Did You Have A Doctor Who Told You....
All of you are welcome to participate in this discussion. If you were diagnosed with diabetes before 1990, you may give a negative response to some of the following questions. I have even seen people diagnosed since the year 2000 who would give some negative responses.
Did you have a doctor who told you....
1. To limit your carb intake, or follow a low carb diet?
From 1945 to 1988 I did not know carbs had anything to do with diabetes. I found the information in a magazine in 1988.
2. To limit your intake of fast acting carbs?
I did not know how to properly deal with fast acting carbs until I joined online diabetes forums in 2006.
3. To rotate sites to avoid scar tissue?
I was never told this until I started pumping in 2007, then I heard about it when I called my pump company on the phone. I used injections for almost 62 years without rotating sites, and developed permanent scar tissue without knowing it. My insulin absorption was poor and that caused much high blood sugar.
4. To not use a pump because your control was too poor, or too good?
I had good control in 2007 and my doctor said my control was too good to justify a pump. I went to an endo for a second opinion, and a pump was approved. Some doctors will deny a pump to diabetics who have poor control. It must be proved that the diabetic is capable of getting good control before a pump is justified.
Did you have a doctor who told you....
1. To limit your carb intake, or follow a low carb diet?
From 1945 to 1988 I did not know carbs had anything to do with diabetes. I found the information in a magazine in 1988.
2. To limit your intake of fast acting carbs?
I did not know how to properly deal with fast acting carbs until I joined online diabetes forums in 2006.
3. To rotate sites to avoid scar tissue?
I was never told this until I started pumping in 2007, then I heard about it when I called my pump company on the phone. I used injections for almost 62 years without rotating sites, and developed permanent scar tissue without knowing it. My insulin absorption was poor and that caused much high blood sugar.
4. To not use a pump because your control was too poor, or too good?
I had good control in 2007 and my doctor said my control was too good to justify a pump. I went to an endo for a second opinion, and a pump was approved. Some doctors will deny a pump to diabetics who have poor control. It must be proved that the diabetic is capable of getting good control before a pump is justified.
Replies to This Discussion
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Permalink Reply by acidrock23 on -
No, no, yes, no
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Permalink Reply by Terrie on -
Hi Richard: :D Good to see Ya.
Did you have a doctor who told you....
1. To limit your carb intake, or follow a low carb diet?
No.
2. To limit your intake of fast acting carbs?
No.
3. To rotate sites to avoid scar tissue?
Yes.
4. To not use a pump because your control was too poor, or too good?
No.
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Permalink Reply by Kari on -
Diagnosed in 1992. I was not told the first two things. The third I was told. The fourth changed from endo to endo. By the time I wanted a pump I was with an endo who said I had too bad of control - so I changed endos!
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Permalink Reply by Tim on -
I was first put on the ADA exchange diet, then in the early 80's on a carb-counting diet (along with starting home bg testing).
The ADA exchange diet might seem to not be "Carbs" but it does have starches which are EXACTLY the same (each starch = 15 carbs).
I'm not gonna say it was "low carb" by modern standards (some tell me that it's not low carb unless it's below 15 g of carb a day!!!! Wow!) but it was not "high carb" by any means.
I personally think that carb counting is a little too simplistic. The other foods eaten with the carbs have a big effect on rate of absorption.
IMHO there are no "fast acting" and "slow acting" carbs. Carbs are carbs, I don't care if they're a sugar or a starch they hit me about the same. BUT carbs can be moderated in their absorption by the other food types. In this way I appreciate that the ADA exchange diet is more sophisticated than I first thought it was.
I am of the opinion that the militantly-low-carb diets (i.e. less than 15 g of carb a day) are not to be recommended for T1 kids. e.g. that pretty much rules out them ever eating fruits or drinking milk except in the tiniest quantities. I hear some parents here feeling guilty because they let their kid drink milk. That's just not right.
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Permalink Reply by Lila on -
1. Yes and no - the diabetes department at the hospital where I am looked after tends to emphasize 'match insulin to carbs', at least for Type 1s/people being treated as Type 1s. I was sent on a carb-counting workshop, 5 days 9-5 so quite intensive and very useful. But not once was low-carb ever mentioned. Though to their credit, no other type of diet be it high-carb, low-fat or whatever, was pushed on us.
