A year in the life of a typical type two diabetic.

A year in the life of a type two diabetic.

The diagnosis.

Hi Doc how did my blood tests turn out ? sorry Fred it’s as I suspected, I’m afraid you’re a type two diabetic. Um, so what do I have to do ? Take these Metformin tablets twice a day and come back in six months time. Is that it, is that all I have to do ? Well, cutting back on sugar will help you, get a bit more exercise in and change your diet, here’s a book sponsored by Takeda, it tells you what to eat. Thanks Doc, it says here to base my meals on lot’s of starchy carbohydrate foods and to eat spuds, bread, rice and couscous, that’s great Doc, there my favourite foods. ( Doctor looks slightly embarrassed and fakes a friendly smile)

So Doc, what’s all this malarkey about high blood glucose numbers ? It says here it can lead to blindness, kidney failure, heart attack and leg amputations, this is a wind up surely ! No, I’m afraid it’s true Fred. Jesus Christ !!! these Metformin pills must be amazing if they can stop all that. (Doctor struggles not to grimace) Tell me Doc, what causes blood sugar to go to dangerous levels ? Err, Err, Err eating starchy carbohydrate foods like spuds, bread, rice and couscous. Come on Doc your pulling my chain, the book says I should eat that sort of grub. See you in six months Fred, keep taking the pills. Gloria, send in the next patient please.

Six months later.

Good morning Fred take a seat, how are you doing ? Well to be honest Doc I am a bit worried, I still feel ill, my eyesight is still a bit blurred and I’m knackered out most of the time, even my old todger ain’t working so good these days. Well that’s par for the course Fred, diabetes is not much fun is it. Tell me Doc, I have been hearing about BG meters and test strips and that they can tell me what my BG levels are, any chance of one on my prescription ? No Fred, for type two’s they are complete waste of time. Why is that Doc ? Well if you tested your BGs, and realised how high they were running, you would become very worried, you might even get severely depressed, and then I would have to treat your mental condition. Take it from me Fred, severe depression, is the last thing you want.

Doc. I joined a diabetes blog and website, and a geezer called Eddie , reckond cutting back on the grub, you and the dietition told me to eat, would help me no end, what do you think ? Um, I have heard of this Eddie, he is a total menace to the diabetes community, he is costing commercially lead forums and pharma companies a small fortune, he has no respect for most forum moderators and he’s a complete nutter, keep well away from him Fred, he’s trouble.

So this low carb lark he pushes is a no,no. Fred, what can some jumped up nobody, know about controlling type two diabetes ? Well Doc, he is always going on about a bloke called Bernstein and he reckons Bernstein is the man when it comes to controlling blood sugar levels, have you heard of Bernstein Doc ? Bernstein……...... Bernstein……..... didn’t he write West Side Story ?

Six months later.

Hi Doc, how was my latest HbA1c test ? Unbelievable ! looking at your tests, unbelievable, sorry Fred they must have got it wrong, these tests can’t be right. What's the problem Doc ? Well it says here your HbA1c has gone from 12 to 5.5, your trig levels have gone from 4 to 0.8, your HDL cholesterol has gone up and your LDL has gone down, these blood numbers can’t be right, it’s totally impossible to achieve these numbers. The last time I saw those sort of numbers they were for a 25 year old iron man competitor. Sorry Fred we will have to do the tests again.

Why are they impossible Doc ? I have been low carbing for six months. Lots of diabetics have done this, by low carbing they have lost weight, and years on, they are still doing well. Fred, do you seriously think, a bunch of low carb barmy army recruits, know more about diabetes control than I do ? Why do you think most of those low carbers have been banned from diabetes forums, I’m telling you Fred, they are nutters and trouble makers, have you seen the amount of fat those people eat ? Good grief Fred, those low carbers are dead men walking. That’s another thing Doc, they are always going on about walking. Exactly Fred, they have lost the plot !

Doc, I’ve been hearing about a guy called Gary Taubes, and he reckons it’s the carbs and sugar that leads to obesity, heart disease and type two diabetes, and not saturated fats. Ah yes, I have heard of Gary Taubes…………………… wasn’t he the drummer with Mott The Hoople ?

So, you don’t rate low carbing Doc ? Well if it works for you Fred stick with it, but no, I wouldn’t recommend it, who but a complete idiot, would take diabetes diet advice from some nutter on the internet ? Honestly Fred I sometimes wonder why I bother to turn up here some days. It’s patients like you that make this job a misery at times. On your way out, ask my secretary to come in would you, see you in six months Fred.

