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Re: [IPk] Carb Counting in the UK

> Carb counting in this context is entirely different since you're not aiming
> for targets - you just need to know how much insulin to take. And out of a
> pump context that can be extremely difficult, since on
> NPH/Ultratard/Insulatard/whatever you do not know with any certainty what
> your basal rate is. The meal bolus and the basal are often
> indistinguishable.

True, but do you think it's any easier with a "healthy eating
approach"? I don't.

> For this reason, the NHS in Britain simply advocates "healthy eating".
> Regular meals. Not too much. Not too little. The beauty of this approach is
> that "heathy eating" brings many other advantages. Achieving normal bg
> levels is not the only aim of good diabetes treatment.

Sure. But there's no reason why you have to chuck healthy eating out
of the window when you adopt carb counting.

> Its not dark age stuff - it's more risk control. Carb counting has been
> tried in the real world, and it's been found that you get better long-term
> results but advocating "healthy eating". 

Ah, but is it the fault of carb counting per se?
Or is it that people either haven't been taught right, or find it too
difficult, or whatever. I really do think you should be able to get
better results with carb counting if you do it right, than with
healthy eating. I appreciate that people do find it hard, but isn't
that the problem we should be looking into? Rather than saying "carb
counting's too difficult" or whatever, we should be looking at ways of
educating people so that they can adopt it.

Hence the dietician's comment
> about Mars Bars, Di. I assure you there are LOTS of people out there who
> live off Big Macs, Mars Bars and Coke for most of their calories. And they
> may ultimately have a very poor health outcome.

I agree. BUT, is that a result of following the carb counting approach
> rather than the healthy eating approach? I think not (though maybe
> you disagree). The sort of people who will live off Mars Bars and
> Coke aren't likely to follow a healthy eating approach either. Like
> I said, carb counting should be taught hand in hand with healthy
> eating, not instead of it.

> Hope that explains things a bit Paul! I don't usually praise the NHS, but
> clearly the British policy does something right, since the average HbA1c is
> much lower in Briatin than in the States, as is the incidence of
> complications.

It doesn't follow that the healthy eating approach is the cause of
this though, does it? There are all sorts of other factors to

Even the fact that people here have better results since the carb
counting was discontinued doesn't mean that's the cause. In the last
few years intensive blood testing has increased dramatically, people
are much more aware of all kinds of things, they are mroe empowered,
they realise the importance of good results in a way which they didn't
before, and so on.
 I don't think you can really draw those kind of conclusions.

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