2. Never by a doctor. A few nurses tried to push low-GI but I told them they were over-ruled by my meter. Um. I have a bit of a reputation for being a smart-alec at the hospital tbh.
3. Yes - and not only did they tell us about this, they also check for scar tissue at regular checkup tim
4. Not really applicable as due to funding issues, not many people are on pumps here in the UK. On the flip side, insulin-dependent people get really good support out of the national health system. We get all our kit free. Even exotic-flavoured dextrogels!
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Permalink Reply by Jonathan on -
Did you have a doctor who told you....
1. To limit your carb intake, or follow a low carb diet?
My first doctor (early 1980s) was all about total calories (and very few of them), not carbs. It wasn't until the late in the 1990s that I was told to increase or decrease injected insulin based on my blood sugar at the time -- no carb counting. Earliest recollection of carb counting was early 2000s.
2. To limit your intake of fast acting carbs?
Originally told not to eat sweets, but that was it.
3. To rotate sites to avoid scar tissue?
Not until I started with the pump.
4. To not use a pump because your control was too poor, or too good?
I was encouraged to use the pump beginning around 2000, but waited a couple of years before starting.
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Permalink Reply by Chele on -
Diagnosed as Type 2 in July of 1976 so the answers to questions 1 and 2 are NO.
Started on insulin in 1991: answer to question 3 is NO. I read the info about scaring in 2000 in Diabetic Forecast.
On question 4, the answer was No reply from Endo. Seems my C-Peptid not within guidlines for pump. Went for pump anyway
and found out Ins. would not pay for the pump as I did not meet Medicare quidlines. Stayed with a pump for three years got Bg's in control and dropped it because of the cost.
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Permalink Reply by Tim on
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Forgot to answer about rotating sites with injections:
Yes, rotating sites was standard issue when I was diagnosed, but it wasn't because of "scar tissue" in the same sense that word is used today.
The real motivation for rotating was and is to minimize lipodystrophy. Many docs over the years have told me that all my injection sites show evidence of both scar tissue and some lipodystrophy despite rotation, but to me they're my tummy and my but and my legs and AFAIK they've always looked like that :-).
Many docs believe that modern insulins (not animal-source, and not U-40 or like we had in the old days) make lipodystrophy less likely and that rotation is not as important as much as is it was decades ago. I'm not so sure there's proof of this but they seem to believe it.
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Permalink Reply by Richard157 on -
Thanks for all the wonderful replies!!!
I started this discussion because I have been angry for a long time that no doctor had ever told me these things. My control is quite good, but it would have been even better if I had learned this valuable information much sooner. I know the information was there, and I have read about other diabetics who knew about some of these things long before I did.
It is now obvious that there are others who were denied this knowledge, just like I was. That does make me feel better about it, but I still don't understand why doctors failed to tell so many of us such important details that would have helped us so much! Did they assume we already knew, or did they just not care?
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Permalink Reply by MossDog on -
I believe it is because a large number of doctors/providers do not know about these things even today!
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Permalink Reply by Lila on
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But can we blame the doctors when the official line is still that PWDs should eat low fat and lots of starchy carb?
A line that is so obviously stupid and illogical that it was flaming obvious to me, newly diagnosed, semi-conscious lying in hospital recovering from DKA, and wondering why the 'healthy' hospital breakfast of wholegrain toast and a banana was giving me such alarming post-meal numbers.
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Permalink Reply by Kelly on -
Richard, I feel just like you are describing... I've gotten to the point that I do not trust the physicians completely, I find myself questioning them often because I think that subconsciously I either feel misled or failed by them. (I am T1 for 30 yrs).
Just recently I was told to never use a spot w/ stretch marks for my pump site or injections. What???? I have a lot of stretch marks on my stomach from being pregnant 20 yrs ago but was never told this before - Not even by the pump trainer. Oh well...
I think as the years progress we will only be told more things that will boggle our minds. I have learned to just "go with the flow".
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