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[IPk] Re: ip-uk-digest V2 #251

Thanks very much to Elizabeth, and to Joyce, who answered my email.

a couple more questions

> Re: [IPk] diabetes resources in the UK
From: "Elizabeth OShea" <email @ redacted>
Subject: Re: [IPk] diabetes resources in the UK

>>My mother, who is 82 and lives in London, has recently been diagnosed
>>with type 2 diabetes
>>her gp (who is a very caring
>>person, and very good about most things) told her to lose weight and
>>eat fewer sweet things and come back to have her blood sugar checked 
>>the surgery in 2 weeks - she did this, and not suprisingly it was not
>>much better

>How on earth did they expect her to lose a significant amount of
>in a 
>fortnight?! That's just silly: the sort of weight loss that will 
>impact BGs takes months.

Evidently I didnt write this clearly - they expected her to have
altered her diet, rather than losing significant amount of weight, and
thus impacted on BG - but how could she really alter her diet
appropriately with so little dietary knowledge???

>>but she doesn't really
>>know what, aside from cakes and biscuits and sweets and potatoes,
>>contains significant amounts of carbohydrate and what doesnt. She
>>doesn't know how large standard portions of carbohydrate foods are,
>>though she has a sneaking suspicion that her diet consists mostly of
>>carbohydrates - as an old person who lives alone and doesnt like to
>>cook, she tends to eat bread with assorted things accompanying it. I
>>tried to suggest that she work towards reversing the proportions -
>>instead of bread with a little accompaniment, change to a little
>>accompanying a larger amount of salad, tuna, sardines, cottage cheese

>I think this advice is excellent advice, Nanette. She should also 
>that the bread she eats is high in fibre, so she should buy wholegrain

>breads - something with oats is ideal, because oats have great health 
>benefits in terms of cholesterol as well.

>All breads, grains, beans, pulses, vegetables, fruits, sweets contain 
>carbohydrate. Would she eat salads with lots of veggies and protein 
>cheese, egg)? Something like that could be a good option because it 
>have much less carb and still be filling.
She has never much liked a high protein diet - I think increasing
veggies is about the best bet for her - when I went to spend a weekend
with her a few weeks ago, I cooked some salmon and made a soup and
interesting salads with all sorts of nice veggies - but don't know that
she'll do that for herself. Since she also has high cholesterol she has
an additional reason for not eating much meat, cheese, egg - none of
which she likes eating anyway.

>The issue is that someone who is 82 is not likely to be doing a  lot
>exercise (I could be wrong!), so they don't need as many calories,
>which come from starchy carbohydrate. The diet they teach us is high
>starchy carbohydrate, so it's high in calories. If you take the 
>recommendation to eat 4-5 servings of fruit & veg and 6-11 servings of

>and bread products and swap it around: 4-5 servings of grain & bread 
>6-11 of fruit and veg, you'll get a more suitable diet for someone who

>playing sport or gardening every day. That's my opinion based on what 
>read about low carb diets, the glycaemic index, and my own experience.
One of the troubles here is that I don't want to get her too confused
with what I do or don't eat - with type 1 diabetes and an active
lifestyle, I can eat some sweet things and a reasonably high carb diet,
and just bolus insulin accordingly, but trying to manage type 2
diabetes with diet and exercise (she walks, but not that much, and
swims, seriously when she gets to the pool, but not that frequently) I
don't think she could do that and maintain control. On the other hand
since she doesn't have to inject insulin, and is not in danger of
flaking out due to ketoacidosis or hypoglycaemia, she believes firmly
that her condition is 'milder' than mine, therefore is tempted to
conclude that if I can be flexible, she should be able to be more so!!
I understand how she gets this logic, but don't know how to deal with
it, particularly since I do not want to upset her.
When I was diagnosed with type 1, I was not in England, and was given
dietary lists (based on exchange system) probably more suitable for
type 2, since they advised relatively restricted carbs (but not low
carb in the sense of real low carb diets) - it was a little rigid (I
have frequently cursed dieticians who know much more about type 2 than
type 1, yet think they know all there is to know about diabetes) but it
was a good background. Do they give out lists like this in England?? if
not I will dig out mine and give her some language practice too.

>You might want to show her the glycaemic index so that she can pick 
>that raise BG more slowly . visit www.mendosa.com/gilists.htm for more

This sounds a useful idea - thanks.

>>I also suggested
>>she discuss with her gp having a glucometer so that she would have
>>satisfaction of seeing her blood sugar go down when she kept to lower
>>carb foods and took more exercise.

>it's malpractice that she hasn't been given a meter and taught how to 
>it. if she tests two hours after every meal she'll also be able to
>of which foods send her BG very high and which don't, and adjust her 
>based on this information. She should _insist_, right now, that she be

>a BG meter and shown how to use it. it's insane that she hasn't been.
Thanks - I had started to wonder if my reaction was extreme in thinking
it negligent that she had not been given a glucometer.

>From: "Joyce Jones" <email @ redacted>
>Subject: [IPk] diabetes resources in the UK

>Sorry to hear about your mother's diabetes, I have been insulin
>dependent now for 20yrs. When I was first diagnosed, a book I found 
>helpful was Dr. Manns Diet Book, also there is some very good 
>on carbohydrate contents available from Diabetes UK.or

Joyce, could you perhaps tell me where on this web site I would find
simple lists of carbohydrate contents of everyday foods, fruits, veg
etc - I have looked all over that site without locating the relevant



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