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  #1   ^
Old Tue, Apr-08-08, 10:37
ReginaW's Avatar
ReginaW ReginaW is offline
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Default Are diabetics suffering for no reason?

Are diabetics suffering for no reason?

John Gibson's leg had been ulcerated, swollen and inflamed for weeks. "It looked like a damson from my toes to my knee," the 61-year-old recalls. His specialist suggested it would have to be amputated. "He whipped out a camera and photographed it. I said, Is this going to be the last time you see it?' and he said, It might be.'"

But when he next visited, Gibson explains as he sits at home in Mauchline, Ayrshire, the specialist was astonished to see that the leg had healed. "He asked me, Where's the ulcer?'" The former army nurse explained that his diabetes was now being managed on a special low-carbohydrate diet, recommended by his GP. "The specialist told me, Oh, we don't believe in that.'"

Indeed, most NHS doctors and dieticians are far from convinced by the way Gibson manages his diabetes. But Gibson's GP, Dr Katharine Morrison, is one of a vocal minority who contend that the orthodox advice given to type one and type two diabetes patients is not only unhelpful but might be counterproductive.

She believes that eliminating or at the very least strictly controlling carbohydrates is the only way diabetes patients can properly control their blood glucose levels. Unless they do this, she says, they remain at risk of the serious complications that can go hand in hand with the illness, including potential loss of limbs, blindness and kidney failure.

Lifestyle change is the first line of treatment for diabetes, type two in particular, with weight loss the main goal. Yet for decades, the standard advice has been that diabetics should cut out sugars and fats and replace them with a diet that is high in carbohydrates. The overall philosophy has been that diabetics should not be deprived of the pleasure of a normal diet.

Morrison disagrees - and she argues that the experiences of her own patients demonstrate that, by following a more restricted diet, patients can avoid the relatively large fluctuations in blood glucose that many accept as near-normal.

So do the experiences of her own son. Steven Morrison, 15, was diagnosed as a type one diabetic four years ago and follows a regime of low-carbohydrate meals, blood glucose monitoring and insulin injections after every meal.

Whether the close personal involvement with diabetes makes Morrison's position more or less credible depends on your own viewpoint. She certainly has a vested interest in being right; she is also passionate about her cause. The low-carb alternative is "patently obvious", she says. "The simple fact is, I will potentially save many more people's eyesight and limbs and even lives by promoting this approach than I will by being a GP."

She will promote low-carb diets at the International Forum on Quality and Safety in Health Care later this month in Paris, and she has devised an online training tool in the techniques for diabetics. It is based on the work of Dr Richard K Bernstein, himself a diabetic, who devised a diet for sufferers with the goal of controlling blood glucose. Since the publication of his book Dr Bernstein's Diabetes Solution in 1997, he has gained an international following. Morrison says that, at a recent forum held by Diabetes UK in Edinburgh, 70% of patients present said they wanted to know more about the low-carb diet.

"If you are swayed more by real people than by statistics, let me introduce you to some," she adds, backing up her points with success stories. But science doesn't move ahead by individual accounts - surely solid research and statistics have to back up clinical case studies? Morrison insists her approach is supported by such evidence.

What if she is right? Are thousands of diabetic patients suffering unnecessarily because official advice is leading them to suffer more and earlier complications, and putting type two diabetics at greater risk of needing to use insulin?

Diabetes UK continues to recommend that diabetic people follow the same balanced diet recommended for the rest of the population. Low in fat, sugar and salt, with plenty of fruit and vegetables, meals can contain some starchy foods such as bread, potatoes, cereals, pasta and rice. Carbohydrates with a lower glycaemic index - those that break down slowly - are better as they don't affect blood glucose as much, a spokesman for Diabetes UK said.

Stephen Fyfe, spokesman for the charity in Scotland, says research on the effects of low-carb diets has been limited in scope and duration. "Until the long-term effects prove the effectiveness and safety of low- carbohydrate diets, Diabetes UK does not recommend them."

However, the ground may be shifting. Diabetes UK and the International Diabetes Federation have commissioned research on the long-term effects, and Fyfe adds: "We may alter our recommendations to patients based on those findings."

The body responsible for making recommendations to doctors, the Scottish Intercollegiate Guidelines Network (Sign), has since 2001 been advising that diabetics be told to replace sugars and fats with carbohydrates. However, the entire Sign policy on diabetes is currently under review, and a spokesman said this process would take in the latest thinking and research.

