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Discussion Starter · #1 ·
Hi all, and seasons greetings :)

I was dx'd with type 2 recently and have to go to my first "education class" on Dec 27th. I'm not looking forward to it really because my understanding is that they will push a South Beach sort of diet, whereas I am more interested in the LCHF diet practiced by most folks I see on this board. My question concerns the approach that one takes when talking to these "diabetes educators". I don't think that debating the merits and con's of either is appropriate, so what have others done in this situation?

I did south beach before and have lost weight on it, but it was hard to sustain more than a few months at a time and there were always cravings. The LCHF diet has been great over the past 3 weeks, as I look forward to my meals and don't see a problem with staying on longterm. The only issue I've had is a slight increase in weight, which I assume is because I'm eating the right stuff, but too much of it and need to cut down on total calorie intake.
 

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I've never been to a diabetes class ever, but if I had to and listen to a lot the things that I know are not true (for me) I'd just listen without argument. You can only reason / debate / argue with someone who has an open mind.
 

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Hi all, and seasons greetings :)

I was dx'd with type 2 recently and have to go to my first "education class" on Dec 27th. I'm not looking forward to it really because my understanding is that they will push a South Beach sort of diet, whereas I am more interested in the LCHF diet practiced by most folks I see on this board. My question concerns the approach that one takes when talking to these "diabetes educators". I don't think that debating the merits and con's of either is appropriate, so what have others done in this situation?

I did south beach before and have lost weight on it, but it was hard to sustain more than a few months at a time and there were always cravings. The LCHF diet has been great over the past 3 weeks, as I look forward to my meals and don't see a problem with staying on longterm. The only issue I've had is a slight increase in weight, which I assume is because I'm eating the right stuff, but too much of it and need to cut down on total calorie intake.
@skb is basically right. Having a stand up fight with someone who is only following orders doesn't do anything except create stress. In your place, I'd go along and hear what they have to say. It is possible that you will find you've got someone with an open mind (unlikely, but....).

If they deliver the standard High Carb spiel, just smile sweetly and nod. Take any notes they offer and when you come home, use them as fuel for the fire or toilet paper (if they are soft enough) and stay on low carb.

When the wife swapped me to low carb, she didn't have to cut my calorie count at all. I'm on around 2000 per day with about 70-80 grams carb (300 calories). Over the first 9 months I dropped 30 lbs off my weight - no cravings, no hunger.

Have you explored Blood Sugar 101 That site may give you a few ideas on diet management that you haven't already thought of.

Good luck, John
 

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Basically a South Beach or Atkins type diet is a LC/HF diet. I doubt many Educators would push that diet. In stead most seem to push a higher carb diet telling us that we need a certain amount of carbs or we will cease to function. I had one single meeting with a CDE and she told me I needed 45-60 carb grams per meal and at least 2, 30 gram snacks. I found pretty quickly that didn't work for me. If you have to go to this D education, I would suggest just listen and see if you pick up any pearls of wisdom. Don't be confrontational because you won't win. When you get home put together a diet that works for you to give you near normal bgs. I know I am super sensitive to carbs and everytime I try to eat more than 15 grams per meal bad things happen to my blood sugar. I overdid it at Christmas and had 2 small squares of corn pudding. Well, this morning bgs were 50 points higher than normal. So you will be able to tell which foods your body likes. The common thinking is D's shouldn't have to restrict foods and we should all just keep taking more and more meds or insulin to compensate. I am not sure I like that thinking.
 

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Discussion Starter · #5 ·
Thank you for the replies, it's appreciated. My understanding is that South Beach is low carb low fat and high protein; and is not satiating in the long run.

John, how do you quantitate calories, paricularly from fats? Are you weighing everything? Also, I have read much on the blood sugar 101 site and will continue to do so, but some gems are buried.

Kind regards to both
 

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Thank you for the replies, it's appreciated. My understanding is that South Beach is low carb low fat and high protein; and is not satiating in the long run.

John, how do you quantitate calories, paricularly from fats? Are you weighing everything? Also, I have read much on the blood sugar 101 site and will continue to do so, but some gems are buried.