Gloria, place a note on Fred’s medical file. Patient far too happy and relaxed for a diabetic, suspect possible alcohol or narcotics abuse.

Eddie wrote:A year in the life of a type two diabetic.

The diagnosis.

Hi Doc how did my blood tests turn out ? sorry Fred it’s as I suspected, I’m afraid you’re a type two diabetic. Um, so what do I have to do ? Take these Metformin tablets twice a day and come back in six months time. Is that it, is that all I have to do ? Well, cutting back on sugar will help you, get a bit more exercise in and change your diet, here’s a book sponsored by Takeda, it tells you what to eat. Thanks Doc, it says here to base my meals on lot’s of starchy carbohydrate foods and to eat spuds, bread, rice and couscous, that’s great Doc, there my favourite foods. ( Doctor looks slightly embarrassed and fakes a friendly smile)

So Doc, what’s all this malarkey about high blood glucose numbers ? It says here it can lead to blindness, kidney failure, heart attack and leg amputations, this is a wind up surely ! No, I’m afraid it’s true Fred. Jesus Christ !!! these Metformin pills must be amazing if they can stop all that. (Doctor struggles not to grimace) Tell me Doc, what causes blood sugar to go to dangerous levels ? Err, Err, Err eating starchy carbohydrate foods like spuds, bread, rice and couscous. Come on Doc your pulling my chain, the book says I should eat that sort of grub. See you in six months Fred, keep taking the pills. Gloria, send in the next patient please.

Six months later.

Good morning Fred take a seat, how are you doing ? Well to be honest Doc I am a bit worried, I still feel ill, my eyesight is still a bit blurred and I’m knackered out most of the time, even my old todger ain’t working so good these days. Well that’s par for the course Fred, diabetes is not much fun is it. Tell me Doc, I have been hearing about BG meters and test strips and that they can tell me what my BG levels are, any chance of one on my prescription ? No Fred, for type two’s they are complete waste of time. Why is that Doc ? Well if you tested your BGs, and realised how high they were running, you would become very worried, you might even get severely depressed, and then I would have to treat your mental condition. Take it from me Fred, severe depression, is the last thing you want.

Doc. I joined a diabetes blog and website, and a geezer called Eddie , reckond cutting back on the grub, you and the dietition told me to eat, would help me no end, what do you think ? Um, I have heard of this Eddie, he is a total menace to the diabetes community, he is costing commercially lead forums and pharma companies a small fortune, he has no respect for most forum moderators and he’s a complete nutter, keep well away from him Fred, he’s trouble.

So this low carb lark he pushes is a no,no. Fred, what can some jumped up nobody, know about controlling type two diabetes ? Well Doc, he is always going on about a bloke called Bernstein and he reckons Bernstein is the man when it comes to controlling blood sugar levels, have you heard of Bernstein Doc ? Bernstein……...... Bernstein……..... didn’t he write West Side Story ?

Six months later.

Hi Doc, how was my latest HbA1c test ? Unbelievable ! looking at your tests, unbelievable, sorry Fred they must have got it wrong, these tests can’t be right. What's the problem Doc ? Well it says here your HbA1c has gone from 12 to 5.5, your trig levels have gone from 4 to 0.8, your HDL cholesterol has gone up and your LDL has gone down, these blood numbers can’t be right, it’s totally impossible to achieve these numbers. The last time I saw those sort of numbers they were for a 25 year old iron man competitor. Sorry Fred we will have to do the tests again.

Why are they impossible Doc ? I have been low carbing for six months. Lots of diabetics have done this, by low carbing they have lost weight, and years on, they are still doing well. Fred, do you seriously think, a bunch of low carb barmy army recruits, know more about diabetes control than I do ? Why do you think most of those low carbers have been banned from diabetes forums, I’m telling you Fred, they are nutters and trouble makers, have you seen the amount of fat those people eat ? Good grief Fred, those low carbers are dead men walking. That’s another thing Doc, they are always going on about walking. Exactly Fred, they have lost the plot !

Doc, I’ve been hearing about a guy called Gary Taubes, and he reckons it’s the carbs and sugar that leads to obesity, heart disease and type two diabetes, and not saturated fats. Ah yes, I have heard of Gary Taubes…………………… wasn’t he the drummer with Mott The Hoople ?

So, you don’t rate low carbing Doc ? Well if it works for you Fred stick with it, but no, I wouldn’t recommend it, who but a complete idiot, would take diabetes diet advice from some nutter on the internet ? Honestly Fred I sometimes wonder why I bother to turn up here some days. It’s patients like you that make this job a misery at times. On your way out, ask my secretary to come in would you, see you in six months Fred.

