The Low Carb Diabetic Forum

The only dedicated low carb forum for the control of diabetes and weight loss in the UK has got off to a great start. Run by diabetics for diabetics, but all most welcome. It’s early days, but already some very well known people on the UK diabetes forum and blog scene have joined up. People from as far away as Australia and the US are also posting some great information.

Why not go over and take a look, better still join up, it’s free and we have no ties to any commercial organisations. Tell us about your success with low carb in either the control of your diabetes, weight control or other health related issues, we would love to hear from you. Why not chill out in Thommo’s bar and coffee shop.

Newly diagnosed especially welcome, let us help you on the road to improving your life and controlling your diabetes the natural way. Eat whole fresh foods, more drugs are not the answer.

The Low Carb Diabetic forum is here.

Join today and join a happy and helpful community.

Posted in Uncategorized | 3 Comments

Thousands Sue for Damages Against Cholesterol Drugs as Big Pharma Defends Billion Dollar Industry !

The $100 billion dollar cholesterol-lowering statin drug industry is under attack, as thousands of Americans are filing lawsuits against the manufacturers of cholesterol-lowering drugs such as Lipitor. Research continues to confirm just how dangerous these drugs are, with yet anotherstudy published recently linking increased statin drug use to type 2 diabetes. Since the study was published by the American Diabetes Association, these known risks to cholesterol-lowering drugs can no longer be denied or defended, and the lawsuits are pouring in at a rapid pace.

Most of the lawsuits at this point are from women who have suffered with diabetes as a result of taking cholesterol-lowering drugs, but lawsuits over breast cancer, Alzheimer’s, liver damage, and others may soon follow now that it is generally known how dangerous these drugs are.

This information regarding a tsunami of lawsuits against cholesterol drug manufacturers has yet to be widely published by the mainstream media, however. To find out the magnitude of the lawsuits being filed against statin drug manufacturers, we turn to law firms who are reaping the fruit of litigation against Big Pharma. According to statistics supplied by various law firms, there were 464 claims filed against Lipitor as of April 15, 2014, which increased to 703 by May 15, and then to 846 by June 16. As of mid-July 2014 over 959 claims have been filed for damages due to Lipitor alone. There are also many claims currently filed against Crestor, the next nearest competitor to Lipitor, and undoubtedly other similar drugs now sold under generic labels. These lawsuits now number well over 1,000, and are increasing at a rapid pace.

More on this latest story here.

Eddie

Posted in Big Pharma, Diabetes news, Health politics | 2 Comments

THE EYES HAVE IT – FINAL PART

Dear Reader, this is the final part of my ‘Eyes ‘series wherein I have tried to give my personal experiences and tips for those having to undergo investigations and treatment of diabetic retinopathy, maculopathy, etc.Those who have read the previous posts in the series may remember that my eye problems were induced by medications, bringing my bg levels down too quickly and by my being advised to eat more starchy carbs in order to tolerate the medication better!

After attending the hospital’s eye clinic every month for a year with nothing but background retinopathy to be seen ,(my doctor had thought he could see something on the macula – before the days of retinal screening) I was told at an appointment that I would be discharged if I returned to have a final scan and to see a consultant 3 days later. I duly returned but the consultant only glanced at the scan before he ran out of the room calling for a nurse. and demanding immediate laser treatment for me. During this 3 day period I had stopped taking one drug – just as it was about to kick in -and had started on another. I always have an immediate and extreme reaction to medication and my blood sugar had dropped immediately, by several points, obviously resulting in the massive bleed.. The consultant – a visitor- did not get his way – Christmas and New year intervened. This was a very good thing as I discovered later.

When there is a great deal of fluid present laser will not work and I have met several patients who have waited six months and more before any treatment was attempted because of major leakages of fluid. Sometimes patients even have to contend with temporary blindness. I think I had to wait about eight weeks for my laser treatment – and these were filled with trepidation. I had heard several patients telling doctors that they did not want more laser treatment as they had found it so painful.

In these circumstances I did what many others do and researched it on the internet. In every other situation I have found this to be useful and would encourage everyone to do so in order to understand treatment.

Eye clinics are busy places and often Drs do not know the answers at a particular stage. Research helps to explain why. In the case of laser – I mean before the first laser treatment – I do not think that this is advisable for several reasons. In the first place the language used to describe laser – numbers of ‘burns’ etc- is very emotive and often distressing to patients. I remember very well how so many members on DCUK hesitated about treatment purely for this reason. When people talk of having had thousands of burns to each eye – what are the uninitiated to think? Then there are concerns about the effect on peripheral vision in some cases and the possibility of driving licences being withdrawn etc. While these things sometimes can and do happen they are unlikely to happen at an early stage and there is no point in worrying unnecessarily. The important thing is to prevent the disease progressing.

Laser treatment to the eye is not comparable to anything else. The eye and the brain work together and intense laser can be very disorientating. Add to that the fact that every case and every treatment is different and individual sensitivity varies so much and you will see why it is probably better to await the first treatment before undertaking further research.

I have heard and read, of people having had one brief experience of laser treatment, telling others that they didn’t understand why some had problems with laser . Nothing to it! I was told that it was not painful per se and this has proved quite true in my case. On the other hand I have had to go to bed -totally- but temporarily-blinded – for 24 hours after intensive laser treatment. This blindness did not come in the form of darkness but of blocks of different coloured light totally filling the field of vision which only faded gradually.