Three factors are still hindering wider take-up of the low-carb message, Morrison believes. The first is a reluctance by the medical profession to concede possible mistakes. Secondly, drug companies and food manufacturers have a vested interest in promoting the high-carb option, she argues. A whole industry depends on medicating diabetics and providing them with specialist foods, which Morrison believes low-carb diets will eliminate.

But the third is also a significant hurdle: the low-carb regime is onerous for patients. In a recent briefing that she sent to her own health board, Ayrshire and Arran, Morrison admits that even her own patients have mixed reactions.

These range from the resistant - she quotes one type one patient who said: "I would rather die than give up my porridge in the morning" - to the indignant. "Look at these blood sugars - they are normal! Why wasn't I told about this years ago?" she says one patient told her.

The Herald contacted several Scottish diabetes specialists, each of whom was reluctant to comment on the diet advice given to patients. Perhaps this is because the issue remains so controversial. Across the Atlantic, the debate continues to rage, too. The American Diabetes Association has tentatively moved towards recommending low carbs, but diabetes specialist Hope Warshaw says many study subjects are unable to stick with Bernstein-style diets. "Diabetes lasts the rest of your life. You need to find an eating plan that you can follow for that long as well."

Young people in particular may find it difficult to avoid carbohydrates in a culture where the norm is to eat prepared food and fast food. But Steven Morrison is unperturbed. "It may be easier for me as I've never known anything else. I think it's harder for people who have to change what they've been doing for years," he says.

http://www.theherald.co.uk/features...r_no_reason.php
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  #2   ^
Old Tue, Apr-08-08, 10:43
LessLiz's Avatar
LessLiz LessLiz is offline
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I freely admit to being stupid and crazy, but I found switching from a diet that was bringing me death in the very short run to a diet that might bring death after 20 or 30 years to be an easy thing to rationalize.

Too bad there aren't more stupid and crazy people in medicine.
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  #3   ^
Old Tue, Apr-08-08, 10:53
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daisyboo daisyboo is offline
Scottish Flower
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Plan: Lighter Life
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I'd really love to get a new GP, maybe i'll persuade my hubby to move back to Scotland and we'll base ourselves in Ayrshire

Seriously though my longterm friend from school is a nurse practioner in Edinburgh, she runs the diabetic clinic and they have been steadily moving towards the lower carb end of the GI diet recommended here, simply put her patients have found it works better for them. Mind you her practice also allows you to have cholesterol testing whenever you like as its seen as preventative medicine, at my practice you have to get down on your knees and kiss your doctors feet before being given permission to have your blood tested for anything (and no i can't actually change doctors as our local health authority will not allow it due to too many patients/not enough doctors so if i piss off my GP i'll be without medical care).
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  #4   ^
Old Tue, Apr-08-08, 13:30
anyway...'s Avatar
anyway... anyway... is offline
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Quote:
The body responsible for making recommendations to doctors, the Scottish Intercollegiate Guidelines Network (Sign), has since 2001 been advising that diabetics be told to replace sugars and fats with carbohydrates.


Ok that cracked me up. Replace your sugars and fats with... sugar.

Mmmk
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  #5   ^
Old Tue, Apr-08-08, 14:23
Rose1942's Avatar
Rose1942 Rose1942 is offline
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Plan: Bernstein-ish
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I have many favorite lines from that article. One is: The overall philosophy has been that diabetics should not be deprived of the pleasure of a normal diet.

Awwww, poor things, they wanna have their porridge. I wanna have some chocolate cake too, but that's not gonna happen!

Another is this:

The American Diabetes Association has tentatively moved towards recommending low carbs, but diabetes specialist Hope Warshaw says many study subjects are unable to stick with Bernstein-style diets. "Diabetes lasts the rest of your life. You need to find an eating plan that you can follow for that long as well."

Well - hello? It really doesn't matter much if the rest of your life is going to be ending pretty soon, but if you want to continue eating for as long as possible, it's kind of a no brainer to eat what gets you there..........
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  #6   ^
Old Tue, Apr-08-08, 14:30
ReginaW's Avatar
ReginaW ReginaW is offline
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Quote:
I have many favorite lines from that article. One is: The overall philosophy has been that diabetics should not be deprived of the pleasure of a normal diet.


Yup....let's just ignore that the "normal" diet is the problem! Run along, go eat your cake!
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  #7   ^
Old Tue, Apr-08-08, 15:10
Bat Spit Bat Spit is offline
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Quote:
Are thousands of diabetic patients suffering unnecessarily because official advice is leading them to suffer more and earlier complications, and putting type two diabetics at greater risk of needing to use insulin?


Umm. Yes.


