Tag Archives: education

The first principle of healthy eating for diabetes

There has been so much in the press and news recently about healthy eating / weight loss: the most effective diets, the healthiest things to eat and the best things to avoid. It strikes me that what applies to non-diabetics isn’t always the wisest advice for people with diabetes, and actually people with diabetes have a more tenuous path to walk to achieve both weight loss and good health. I’m not talking about out-there whacky fad diets here. There’s some quite mainstream, some might say “sensible”, advice that doesn’t quite hit the mark for people with blood sugar issues.

I suppose the thing that got me thinking was a strap-line in an article in The Times recently. It read: “The debate over fat and carbs obscures the truth that consuming fewer calories than we burn is the only way to slim“.

Well the truth is, that the debate about fat and carbs is crucial for people with diabetes, and it matters very much what form of calories you consume. The reason being of course that what the calories are made from has a huge impact on their effect on blood sugar levels. The difference between carbs and fats or indeed proteins is vast in terms of their effect on blood sugar.

But it isn’t just the number or nature of your daily calories that impact on blood sugar. The timing and size of meals is also a key factor in keeping your blood sugars balanced. Just these 2 factors could be the difference between burning body fat or storing more of it!

The two diagrams below illustrate what might happen if you eat fewer larger meals compared with smaller more frequent meals. Though they may involve the same actual foods overall, you can clearly see the different effects timings and meal sizes would have on your body.

InsulinGraph

InsulinGraph2

Blood sugar balance is one of four major principles underpinning the RebalanceDiabetes programme. I explain all of them in the FREE RebalanceDiabetes seminars that I hold each month. I would love to explain the other 3 to you in person and if that sounds good to you too why not book your place at the next event on Monday 23 March – here’s the link.

See you there?

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Type 1 diabetics being let down by inappropriate nutritional advice?

I was intrigued this week to read an online discussion about the nutritional advice and examples being given to people with Type 1 diabetes via the most commonly delivered education programme, DAFNE.

It’s a tricky problem isn’t it?  Type 1 diabetics need to take insulin – there’s no getting away from this simple truth. But there is a whole lot of subtlety about how to get the best outcomes by using foods and insulin in the most intelligent and appropriate ways.

I can completely appreciate the temptation for someone with Type 1 to eat whatever carbs they fancy knowing that on one level an insulin injection can compensate, by bringing blood glucose back into acceptable levels.  What that insulin injection cannot compensate for, however, is the fact that those sugary, high carb foods have great potential to cause weight gain, belly fat, systemic inflammation, high cholesterol, insulin resistance and more.  In this sense someone with Type 1 diabetes is no different from a non-diabetic.  High carb diets are intrinsically linked with weight gain, obesity and the risk of developing serious diseases – FOR EVERYONE!

So to actively encourage anyone at all to recklessly indulge in sugary, high carb foods is irresponsible.  To tell anyone that it’s OK to eat copious amounts of sweets, cakes and biscuits is irresponsible.  To do that within the context of a course delivered at the expense of the NHS – remember the taxpayer will pick up all the future bills for the consequences of this advice – is irresponsible.

To encourage this in a person with Type 1 diabetes is worse – and that’s because injecting insulin brings with it significant side effects – as I covered in my last blog post.  Insulin is not a benign medication.  Just because it is a natural hormone doesn’t mean that having large amounts present in the blood stream is desirable, or even OK. Large amounts of insulin comes with risks!

People with Type 1 diabetes know that over time weight gain is likely: this is one of the signs that the carb balance for their lifestyle is wrong.  More than weight gain, they will experience complications from the effects of the disease and the medication, and are likely to die several years before their non-diabetic counterparts.

We really need to understand that when we put food inside our bodies it has an effect.  We all have a choice whether that effect will be beneficial or harmful.  But we only have a real choice if it is based on sound knowledge of what that effect will truly be.  The role of carbs is to provide energy.  If we don’t expend energy, we don’t need many carbs.  If we don’t need many carbs but consume them anyway they will be stored – as body fat. ALWAYS! Even when someone with Type 1 diabetes resolves any blood glucose crisis with a shot of insulin, those extra carbs will still be turned into body fat.