For patients with certain conditions, for example, epilepsy, migraine, asperger’s syndrome, laser can be especially traumatic. Patients should ensure that any concerns are made known to the medical staff before the treatment day, as sedation can be given and the person delivering the treatment be made aware of potential problems. Here again, the laser machines themselves and the operators, vary. Should a patient experience discomfort they should always mention it to the Dr. at the time. The machine setting might need to be changed to suit the individual, or a pause in the proceedings might be indicated. Patients should never be afraid to ask for the procedure to be halted if they are uncomfortable. Laser treatment requires concentration. and co-operation from patient and operator, but it is the patient who risks damage and for whom the treatment is vitally important.

Some doctors may become a little testy with patients, as in other procedures. I try never to take this personally, as it often takes the form of chiding the patient to keep still etc but may reflect anxiety on the part of the Dr. In this case a break may be in the interests of all.

When the laser gets closer to the macula it is very important that the patient is able to concentrate and keep as still as possible for a few, vital, seconds. That is why it is so important that the whole procedure is as relaxed as possible before this stage is reached.

But what actually happens at a session of laser surgery?

The patient will already have had dilating and iodine drops instilled. An anaesthetic drop will also be given before a contact lens is placed on the eye or eyes. The patient will sit facing the operator at the table with the laser machine – very much in the same way as for eye examinations – and place chin on chin rest and head against head rest The patient will see large blocks of light filling the screen, again as in eye examinations. He/she will be asked to confirm that they can see a red dot and to follow it with the eye, then told not to follow it but to look straight ahead. This is quite difficult sometimes as nothing of the room beyond or the operator can be seen and the red dot is the only point on which the eye can focus.

When the treatment begins little bleeps will be heard and small black or grey dots or holes will appear in the vision. This is not painful – the discomfort – if any, generally comes from the lights. When a crucial point is reached the patient should be warned not to move for a short time. When the procedure is finished the lens will be removed and the patient told to sit back. After-effects will depend on the individual and the amount and intensity of treatment given. This is another reason to be extremely careful about reading well intended literature – even sometimes that issued by hospitals.

My first session of laser was very intense. I was not given any particular advice or told what to expect – merely to call if I had any concerns. I had already downloaded a leaflet from a hospital in another region on this subject. That night and for each night until my next appointment two months later I experienced a ‘firework display’ in both eyes when I went to bed. This lasted for several minutes and was quite unlike anything I had ever experienced before. I was not worried – the leaflet from the other hospital informed me that this was perfectly normal and to be expected.

The point I missed ,however, was that the leaflet did not tell me for how long this phenomenon should continue. At my next appointment I mentioned the matter and was told that side effects of that kind should only last for a few days, and that they could, in fact, have been a sign of a detached or detaching retina.

It was some years before I discovered what the firework displays actually were a sign of, and in the meantime I was given another session of laser – but not so intense, which I also understood better later.

As neither of the laser treatments made the slightest difference to my retinopathy, maculopathy, or macular oedema I was told I would be referred to a consultant for consideration of eye injections as, apart from laser, this is the only treatment available at present.

When I finally saw the consultant, he explained that the laser had not worked because there had been too much fluid present. He said the injections would dry up the fluid by sealing blood vessels and that he thought he would then be able to perform effective laser treatment. He told me of the worst case scenario risks -blindness and retinal detachment. He then asked if I were willing to go ahead with the injections.

He was new to the hospital and before his arrival patients had needed to go elsewhere for this treatment. As there seemed to be no alternative, I agreed. It was explained that I would be admitted as a day case and the pre-op was carried out immediately.

The procedure – injection of the steroid triamcolone into the vitreous part of the eye took place under full operating theatre conditions. The steroid is intended to reduce inflammation and swelling in macular oedema and other retinal conditions. Other side effects include glaucoma and progression of cataracts – I suffered all these side effects eventually – but for a long period it was effective -with laser-ing preventing the progression of the disease.

On the first occasion there were students with laptops literally lining the walls of the operating theatre. I had had a long wait because the previous operation had been difficult. Every passing doctor or nurse had renewed my anaesthetic drops – which I found very reassuring.! Of course, the thought of an eye injection is frightening and disturbing. It is almost against nature to allow a sharp pointed instrument near the eye, I wish someone had told me that I would not be aware of a sharp pain but only a deep pressure. Not pleasant but certainly not agonising. Before the procedure the eye is cleansed thoroughly and either painted with iodine, or an iodine eye wash is used. I must say that this eyewash is the most painful part of the procedure, but again this will vary according to individual sensitivity.

A hood made of some substance reminiscent of bubble wrap with an adhesive inner surface is placed over the patient’s head and pressed down to adhere closely to the skin. to seal off the treatment area. The surgeon then uses a scalpel to cut holes for the eye to be treated, or nowadays, sometimes pushes through, perforated eye sections. The aim is to expose as little of the facial area as possible in order to avoid infection. The eyelashes are clipped upwards. Some surgeons mark the place where the needle is to enter the vitreous part of the eye. They also have a choice of needle sizes, but that does not affect the patient experience. If both eyes are to be injected the hood is removed and the procedure repeated on the other side. This hood removal sometimes requires two people to remove it and is probably the most effective exfoliation any of us will ever experience!

