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…
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.
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!
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.
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.
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.
Yes - and not only did they tell us about this, they also check for scar tissue at regular checkup tim
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!
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.
To limit your intake of fast acting carbs?
Originally told not to eat sweets, but that was it.
To rotate sites to avoid scar tissue?
Not until I started with the pump.
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.
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.
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.
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?
I was diagnosed in 1972 and the only nutritional advice I was given was to not eat sweets. There was no talk of rotating sites and pumps were still a dream in someone’s head I imagine.
yes yes yes annd yes. The only reson I got on the pump was b/c I was pregoo.
I was told in 73 NEVER to have kids. Well now I got 2 girls and 3 g-kids so there!
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.
You were told you would live til the 40’s back then? I was told I would never live til 30. Ugh the dr that told me that is gone now and I’m almost (in 2 months) 48.
1. To limit your carb intake, or follow a low carb diet?
No, but was a couple of years ago told about “limit the carbs” when looking into pumping, still haven’t been told about low carb diet, which I wouldn’t follow anyway.
2. To limit your intake of fast acting carbs?
No and still haven’t heard it…
3. To rotate sites to avoid scar tissue?
Yes and have never had any scare tissue…yet.
4. To not use a pump because your control was too poor, or too good?
Nope never heard that one until I started visiting this site.
To limit your carb intake, or follow a low carb diet?
After I left WW, which worked for both weight and lowering my BS’s…I was “taught” a low carb diet, at first I gained 10 lbs, and then started cutting out and adding other things than what the dietican gave me. It’s all trial and error, in my book.
To limit your intake of fast acting carbs?
I wasn’t told about “fast acting” carbs until about a year ago, now I watch those very closely, as they go up and then they down, Don’t like that smack down when they quit. Do use them in emergency lows when nothing else is available.
To rotate sites to avoid scar tissue?
Haven’t had to deal with that part of “D” yet, but know from migrane shots that it must be a pretty good idea, because I have a site on my hip that is numb from them using that hip so often.
To not use a pump because your control was too poor, or too good?
I have wondered that about using insulin, period. I have asked about it…not in a pump form, and been told I am too good and don’t need to add that yet. I figure if not now when?
Good to see Ya.