So we have to get away from the idea that insulin can make it all alright to overdo the carbs.  It can’t, it won’t and it doesn’t!

Last week one of my RebalanceDiabetes guys, a Type 1 diabetic, reported back that since he had started to tailor his carb intake to match his lifestyle and activity levels, he has lost 6lbs of belly fat, halved his insulin use, and feels better in himself for as long as he has been diagnosed. IN JUST 2 WEEKS!

DAFNE is the acronym for “Dose Adjustment For Normal Eating”. Where carbs are concerned we have to redefine “normal eating”.  In the past few decades our lifestyles have become increasingly sedentary, yet we have failed to reduce our carb intake to match that.  We still consume carbs as if we had the activity levels of previous generations.  In fact we consume MORE carbs now – more sugars than ever are loaded into our daily diets.

We are paying the price – with our health!

Activity on the decline, carbs on the up = disease on the increase!

I am all for individuals having freedom of choice.  If you choose high carb – well OK.  If you choose to match your carbs with your lifestyle – fantastic.  But one thing is for sure – education should at least provide the proper information on which those choices can then be more intelligently made.  Let’s make our diabetes education at least responsible for providing the right advice and examples – the rest is then down to the individual.  They will make their own choices based on their own self-worth not on the basis of incorrect or incomplete information.

If our healthcare educators cannot deliver quality advice or better examples, then how do expect individuals to get it right for themselves?  There is something quite shameful about not taking the opportunity to encourage those who are motivated to take responsibility for their own health.

See for yourself what the right advice can help someone with Type 1 diabetes do for themselves:

 

 

The need for Rebalance!

Monday 6th January: The official launch of RebalanceDiabetes.

diabetes-1

It was great, thanks to all those who contributed to the success of the launch of 3 products: the RebalanceDiabetes structured nutrition and lifestyle education programme for those living with diabetes; my new book ‘the 6 diet’ published by FisherKing Publishing and soon available on Amazon worldwide; and this website www.rebalancediabetes.com – a single source of all things diabetes-related.

Since 2005, NICE have been recommending that structured education is the way to tackle diabetes in the UK.  Nine years on, it simply isn’t happening.  And that is quite simply not good enough!

The figures speak for themselves:

  •       around 3 million people in the UK have diabetes
  •       an estimated 850,000 people have undiagnosed diabetes
  •       by 2025 5 million people in the UK will have diabetes
  •       7 million people are thought to be at high risk of developing type 2 diabetes
  •       10% of the NHS budget is spent on diabetes

10% of the NHS budget?  Yet the NHS fails to provide the very education that might help to save some of those costs?  One source, Xpert, estimates this at £347 million!!

What remains inestimable, of course, is the value that could be assigned to the improved quality of life that patients might realise from improved clinical outcomes.  Why is it that reports all focus on monetary costs to the NHS, but neglect the value of health to the patient who otherwise faces the horrendous consequences of complications associated with poor diabetes care: cardiovascular disease, blindness, neuropathy, amputations, depression…?

One might be forgiven for thinking that the lack of care boils down to a mere lack of money – but a recent report of proposed moves by the NHS to financially incentivise GPs to provide the simple tests to which patients are already entitled indicates that money per se is not the issue.  Rather it alludes to something much worse than financial constraints – apathy!

Patients should already be receiving:

  •       HbA1c test
  •       Cholesterol test
  •       Blood pressure reading
  •       Albumin to creatinine ratio (a measure of kidney health)
  •       Serum creatinine measurement (another kidney health check)
  •       Foot examination
  •       BMI measurement (height and weight)
  •       Smoking status recorded

The fact that this also is failing to happen is truly shocking – regular routine monitoring of a serious disease not being carried out, and GPs being paid incentives to meet this minimum requirement?

How about the NHS insisting on minimum standards without incentives, and spending the money that it has reserved for that on better education as recommended by NICE to actually improve the levels of care?

Tell me – is that too logical?