My first steroid injection was almost a psychedelic experience. I saw flashing lights, amazing colours and when the surgeon asked me if I could see a light and then tell him how many fingers he was holding up, I was amazed to hear a round of applause from the students watching the procedure around the table and via computers around the walls. Later treatments were far less spectacular, so I assume much was due to the state of my retina at that time. I later discovered that the original laser treatment, before the injection, had been so intense – albeit ineffective, that it had caused extensive scarring to the retina. It was fortunate that I had mentioned my side effects to the Dr or I would have had a second round of over-intensive laser, while still believing [as per the hospital leaflet] that this was normal.

Over six years later I was shown the area of scarring on a photo and have to say that this was the most shocking thing I have seen in the course of my treatment. The biometrist had told me that there was a large area of scarring but until I saw the blackened area for myself I did not understand the extent of it. This makes other procedures more difficult and gives me an increased risk of irreparable retinal detachment. Being shown that photo was when I first understood the term ‘burn’ in connection with laser. A reminder that although there is no outward sign – this is what it is doing, in fact, although the patient is unaware of it. Once these things have happened there is no reversing them so I would advise people to speak up even though most of us are reluctant to make a fuss.

The HCP’s can’t know if the patient doesn’t tell them. I completely understand now, why not every hospital will produce its own guide to laser treatment. There is always the problem of false reassurance but in this particular area it is almost impossible to avoid pitfalls and much better to deal with these matters on an ad hoc basis.

The steroid injections can cause side effects for a few weeks after treatment. Floaters may have been mentioned but I was not prepared for the outsize spider webs in my eye for four weeks on one occasion. The chemical, or its carrier is black, it became very irritating when strands began to break off from the web and behaved as pendulums swinging back and forth across the eye. I once drew what I could see each week until the after-effects faded for the surgeon, he had had no idea previously of the extent of the problem and changed his injecting technique as a result. I find that it is always worthwhile mentioning these matters.

The other injection used in the treatment of retinal eye disease is Avastin also known as bevacizumab. This is an anti-cancer drug used off-licence to prevent the growth of new blood vessels, which in retinopathy will often be fragile and weak as well as in the wrong place. In the hospital I attend, Avastin injections are given in a mini-operating theatre, as these are often used in age-related wet macular degeneration too. The procedure is the same for both injections but with Avastin the fluid is clear and there should be no floaters after the injection. With both types of injection it is necessary to use antibiotic eye drops 3 or 4 times daily for a week afterwards.

Avastin is what I always think of as Poor Man’s Lucentis. Lucentis was developed for use in eyes, Avastin was not. I have heard it described as the same chemical with a few cosmetic changes – it is even made by the same company. There is however, an enormous difference in price, so using Avantis allows for treatment of many more patients.

How effective are these treatments?
From a personal perspective steroid injections always worked for me and I hoped to have a steroid implant so that the number of injections and hospital visits could be reduced. Unfortunately I developed glaucoma and as this is a major risk with implants this option seems to have been ruled out. I have had several Avastin injections over the years but none have worked for me. At present I am awaiting the results of an intensive course of 3 injections to each eye given at monthly intervals. This does not appear to have been successful to date but has worked for others. Avastin has been very successful in treating wet macular oedema in some patients and diabetic eye disease in some patients too.

Steroids are also effective for a limited time. All of these procedures carry risks – and very real risks .but some patients need only the minimum of treatment to successfully treat the condition. I think the jury is still out overall but current treatments work for many even if the condition recurs and thus buys time. It should never be forgotten that it is tied to diabetes but there is disagreement about exactly how this works.

Too strict control of bgs has been found in some studies to be counter productive and certainly I have found that low bgs affect it as much as high.

HCP’s in my hospital are discovering ,all the time that Type 1 ophthalmology patients fare better than Type 2, and some think that is the case with most diabetic complications. Although it is true that some may reverse retinopathy with treatment and lifestyle changes often the damage has been done and it is much more difficult to diagnose than most people believe. In my case there were only the smallest signs of background retinopathy and, at times, the treatment appeared to be working. Unfortunately angiograms have shown that although they no longer leak fluid the blood vessels are spongy. From wear and tear over the years and fluid gradually accumulates causing maculopathy .As the only available treatments are no longer effective then the outlook appears bleak at present, but I feel that I have been fortunate, in many ways, in my consultant and hospital and will continue hoping for as long as possible.

Whereas most diabetic complications may be reversed or minimised by the appropriate diet and bg control this is not necessarily the case with diabetic eye disease. That is why I explained some time ago that it can be equally important to keep levels stable. A sudden drop or spike can cause a bleed. Sometimes the effects can be temporary and reversible – but not always. I stress that I mean in those already diagnosed with retinopathy, I try to keep my levels low and stable to avoid further complications.

It is now recognised that bg control alone is not sufficient to keep retinopathy at bay and it is suggested that as well as blood pressure levels – which are always important, cholesterol levels also have a part to play. As ever this is not properly understood, but is another reason why patients will have lipid levels looked at, – and, no doubt, statins prescribed.

