We welcomed Mary Hall, Advanced Diabetes Dietitian, Cambridgeshire & Peterborough NHS Foundation Trust, who covered the topic of weight loss and diet. Mary is an advocate of reducing carbs in moderation for diabetes sufferers, so around 130 g/day. A good guide is a quarter of a plate should be carbs. She also pointed out that changing foods to those with fewer carbs does not mean you can increase portion sizes!
Overall a balanced diet including carbs is healthy. A big concern of the very low carb diets that have become fashionable is that they lack fibre, and 25-30g of fibre is ideal. Fruit is OK in moderation, a eg a handful of grapes rather than a whole punnet! In particular increasing the amounts of saturated fats consumed should be avoided on low carb diets, the advice is to keep consumption low. Generally dietary habits should substitute whole grains for processed (white) grains and reduce the amounts of processed meats and saturated fats.
|Carbs found in…||No/low carb foods|
|Milk, yoghurt, ice cream|
We discussed how to keep track of carbs and calories consumed, and Mary recommended the book “The Carb and Calorie Counter”. You can find a link to buy the book at the Carbs and Cals web site at www.carbsandcals.com, and also you can sign up for their newsletter which then allows you to download 40 pdfs of useful charts – how to identify low carb foods, healthy meal planning, etc., and even the Bristol Stool Chart and a Urine Colour Chart!
Some members in the group discussed their own dieting successes. One has lost 3 ½ stone (22 kg) over 6 months by at first using the Milk Diet under hospital supervision. This was followed by a half liquid/half food diet, and eventually 1,200 calories a day. He is now off insulin. Another group member lost 3 stone (19 kg) using the Blood Sugar Diet, which has enabled him to avoid having to go on medication.
Several in the group commented that they were diagnosed with diabetes almost by accident, which raised the question of is there a screening programme for diabetes? The NHS runs a 40+ health check which your GP should offer, and this includes checking for risk factors for diabetes, not a blood test. It is recommended that all newly diagnosed see a dietitian, the referral is via your GP practice.
A relatively recent programme is the NHS Diabetes Prevention Programme https://www.england.nhs.uk/diabetes/diabetes-prevention/ that is aimed at those who are pre-diabetic, with an HbA1c of 42-47. The programme consists of identifying those at high risk and refers them on to a behaviour change programme. Cambridge and Peterborough are now part of this programme. There are trials at delivering the behavioural change digitally; that is using an app and telephone calls.