Kind regards to both
Calorie counting - I don't do it - simple as that.

My OH does all the catering and the only item we track carefully is the carbohydrate content of the meal.

Portion size is something Judy does virtually on auto-pilot. For instance, we get salmon fillets in packs of 2 - figuring out my share seems fairly straightforward :).

Her "rules of engagement" are simple. Each day she tries to ensure that I have no more than about 80 grams of carbohydrate spread over three meals.

She buys free range products whenever possible and cooks them with good quality fats like butter, olive oil or walnut oil. She avoids anything like colza, corn oil or other highly processed oils.

Each meal sees me with a piece of fruit, about 1 oz of nuts, about 1 oz of cheese (from unpasteurised milk), a meat or fish portion and a portion of lowish carbohydrate veggies. (cauliflower, broccoli, zuchini, carrot....) How she manages to ring the changes amazes me! :D

Breakfast is about the only meal that's more or less constant. Two fried eggs, a homemade beefburger (4oz), a green salad or a portion of endive. Washed down with a large black coffee, my ounce of nuts (usually walnuts) and my piece of fruit (which fruit depends on my blood glucose reading) - if that's low - a banana, high and I get some lemon juice in the glass of water that accompanies every meal.

You are right about Blood Sugar 101 - Every time I have a look at the site I find a new gem of information.

Good luck, John

John
 

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When I was dx'ed, I spoke with 2 diabetes educators. By the time I met with the 2nd one, like you, I had done some research and was already en route to LCHF. My numbers had plummeted and after our hour meeting, she agreed there wasn't much her class would teach me so I bowed out.

Both the CDEs followed the ADA guidelines, and I think those classes are mostly spouting things we know don't work for the majority of diabetics who want to minimize their meds, and dish up goals that are different from most of us on this forum.

It's probably not a good idea to waste energy arguing, but I seem to be a big energy-waster by nature. I'm sure I'd have been raising my hand repeatedly in the class, annoying the CDE but =maybe= raising questions in some of the participants minds which isn't a bad thing. I raised plenty of questions with her in our 1-on-1 and later she acknowledged a doc in town admonished her for recommending so many carbs but said she had to follow ADA guidelines.

Like John, I don't count calories. I don't count much of anything except carbs and now not even those specifically, I simply avoid them. Am making a conscious effort to reduce protein and increase fat, though getting in touch by specific counting would probably be a good idea from time to time.

After having fallen off the LC wagon on a couple of occasions recently, I did survive Christmas and was rewarded with an 86 fasting this AM. Yeah!
 

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John.in.France said:
Calorie counting - I don't do it - simple as that.

My OH does all the catering and the only item we track carefully is the carbohydrate content of the meal.

Portion size is something Judy does virtually on auto-pilot. For instance, we get salmon fillets in packs of 2 - figuring out my share seems fairly straightforward :).

Her "rules of engagement" are simple. Each day she tries to ensure that I have no more than about 80 grams of carbohydrate spread over three meals.

She buys free range products whenever possible and cooks them with good quality fats like butter, olive oil or walnut oil. She avoids anything like colza, corn oil or other highly processed oils.

Each meal sees me with a piece of fruit, about 1 oz of nuts, about 1 oz of cheese (from unpasteurised milk), a meat or fish portion and a portion of lowish carbohydrate veggies. (cauliflower, broccoli, zuchini, carrot....) How she manages to ring the changes amazes me! :D

Breakfast is about the only meal that's more or less constant. Two fried eggs, a homemade beefburger (4oz), a green salad or a portion of endive. Washed down with a large black coffee, my ounce of nuts (usually walnuts) and my piece of fruit (which fruit depends on my blood glucose reading) - if that's low - a banana, high and I get some lemon juice in the glass of water that accompanies every meal.

You are right about Blood Sugar 101 - Every time I have a look at the site I find a new gem of information.

Good luck, John

John
John your so pampered - you lucky guy ;)
 

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The only really useful thing that I gleaned out of a 2-day Diabetes Class was how to read the labels and gauge a serving size.
 