I feel strongly that insufficient evidence is available at present to evaluate treatments, but that there is hope on the horizon, in that the Americans are now investigating the efficacy of treatments, after shunning injections for a long time because insurers would not consider them. Many still refuse to do so but will help with some aspects and patients can choose to pay for injections. This means that they are more widely available and that the data is also becoming available, and many trials are in progress. Some advances has already been made in assessing the best way of using Avastin and there are alternatives, including drugs, in the pipeline.

It is of course, a personal choice whether to accept treatment by laser and /or injection I know of many who hesitate for months. I feel that I must say, from my own experience, that they are deluding themselves. Many, including me, will at some stage, think, when one eye is being treated and the treatment is not particularly successful that they will settle for sight in the other eye. I hear this all the time and once believed it possible myself. Believe me you do not have this choice. Overnight things may deteriorate in the other as many of us have discovered. Those who hesitate because of fear of loss of peripheral vision cannot have considered how their driving licence will be affected should they lose their vision completely.

The fact is, that when you are told that treatment is required then it is important, although often unpalatable, to accept and come to terms with it. As with all other treatment it is the patient’s own responsibility to stay abreast of the treatment, to ask appropriate questions, to report side effects, to indicate when treatment is uncomfortable or painful. Be proactive – but also be patient. Laser and injections do not work instantly. HCP’s are not issued with a crystal ball. If you do not always receive a satisfactory answer it may be that it is not possible at a particular stage.. Many of us are very busy these days. Please be a patient, patient. If a particular Dr is busy and in great demand there may be very good reasons for that. Worth waiting for, perhaps, I have often observed staff being bullied into pushing a patient through the system because that person’s priority is obviously just to be seen by anyone and to leave as soon as. possible Obviously, this will only lead to further appointments having to be made and more time being wasted. It is the same with preliminary checks at each visit. They are essential and no progress will be possible without them. In other words – be patient, co operate but always remember it is your vision at stake and you have a perfect right to choose and to question. The best HCP’s know this. Above all never expect to pay a short visit to an eye clinic.

I recently found this video on You tube which avoids some of the pitfalls of information sheets, but which may be of interest, to anyone who is concerned about treatments for diabetic eye disease.

I have not attempted technical descriptions of eye disease or treatment as they are readily available for anyone to Google but merely  speak from my own experience. I have undergone other procedures as side effects of my treatment and may undergo more. In this series I have concentrated on the common treatments and diagnostic tests which most patients will undergo.

You Tube – Understanding Proliferative Diabetic Retinopathy

I hope none of this is ever necessary for any of you but please remember many people are successfully treated.

I am a “difficult and unusual case” That is official.

Best wishes Kath

Posted in Blood glucose, Diabetic complications, Living with diabetes, Type two diabetes | Tagged , , | Leave a comment

People with Diabetes Need Balanced Snacks, Right?

Wrong. People with Type 1 and Type 2 diabetes don’t require snacks, and anything eaten between meals should contain as few carbohydrates as possible.
I recently joined Pinterest and came across  this link as I was looking  for images to pin to my “Healthy Low Carb Board”:  10 Low-Carb Snack Ideas for People with Diabetes.  Looking at the list of foods had me scratching my head. These snacks are low carb? Then I read this:
‘If you need a pick-me-up between meals, a snack with 15-20 grams of carbohydrate is often the answer. For someone with diabetes, it’s important to eat a fiber-filled and nutrient-rich snack to curb the appetite before the next meal,’ says Angela Ginn-Meadow, a registered dietitian and a spokesperson for the American Dietetic Association .”
So the person who wrote this article is not an RD but obtained information on snacks for PWDs from a dietitian and spokesperson for the AND (Academy of Nutrition and Dietetics).
As a diabetes educator, the suggestions in this article bother me on a number of levels. First of all, why are we still promoting snacks to people with diabetes? In the days of insulin peaking in the middle of the night and causing overnight lows this was  understandable, but most people are on modern insulins that do not cause this problem.  I know that many dietitians and nutritionists recommend eating every 3-4 hours, but I strongly disagree with that strategy.  First of all, I find that people generally end up eating more if they are snacking or grazing.  If someone eats 2-3 meals a day containing adequate protein and fat, there is no need to snack in between.  Snacks with 15-20 grams of carbohydrate can hardly be called “low carb.” I consider an item with less than 5 grams of carb, preferably less, to be low carb.
There are a number of reasons to avoid carb-containing snacks in people with all types of diabetes. For T2s with insulin resistance, eating carbs between meals causes a rise in blood sugar, resulting in the pancreas needing to produce more insulin, perpetuating hyperinsulinemia and promoting weight gain. Blood sugar is expected to rise after eating; the extent to which it does depends largely on the amount of carbohydrate consumed. Fasting/premeal blood sugar targets differ slightly between the American Diabetes Association (80-130) and American Association of Endocrinologists  (80-110), but the idea is for blood sugar to return to a healthier lower level by the time the next meal comes around. By eating snacks containing more than a minimal amount of carbs, the likelihood of meeting this goal is significantly reduced, and the person ends up well over the target range for most of the day. Snacking on carbs between meals is an equally terrible suggestion for  people with T1 diabetes and people with T2 on mealtime insulin. Bolusing insulin to cover snack carbs places a T1 at risk for hypoglycemia due to stacking doses from the previous and subsequent meal, and foregoing the insulin is certain to spike blood sugar to extremely high levels.
In my opinion, the only time someone with diabetes should eat carbs in between meals is to treat hypoglycemia, universally defined as blood glucose less than 70. In that case, the treatment is 10-15 grams of rapid-acting carbs, preferably glucose tablets or gel (alternatively 4 oz juice, soda, etc). The snacks in the list above contain some fiber, which would delay recovery and  therefore would not be a good choice.
Although I think carbohydrate restriction is the ideal way to manage diabetes, I know not every person wants to adopt it, and I respect a person’s right to make that decision. However, I think promoting “balanced” snacks containing carbs to PWDs is terribly misguided. If truly hungry between meals, a hard-boiled egg, piece of cheese, or a few nuts makes much more sense in terms of maintaining stable blood sugar levels, satiety, and decreasing potential for weight gain.
This article by Registered Dietitian and Diabetes educator Franziska Spritzler Here
Eddie
Posted in Diet, Diet and dieting, Dietitians, Living with diabetes, Low carb diet | Tagged , , , , , , , | 1 Comment