Gloria, place a note on Fred’s medical file. Patient far too happy and relaxed for a diabetic, suspect possible alcohol or narcotics abuse.

Last line was a great ending, really did have me laughing with gusto. [ not that internet terminology lol bulls...]

Thanks Eddie, sad but true.

Great post Eddie, I bet parts of that ring true for so many diabetics. Anyone had any similar advice ?

Only retrospectively Mo - probably one of the good things about the delays in seeing the DN for the first time (3 weeks in my case, queues getting longer by the month though, can't for the life of me fathom why ...).  Sadly not everyone does some research first to realise what a load of bollox it is.  By the time I saw my DN she had no argument to put.

sanguine wrote:Only retrospectively Mo - probably one of the good things about the delays in seeing the DN for the first time (3 weeks in my case, queues getting longer by the month though, can't for the life of me fathom why ...).  Sadly not everyone does some research first to realise what a load of bollox it is.  By the time I saw my DN she had no argument to put.

That's what amazes me sometimes. OK, when I was first diagnosed I believed everything the doc/DN told me without question at first. Then, after literally a couple of hours I was trawling the internet. Google is such a powerful tool nowadays in self education. Yes, there are a few differences of opinion but by far the huge majority of success comes by dramatically cutting the carbs. I know the internet is not for everyone and some can't be bothered or simply won't give up the spud or bread but surely these should ( but they aren't ) a minority ?

mo1905 wrote:Great post Eddie, I bet parts of that ring true for so many diabetics. Anyone had any similar advice ?

Yup!

I was handed the usual diet leaflet and told that "we" don't like our patients testing.

I thought maybe I'd gotten through to her when she saw the massive improvements in my BG and lipids and smaller improvement in BP, oh and the 15 kg weight loss which I had only put on as a direct result of a dietician.

I was FURIOUS when my late mother was getting postprandials of 11 - 15 and the clueless muppet stated categorically she was "not diabetic" because her A1c was "only" 6.4%. Plus her kidneys were failing and she had obvious diabetic neuropathy after eating.

She stated that this was "because of the steroids" which was no doubt true, but only in the UK do doctors believe steroid-induced diabetes is harmless, in other countries they routinely prescribe drugs or drug increases up to and including temporary insulin. Here I've seen patients left running BG from 20 to 30 with no help.

She told my mother to eat "lots of brown bread and fruit, that's really good".

Another doctor - the massively obese one - stated categorically that "everyone has to eat carbs or you have no energy" and that "diabetes is always progressive, it's the nature of the disease" without understanding no, it's the nature of the TREATMENT.

Probably fortunately my mother died soon after, not surprising as she was 95, a record even in our long-lived family.

A friend down the road was told the same, to eat a high carb low fat diet and on no account to test her BG, and that she would be on insulin within 5 - 10 years. She was lucky to persuade an endo (who she was seeing for a different problem) to prescribe test strips, I think 50 a month.

Since then she has achieved an A1c below 6% for over ten years: she even came off her metformin. How was she rewarded? Every six months to a year her strip prescription is cancelled and she has to ring the endo who rings the GP to have it reinstated.

Another friend not far away WAS prescribed strips but told she could run a postprandial BG of 10 or even more. She cannot reconcile what she was told with her ongoing angina and her stroke.

When I saw a different GP I was told I had never been prediabetic let alone diabetic, and that I should ignore the "cranks on the internet". This clueless one has too much cognitive dissonance to even consider the fact that I have CONTROLLED my "prediabetes" for over a decade and avoided becoming diagnosed diabetic. Somehow I must have found a way to make up my low HDL, high LDL and massive trigs becuase I don;t have them now.

Strangely when I finally got to see my original GP she admitted I was expected to be diabetic by now and on metformin and at least one other drug, possibly two but "probably not insulin yet". She had never even heard of Gerald Reaven or Ron Krauss, let alone the now huge number of low carb researchers.

That's IMO the main problem, they are fed a carefully selected subset of information as "Evidence-Based Medicine" and have no clue what they are not being told about.

Back when (I think) Barbara Young was in charge of the CQC she determined that it would be a disciplinary offence for doctors not to follow NICE guidelines. I've heard of cynical doctors elsewhere claiming that being found in possession of well controlled diabetics could lead to disciplinary action for failing to abide by NICE guidelines/PCT protocols. How often this has happened I don't know.

Meanwhile I've heard of a couple of local-ish GPs who have now adopted low carb diets for their diabetics with the expected success, and so far without any sanctions. Still far from common though.