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the only thing I got out of that class was , this is BS. and how hard the chair was. I left the building never to return.
Even as dumb as I was about D I knew what they where telling was wrong. I had to find out on my own .

I looked at SouthB. It is to 'plus' on certain food items like bread,rice,fruit. many of those food items I have dropped from my diet. I also found it to restrictive. Even boring.

For me Atkins works the best. To each thier own & what works for you..
 

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John your so pampered - you lucky guy ;)
You are so right!:)
And I know it.
I was trying to list the folk who helped me get to where I am today. This is the list:

  • My wife - Judy - without her cooking and support, I wouldn't be here.
  • This forum
  • Blood Sugar 101
  • My neighbour Christine. If she had done as we asked, she would have left me in a little cottage hospital rather than in a proper one. It cost her the whole day and may have saved my life.
  • My doctor - for his policy of non interference
  • The hospital in Autun for their technical handling of the DKA and e-Coli infection.
 

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I turned down the classes, and am so glad I did! The only "education" I got was how to inject; took about 5 minutes and I skipped the orange!

You do not need to know the information they are pushing. Save your co-pay and your insurer's money -- hah hah!
 

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I took 1 class out of my HMO's recommended 5. There, we "learned" that Type 1 occurs only in childhood. And, of course, that we all need a big load of "healthy whole grains" and fruits with every meal. :rolleyes:

My fellow students, for the most part, did not know what D-type they were ... several didn't even know more than 1 type exists! My HMO presumes that adult-onset = Type 2. Period.

And, admittedly, at least a couple of them were into major carb-shoveling and beer guzzling. For them, anything would be an improvement ... they really flinched at the thought of "only" 45g carbs per meal.

All I did was mention -- politely -- that I simply cannot manage the recommended number of carbs. The instructor mumbled a suggestion that I explore the Glycemic Index. Afterward, she told me -- in a very nice way --- that I was a tad too advanced for her class.

Clearly, the instructor knew better. For example, she equated "pre-diabetes" to "a little bit pregnant," and made a most excellent face when someone touted Dr. Oz. But my HMO adheres pretty strictly to the ADA Guidelines and she's got an interest in staying employed.
 
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I don't count calories either, just carbs. I pretty much know what foods I can and cannot eat without spiking. Of course on holidays meals I cheat a little and do pay for it with higher bgs for a few days. I try to make sure each meal is around 12-15 carbs, at least 15-20 grams of protein and 20-30 grams of fat. It seems the fat helps with keeping the bgs low. Some people will spike with too much protein so watch the portion size and always test about 4-5 hours after a meal with a lot of protein.
 

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It was only on my last visit that my doctor offered classes to me and I said No Thanks, and he didn't push it. It would have been awfully hard to sit through those classes with my mouth shut.

I don't eat particularly low carb, but there's no way I could consistently eat 45-60g of carbs at a meal. If I start lunch or dinner with bg in the 80s, then sure, 45g is okay. But if I start at 110, no flipping way. And breakfast is a-whole-nother story. I eat to the meter, eat to the meter, eat to the meter. (Sorry for the broken record. I thought it bore repeating. :p)

I do count calories, because I want to lose a total of 120 pounds, and calories matter, even when eating LCHF. (They matter differently, but that's a subject for another post.) I average 1650 calories per day and always stay below 2000 calories. Carbs make up about 30% of my diet. I've never figured out the percentages of protein and fat.

If I had to listen to a CDE tell me to ignore my own body and eat a certain way because that's what works for the masses, I'd scream.
 

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I went to the CDE and she tried to tell me the same bulls*** they all do...eat 45-60 grams of carbs (whole grains, etc. etc.) per meal and the snacks...blah, blah, blah. When I told the CDE I couldn't eat brown rice as well as white rice she looked at me like I was an alien. She asked me why not? I told her the brown rice spikes me just as much as white rice. She kind of ignored me and went on. I told my endo about this and what a waste of time it was, and she was appalled at the amount of carbs they are teaching a diabetic to eat per meal. She actually went and told them (the CDE's) that they are killing people with what they are teaching diet-wise.