Featured food of the day-Beef

 

Ingredients:
250 grams of diced braising steak
A handful of shallots
A handful of button mushrooms
50 grams of smoked bacon lardons
1 teaspoon of mixed dried herbs
1 bay leaf (optional)
2 beef stock cubes
1 large glass of red wine
Salt and pepper to taste
1 table spoon of olive oil
Method
Heat the oil (to medium heat)in a frying pan. Add the shallots and mushrooms, fry/saute until golden brown, Remove from pan into oven proof casserole dish. Add bacon lardons to pan and cook until they are lightly browned, add to casserole dish. Finally put diced beef into frying pan and lightly brown each side of cubed beef then put into casserole dish.Make up the beef stock to approx. half to three quarters of a pint, but the red wine should make up about half of the liquid.Bring to a gentle simmer in the frying pan and add the mixed herbs, salt and pepper to taste. Pour over the ingredients in the casserole dish, add your bay leaf (optional). Cover and cook for approx two to two and a half hours at Regulo 4 Electric 180 stirring after the first hour. Serve with steamed broccoli and white cabbage or vegetables of your choice. Delicious, very easy to make and very low carb.
A recent study of children and teens in the U.S. has shown that individuals in these age groups depend on their intake of beef for the following key nutrients and in the following amounts.
  • Vitamin B12: beef provides 14-21% of this B vitamin to U.S. children and teenagers
  • Zinc: 13-19% of this mineral is provided by beef to these age groups
  • Vitamin B3: U.S. children and teens receive 6-10% of their vitamin B3 from beef
  • Vitamin B6: 5-8% of this vitamin is provided by beef to these age groups
  • Iron: up to 8% of dietary iron is provided to these age groups by beef
More great beef information can be found at the
Worlds Healthiest Foods site here. WHF is a not for profit goldmine of great food information.
All the best Jan
Posted in Low carb diet, Low/Reduced carb food | Tagged , , | 2 Comments

Potential diabetes ‘cure’ to end misery of insulin jabs

Great in principle but I wonder how many diabetics will be eligible considering the current economic state of affairs.

A snippet…

“The British invention will transform the lives of millions who have to endure injections of insulin every day.

Health experts say that the artificial pancreas is as good as a cure because it means patients will no longer have to manage the condition themselves.

The wristwatch-size device is surgically implanted into the abdominal cavity and releases a precise amount of insulin into the bloodstream. Supplies are topped up via a short tube which passes through the skin.

Human trials are set to start in 2016 with the first implants taking place on the NHS within 10 years. Inventor Joan ­Taylor, 64, professor of pharmacy at De Montfort University, Leicester, said: “It works like a healthy pancreas should, regulating blood sugar by releasing just enough insulin into your bloodstream. You don’t need to fill it up every day, so avoid painful daily injections.”

More from the article can be found here

Paul

Posted in Blood glucose, Diabetes news, Living with diabetes | Tagged , , , , | 2 Comments

Diabetes UK and reduced carb success

I thought I’d post my story as reduced/low carbing was the only way forward for ME despite what the current guidelines from the NHS and DUK state.

Around October 2011 I noticed things were ‘Not quite right’ and I was falling asleep at the drop of a hat,my gums were bleeding heavily when I brushed my teeth,I was peeing like a racehorse,boils and abscesses were popping up everywhere and I had more ‘Thrush’ than a songbird chorus with the added nasty complication of ‘Balintitus’,my vision was often blurred,I could drink litres of water but still felt as dry as the desert and had to carry water with me EVERYWHERE which was a right pain. .BUT, I put it down to just getting on a bit and being under stress from another illness in my life.

After a search on ‘Dr Google’ my symptoms were showing consistency with a condition called Diabetes although I wasn’t sure which type as I didn’t have a clue and I asked a friend who was a Type 1 since aged 4 if I could borrow his spare optium xceed meter. Well a random test many hours after my usual breakfast of 2 weetabix came back with a reading of 19. Well this was a mistake surely? Tested again and it recorded just over 20.This can’t be right I thought, I’m eating a healthy diet of low fat with heart healthy whole grains,cereals and I don’t take sugar so this MUST be wrong…SURELY?

