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Re: [IPk] Dietetic Support

I had a meeting with a dietician after three months of pumping  The
initial support was the leaflets-on-carbs.  At the meeting with the
dietician, I said what I needed (the carb values of ciders!) and we
agreed to meet again after six months if I had problems (I didn't).

I don't think, once you've absorbed the very basic knowledge about what
carbohydrate, protein, fat and alcohol do to most people's bgs, and what
the glycaemic index is, that you need a dietician in order to make some
great strides.  You need a statisitician.  You need the time to write
down what you actually eat, and what it actually does, and the time to
think about that, to guess what difference you need to make to
calculations, and to continue on in the process of trial, recording, and

This is based upon my conviction that there is not 'a plan' which will
give you good control.  Instead, start with what you want to eat.  If
that's fish and chips every night, and twelve pints of lager on a
Saturday, start there.  Yes, of course, consider the long-term effects
of what you eat, and look towards moving it to more healthy eating (and
there's lots of information out there on healthy eating.  For diabetics,
the risk of heart disease is higher, so you might want to consider
putting a little more weight on the heart-healthy end of food - but
diabetics have a LOT more to worry about than heart attacks, and that's
why you shouldn't do 'healthy eating' first and 'diabetic control'
second.   OK, having decided what to eat, then eat, and observe.  You
will probably find that there are certain foods which are complete
pains.  For me, it's beans. 

I suggest you start by keeping a food and blood glucose diary for two or
three weeks.  You will probably see a couple of trends, such as needing
to inject less a day after a lot of exercise, or needing to inject later
for pizza, but most of what you see will be random - one day you just
need more insulin than another.  Perhaps try pushing the boundaries by
trying a few meals with incredibly high and low gis, high and low % of
calories from each source, and so on.

Don't worry about healthy eating while experimenting: you need to find
out how and what to inject to cover food.  Then, when you know what
every food will do, from an apple to zucchini and mozzarella pasta bake,
that's the point, I think, to go to a dietician and ask for guidance.
Don't bother about asking her about cho, or the GI index: they clearly
can't help.  She or he's probably good for finding out about healthy
eating, but I don't think you are in a position yet to worry about it.

Best wishes,

(dm 30+, 508 1+, 

In message <email @ redacted>, Heather Bowler
<email @ redacted> writes
>I'm interested to know how much dietetic support people were given when you 
>first started using a pump. We were given a few sheets with carbohydrate 
>values and a ratio to use. However, I feel, increasingly that having a 
>better knowledge of food would optimise control. I am not trying to shirk 
>responsibility but I would very much like to go through diet in detail with 
>a dietician and am struggling to do so. The dietician at our local hospital 
>does not have the time (apparently) to discuss either carbohydrate counting 
>or more importantly the glycemic index with me outside of a clinic 
>appointment. Of course that would be far from ideal with 2 children in tow 
>and quite how long she would give me I don't know. The hospital where we are 
>getting the 'pump' treatment for Sam is over a 100miles away and it's just 
>not convenient to nip over there.  We have bought books, including 'The 
>Glucose Revolution' but I'm struggling to read and absorb it. I know it's 
>important and I should find the time, but 3 young children and plenty of 
>commitments have made me long for somebody to help with a plan.
>Is there an easy solution? I've been on the British Dietetic Association's 
>website and got some details of freelance dieticians and I feel I'm left 
>with little option other than to pay forappropriate dietetic advice.  I've 
>just laughed as I've read the leaflets from Diabetes UK 'What care to expect 
>when your child has diabetes' and 'We're fighting diabetes together'. Ha!
>I'm feeling somewhat dispirited.
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Pat Reynolds
email @ redacted
   "It might look a bit messy now, but just you come back in 500 years time" 
   (T. Pratchett)
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