Don't listen to the crap they want to feed you. I've done their diet; I've followed the advice and information to the letter and it ended in alot of weight gain and horrible control of my diabetes. I have not perfected the LCHF WOE as of yet, but I'm still relatively a newbie in my eyes I have gotten my numbers to a better place, my lipids are definitely better. I'm not a saint and I've "fallen off the wagon" with eating things I know I should not; but with that said, it is easy enough to get back to where I need to be. I do notice big differences in how I feel when I eat things I know I shouldn't and it just makes me want to get back to eating LCHF. Tomorrow is the start of my way back; I've been through the last couple of days with the holiday "treats" and I'm done with that. It was nice to taste forbidden fruit, however I want my salads back! I feel like total poop tonight; lethargic, lazy, brain foggy, stuffed up I need my veggies and good fat! Oh, and the gym will be open again tomorrow! I need my exercise as well. The last three days have been a definite learning experience. Not worth it.
 
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Discussion Starter · #17 ·
met the CDE

Well I finally got to meet with the diabetes educator, who is a nurse with tons of experience with diabetics. I expected a canned speech and ADA talking points about diet but was pleasantly surprised. She first showed me how to download all the data from my glucometer and the provided a new one (OnTouch Ultra2), which seems perfect as you can annotate each reading on the machine to put some context to the numbers later on. She also tested my A1c on site (just a couple of minutes) and I gagged a bit when it came back at 8.4, even after the past few weeks diligently exercising and religious LCHF dieting. I do understand the it is a moving average and reflects my recently uncontrolled condition, but it sucks nonetheless. We discussed my meds, and she supported my suggestion that I drop my glyburide and significantly increase my metformin. This was a pretty good start (I thought), but the issue of diet came up next ;)

I leveled straight away that I would not consume sugar/starch regardless of glycemic index, at least not until my glucose levels are stably in the normal range. I think she was bummed because I gather that calorie and carb counting is one of their most fun things to do. I told her that 45g per meal was crazy and the recommended A1c value from the ADA is equally lethal. I principally thank this site for putting me on that path.

She was very enthusiastic about my attending a 1.5 days of group lecture, but I respectfully declined as the basic stuff taught was a waste of my time. She was good with that. The end of the meeting (oddly 2 h went by) left us mutually agreeable that I would not change my diet or exercise, and after 3 weeks on the new med regimen we will meet again for a look at my new numbers compared to the baseline established there (including lipids etc). All in all I like having the partner helping me, but I don't know how long it will last.

On another point, I was concerned about my high fat intake whilst my glucose levels can still get to 150-160 after meals and are in the 100-110 range fasting. I think that if the educator brought that up, I would have been stumped for an answer. However, Jenny Ruhl (the bloodsugar101 lady) convinced me that it probably was not a problem with defunct insulin.

I apologize for the long-winded post, but wanted to share my experience.
 

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Sounds like you may have found that unusual DE - one that isn't totally sold on the ADA script!
On your HbA1c. What was your old figure?
It took me fully two months to knock mine down to 6.2% from 8.2. And I also understand that the "quick" test is noted as fairly in-accurate, so I wouldn't worry too much about that just yet!
Well done, John
 

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mine was same as John. 8.2 in 2 months it came down to 6.1.
I was in the 150/180 ##. then dropped to 87/90/low 100's & a few 115.
my Morning ## have really dropped. Low carb/high fat. eating right.
you will get there. oh & I dropped 45lbs :amen:
 

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It all sounds great, Darbo. The second CDE I had was similar to yours. She gave me the party line, but did admit she has to follow ADA guidelines, and when she saw my solid fasting numbers said to just keep doing what I was doing. They need their jobs, but some of them have some underlying common sense.

I especially like her take on your meds. I was in a similar position as you and got off the glipizide after about a month and the metformin (2000 mg ER) has served me well.

Wonderful report!
 
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