Well I thought I’d better rule this out with an appointment with a HCP. Well the day came and I got to see the practice nurse who after ordering a fasting blood test and HbA1c asked me in for my results and told me I had something called Type 2 diabetes, my fasted level was over 12 and I had an HbA1c of 7.5% BUT no worries I was told, 7.5% is good control and I should make sure I eat plenty of whole grains,fruit,vegetables,low fat spread,skimmed,milk avoid fatty foods etc. Well this was going to be a piece of cake….wasn’t it?

Well, not quite! Apart from still always feeling hungry and ‘ill’ all the time my sugars continued to get worse. I’d already joined a support forum just after diagnosis and I was advised that something called ‘Carbohydrate’ as the main factor in raising our BG levels. I didn’t know what a carb was to be honest except that I believed they were healthy and I thought to myself “This can’t be right or healthy surely???” (The irony I feel now!)

Anyhow, things continued to get worse and I kept reading the forum and saw there was fierce debates between low carbers and another much smaller group that advocated low GI, low carb-low fat-low calorie and me being confused ended up trying all of them, yet my BG’s continued to climb, I was starving hungry, never felt satiated, was as weak as a kitten and was losing fat AND muscle at an alarming rate. My GP, realising my HbA1c was now 14.1% gave up with all the oral meds he had tried me on which did nothing and packed me off to the Endo who ordered tests which revealed I had Type 1 diabetes although it was a slower onset form and I might get away with Byetta for a while…that failed and Insulin it was to be…by this stage I’d been reading the forums for a while and I noticed something big and that was all the success people were enjoying on a low carb high fat diet,weight loss,normal BG’s,blood pressure,lipid panels the lot and I thought to myself ALL these people can’t be wrong and they’re all eating great grub that we had been told to avoid….I then read a link which told a story of another Type 1 diabetic called Fergus who had transformed his health and reduced his insulin requirement way down on a Low carb high fat regime and I’d also heard about Dr Richard Bernstein,a long term Type 1 diabetic who was fighting fit and advocating the very same through his books and his own lifestyle.

Out went all the low GI cereals,skimmed milk,low fat spread,bread,spuds etc and in came full fat greek yoghurt,blueberries,blackberries,strawberries,real butter, eggs, cream,coconut oil,lard,olive oil,meats,green veggies,salads and bacon,sausages,mushrooms and eggs were back on the menu for breakfast,that filled me up until teatime and I no longer felt the need for lunch and if I got peckish I would nibble on some mixed olives from the deli,or I’d have a few pork scratching or walnuts and I rediscovered mini salamis were handy snacks, too all of which had little or no effect on my BG’s. Dinners are DEAD easy too..meat and 2 veg,chicken salads with plenty of cold hard boiled eggs,roast dinners without the spuds and with some mashed swede,shepherds pie but with a topping of mashed cauliflower and mashed swede mixed together with lots of butter,Indian takeaway without the naan bread and rice but bulked out with spicy lamb kebabs and salad and many other combinations and recipes I’ve learned off the internet have been great!

My meter was showing great results as an upshot of this and at my diabetic review last year my tests revealed my HbA1c was down into the 6’s despite my insulin use being very low on just 2 injections a day, my BP was down and my lipid panel had all improved to a good level despite being told by the NHS that sat fats will push them through the roof..well they were wrong! I have continued since then with this lifestyle,my weight is the best it’s been in years and my last HbA1c was 31 (4.9%).

Paul

Posted in Diabetic complications, Diet, Diet and dieting, Fats, Foods to avoid, HbA1c, Lipids, Living with diabetes, Low carb diet, Low GI diets, Saturated fats, Support for diabetics, Type one diabetes, Type one-five diabetes, Type two diabetes | 3 Comments

Metformin beyond it’s blood sugar lowering properties

 

The flower is of course,the French lilac or goat’s rue,the original source of that well known anti-diabetic drug Metformin. Believed to be the most widely prescribed diabetes drug in the world,it was introduced into Britain in 1958 but not licensed for use in T2 diabetes in the US until 1994.