But a whole generations of physicians couldn't possibly have been lied to by the pharmaceutical companies and their governments, could they?
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  #8   ^
Old Wed, Apr-09-08, 07:14
renegadiab renegadiab is offline
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Quote:
Originally Posted by Rose1942
I have many favorite lines from that article. One is: The overall philosophy has been that diabetics should not be deprived of the pleasure of a normal diet.

Awwww, poor things, they wanna have their porridge. I wanna have some chocolate cake too, but that's not gonna happen!

Another is this:

The American Diabetes Association has tentatively moved towards recommending low carbs, but diabetes specialist Hope Warshaw says many study subjects are unable to stick with Bernstein-style diets. "Diabetes lasts the rest of your life. You need to find an eating plan that you can follow for that long as well."

Well - hello? It really doesn't matter much if the rest of your life is going to be ending pretty soon, but if you want to continue eating for as long as possible, it's kind of a no brainer to eat what gets you there..........


I find low carb with unlimted fat more pleasurable than the low fat, high carb approach. Much tastier and I don't miss the carby stuff even though at one time I thought I couldn't live without it.

Low carb is much easier to stick to. I have already made it a lifestyle and will follow it for the rest of my life. when I saw Hope Warshaw debate Dr. Bernstein on dLife, I wanted to reach through the TV and shake the living you-know-what out of her.
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  #9   ^
Old Wed, Apr-09-08, 07:47
Hutchinson's Avatar
Hutchinson Hutchinson is offline
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Plan: Dr Dahlqvist's
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Well at least Dr Morrison didn't lose her job as Doktor Dalhqvist did in Sweden.

Still the Swedes did eventually agree she was still fit to practice.

It was reading that article that got me started on low carbing. Oh how I wish I had done so years ago.
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  #10   ^
Old Wed, Apr-09-08, 07:52
Hutchinson's Avatar
Hutchinson Hutchinson is offline
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Plan: Dr Dahlqvist's
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Quote:
Originally Posted by Bat Spit
But a whole generations of physicians couldn't possibly have been lied to by the pharmaceutical companies and their governments, could they?
I presume that was ironical but perhaps you haven't yet listened to Gary Taubes Berkley lecture. or read his book although he doesn't actually go into lies and corruption the way the research is manipulated by big business is pretty much the subtext of his argument.
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  #11   ^
Old Wed, Apr-09-08, 09:06
Wifezilla's Avatar
Wifezilla Wifezilla is offline
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Plan: I'm a Barry Girl
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The "some people can't do it so lets not tell anyone" line of reasoning makes my freaking head spin.

Do we start telling alcholoics to keep drinking since so many people fall off the wagon?
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  #12   ^
Old Wed, Apr-09-08, 09:54
Bat Spit Bat Spit is offline
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Plan: paleo-ish
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Progress: 34%
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Quote:
I presume that was ironical


Yes, that was laden with so much dripping sarcasm that it was making little puddles on the floor!
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  #13   ^
Old Wed, Apr-09-08, 10:17
Wifezilla's Avatar
Wifezilla Wifezilla is offline
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Plan: I'm a Barry Girl
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I slipped in one. Didn't you see the "caution wet floor" sign I left next to the puddle?
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  #14   ^
Old Wed, Apr-09-08, 10:30
Citruskiss Citruskiss is offline
I've decided
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I don't know what to say - just that this whole thing makes me pretty angry.

I told my diabetic uncle awhile back about the benefits of low-carb eating. Furthermore, his own eye doctor suggested low-carb to him, to help improve his eyes.

So, my uncle went in to see his 'diabetes specialist' doctor, who told him in no uncertain terms that he didn't need to change his diet.

Meanwhile, more and more new medications are being added, and the latest and greatest is that he may need to start taking insulin soon. Of course, he's following the 'diabetic diet' given to him more than 20 years ago just beautifully - whole wheat toast in the morning with diet margarine for breakfast, sandwich for lunch, and something relatively low-fat for dinner, and the 'no sugar' thing.

Um, he's been gaining weight. Adding in a whole slew of new and fancier medications.

I sent him the books. His eye doctor suggested low carb, but the 'diabetes expert' told him no.

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  #15   ^
Old Wed, Apr-09-08, 13:50
mike_d's Avatar
mike_d mike_d is offline
Grease is the word!
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Plan: PSMF/IF
Stats: 236/181/180 Male 72 inches
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Progress: 98%
Location: Alamo city, Texas
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Yesterday I was surprised when I realized I had eaten almost a whole stick of butter.
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