who are on NHS gestational diabetes diets.
This thread surprises me.
We are all eating around 50-100g carbohydrate a day, mostly as veg. So more than an Atkins/ketosis diet (which I think is about 35g carbs) but less than an average uk "healthy" food pyramid diet which is around 250g carbs a day.

Anyone questioning whether a lower carb/ higher fat diet actually works should try it.

And you don't need to go crazy low carb either : include beans and pulses, squashes and loads of veg.

YANBU

When I had gestational diabetes I was appalled by the diet suggested by the NHS dietician. 2 weetabix for breakfast, followed by a sandwich for lunch, fruit, and pasta for dinner.

Just, why?