It works by blocking the production of glucose in the liver and also by helping the body to utilise insulin properly.
It appears to be most effective in helping with weight loss and thus reducing insulin resistance. This effect is not maintained at the same rate after the initial period of weight loss and treatment, but many patients, including those not overweight at diagnosis ,continue to take it for the cardiovascular protection it is said to  afford. Although this cardiovascular protection, appears to be generally accepted; there does not appear to be conclusive proof. See below *
Reappraisal of Metformin Efficacy in the Treatment of Type 2 Diabetes: A Meta-Analysis of Randomised Controlled Trials  PLOS Medicine
This showed no evidence that metformin has any beneficial effect on all-cause mortality, on cardiovascular mortality, or on cardiovascular morbidity among patients with type 2 diabetes. These findings must be cautiously interpreted because only a few randomized controlled trials were included in this study, and only a few patients died or developed any cardiovascular illnesses. Importantly, however, from these findings, it is impossible to exclude beyond reasonable doubt, the possibility that metformin causes up to a 25% reduction or a 31% increase in all-cause mortality. Similarly, these findings cannot exclude the possibility that metformin causes up to a 33% reduction or a 64% increase in cardiovascular mortality. Given that a large number of patients take metformin for many years as a first-line treatment for diabetes, further studies are urgently needed to clarify this situation.
T2s and some T1s and other types may be prescribed metformin, as also – pre-diabetics, those suffering from polycystic ovary syndrome, and Gestational diabetes. It is also used in the treatment of nonfatty liver disease. Some studies appear to suggest that it can protect against certain cancers-mainly those to which diabetics appear to be more susceptible. This is very exciting and appears quite feasible  in the light of recent discoveries re sugar and insulin markers and receptors  but a great deal more needs to be done before this view can be substantiated.  The meta analysis=http://journals.sfu.ca/ijmbs/index.php/ijmbs/article/download/330/696will be of interest to those who are interested in the current thinking about this drug.
There are many studies concerning various aspects of metformin therapy, but the meta analyses referred to here are the most recent.*
*Metformin is accepted as the first line drug of choice, where diet and exercise and other lifestyle changes, are not sufficient to reduce blood glucose levels. There are of course contraindications. Metformin is not suitable for everyone. It is not currently prescribed to those with renal impairment or heart failure. Mainly because of the role it is thought to play in the development of Lactic acidosis – see below in ’side effects.*
So what is the downside to this ‘wonder drug’? Most patients would cite the gastro-intestinal upsets which can last for some time.  Switching to the slow release version is the answer for most people although there are some who cannot tolerate it in any form. ‘Many studies will quote lactic acidosis as the worst side effect of metformin as it can be fatal.*patient.co.uk/doctor/Lactic-Acidosis.
The reputation of the biguanide metformin for causing lactic acidosis may be overstated, and largely based on experience with its more toxic predecessor phenformin. It can cause lactic acidosis in overdose, or if continued in severely ill diabetics who become dehydrated, but seems to be well tolerated on the whole, with many of the current cautions for conditions such as heart failure, probably being overzealous and denying a safe and useful therapy to many patients.[5] A Cochrane systematic review found no evidence of an association with lactic acidosis, or hyperlactataemia in study-based use.[6]
*Lactic acidosis is quite rare in any event, the usual figure quoted is less than 1 in 10,000.This seems quite reassuring, until one considers that the same figure is given for the side effects, which appears to be on the increase in some groups and which is often misdiagnosed. The real reason in fact for this post.
We are two T2 diabetics who have been on metformin for a number of years.  Both naturally slim-so metformin probably makes very little difference to our HbAIC’s and both have taken it mainly for the potential cardiovascular protection.
We are at an  age when we may not be able to absorb an important nutrient  from diet alone-some studies say this may be as low as age 50 although others estimate it as much later, and are concerned that we may be in danger of suffering Vitamin B12 deficiency.
It is very well documented that metformin use for an extended period, or in older age groups or at a high dosage can have this effect. The effects of Vit B12 deficiency can be serious if left untreated. It is also often misdiagnosed..
09 December 2013
Anaemia and anaemia caused by a lack of vitamin B12 can result in symptoms which include:
Extreme tiredness or fatigue
A lack of energy or lethargy
Being out of breath
Feeling faint
Headache
Ringing in the ears ( tinnitus)
Lack of appetite
More specific symptoms linked to a lack of vitamin B12 include:
Yellowing of the skin
Sore, red tongue
Mouth ulcers
Changes or loss of some sense of touch
Feeling less pain
Walking problems
Vision problems
Mood changes, irritability, depression or psychosis
Symptoms of dementia
Causes of vitamin B12 deficiency
 
Vitamin B12 deficiency is more common in older people and affects around one in 10 over 75s.
The most common cause of vitamin B12 deficiency is pernicious anaemia, an auto-immune condition that affects around one in 10,000 people. Pernicious anaemia is caused by a lack of a protein called intrinsic factor that’s needed to absorb vitamin B12 from food into the body from the gastro-intestinal tract. This condition is more common in people over 60, in women, in people with a family history of pernicious anaemia or some autoimmune conditions, including Addison’s disease and vitiligo.Vitamin B12 deficiency is risk for people who follow a strict vegan diet who don’t eat the major food sources of B12: meat, eggs and dairy products. Babies whose mums are vegetarians may have vitamin B12 deficiency.
Other causes of vitamin B12 deficiency include:
Atrophic gastritis, or thinning of the stomach lining
Stomach ulcers
Surgery to remove part of the stomach or small intestine
Digestive conditions such as Crohn’s disease, coeliac disease, bacterial growth or a parasite.
Medication, including proton pump inhibitors (PPIs) for indigestion
Diagnosis of vitamin B12 deficiency

Blood tests and examination of blood cells under the microscope assess haemoglobin levels, the size of red blood cells and the level of vitamin B12 in the blood. The levels of folate are also usually checked for the related condition folate deficiency anaemia.Once the diagnosis is confirmed, further tests may be carried out to try to find out what’s causing the anaemia.A referral may be made to a specialist, such as a haematologist for blood conditions, a gastroenterologist for digestive disorders or a dietitian for advice on eating food containing more vitamin B12.
The above does not mention metformin specifically but many other studies do.  Apparently up to 30% of metformin users go on to develop B12 deficiency. Misdiagnosis is common as Vit B12 deficiency can mimic several serious disorders.
Dementia—Alzheimer’s disease
Multiple sclerosis
Depression
Post-partum depression/psychosis
Bipolar disorder
Neuropathy (diabetic, CIDP)
Diagnosing and Treating Vitamin B12 Deficiency (video)

Vitamin B12 deficiency can sneak up on you, and can lead to a myriad of diseases and disorders. Know the signs and symptoms. You could be deficient yet still test in the so-called range of “normal B12” on a blood test, especially if you have taken an oral B12 supplement of uncertain quality, or you have been under-treating the deficiency. Oral B12 supplements do not work for all patients; patients with digestive/absorption problems benefit from B12 injections, as do patients with nerve damage.
*Conclusion

Despite the above and  recommendations from many studies over the years,  there is still no standard requirement or directive for routine testing for vitamin B12 deficiency  for long-term or high dosage metformin users  in the UK.
Diagnosis is fortuitous in many cases and this is a great pity because the condition is easily treated.
Universal screening is still not considered to be cost effective  but there is sufficient evidence, in our opinion, to justify routine testing of those on long term and/or high doses of metformin and of the elderly who cannot absorb sufficient B12 from their diet. Testing could easily be included with the blood tests for the annual review.
It would be worthwhile in order to raise awareness of possible Vit B12 deficiency for those on metformin who might by those at risk and aware of it raising the issue with their HCP and asking to be tested. It is not a question of causing extra expense to the NHS but of saving it by avoiding misdiagnoses and more costly treatment being required unnecessarily, where the condition mimics other disorders.
This is a serious matter and should be treated as such.  The mantra about metformin being safe and cheap and effective may be true, but it is not the whole story.
There are those like our own Paul and others, contributing to diabetes forums, who because they suffer from B12 deficiency, not caused by metformin, are yet able to recognise the symptoms in others and I am sure must have  been the means of helping many to a faster diagnosis.  If routine testing of certain groups is impossible, then it should be possible, surely, to include, in the annual review a few questions about possible symptoms as a marker for those who may require tests.
As the numbers diagnosed with diabetes continue to increase and as people live longer with the condition, this matter becomes more pressing and affects more people.
Please be aware of the risks for yourselves-diabetic or not-and help spread awareness of this potentially dangerous but easily treated condition.Kath & Graham
Posted in Big Pharma, Blood glucose, Living with diabetes, Type one diabetes, Type two diabetes | Tagged | 2 Comments

The British Dietetic Association a complete unprofessional shambles ?

From the British Dietetic Association website re a recent meeting of members.
“Carbohydrate Advice in Type 2 Diabetes – The ‘Hot Potato’ of  ! ! Dietetics?”
“The latest UK nutrition guidelines for diabetes suggest an individualised approach to carbohydrate in Type 2 diabetes, and focus on calorie reduction and weight management in those who need to lose weight. But where does that leave more detailed or specific advice about carbohydrate for individual patients? What should Dietitians be advising their patients? Preliminary research into the current practice of UK Dietitians in this topical field will be reported, together with the current evidence-base. Participants in this session will have the opportunity to review their own practice in this area and contribute to the ongoing debate.”
.

Diabetes care in the UK is abysmal for the majority of diabetics. The NHS audited annual statistics are grim, and they are grim year after year, no progress is being made, in fact the situation is getting worse. One of the keystones of good diabetes control is diet. And the experts on diet in the UK are the dietitians who are members of the British Dietetic Association. Recently they held a meeting and produced a survey conducted on some of their members opinions, some of the results you see below. As you can see their methods seem to be very unsound, in fact I don’t see any method at all. Clearly UK dietitians have no general guidelines or policy agreement to work to whatsoever. To the question How frequently do you advise carbohydrate restriction with type two diabetes on oral medication, sometimes was the answer for the most. The question what would be a realistic carbohydrate restriction in type two diabetes 30 to 50% of energy was the overwhelming reply.

The $64000 question is, how could any successful organisation operate with absolutely no overhaul common policy ? no corporate structure or method of operation whatsoever. Remember we are not talking about flogging nuts and bolts here, we are talking about the health of millions of people. Is it any wonder the UK diabetes statistics are so grim, when the very organisation that should be leading the way to better health for so many, could not run a whelk stall. Until the BDA at the very least, issue some basic guidelines to their members and have some sort of common policy, regarding carbohydrate control or restriction, the carnage will go on. It is my opinion, the BDA is at the very least partly responsible for the early death of countless diabetics. Will it be ever thus ?

Source of information http://www.bda.uk.com/BDAlive/Paul%20McArdle%20.pdf

Eddie

Posted in Diabetes news, Diet, Diet and dieting, Dietitians, Health politics, Uncategorized | 1 Comment

Dr.Troy Stapleton – I Manage My Type 1 Diabetes By Eating LCHF

Another must watch video. Low carb high fat not just for type two diabetics. Eddie

Posted in Blood glucose, Diet, Diet and dieting, Fats, Keto diets, Lipids, Low carb diet, Support for diabetics, Type one diabetes, Type two diabetes | 1 Comment