If UK’s leading diabetes charity wants better care for diabetics, it should start by getting its own house in order

Baroness Barbara Young is the chief executive of the UK’s largest diabetes charity – Diabetes UK. She’s been on the warpath recently, calling the UK Government out on a ‘lack of political will’ to do something about substandard testing and care of those with diabetes. Baroness Young has this week performed something of a media blitz, appearing on radio and television to raised awareness regarding the plight of those with diabetes. Here’s an except from an item about this that appears on Diabetes UK’s own website.

Health professionals are constantly telling us how frustrated they are about the constraints the system places on them and we want the Government and the NHS to give them the tools they need to provide the excellent care that people with diabetes deserve. It is time to stop just talking the talk on diabetes healthcare and start walking the walk.

I don’t have any issue with Baroness Young’s desire for those with diabetes to receive the best care possible. But, if she really would like more of us to ‘walk the walk’, then I suggest she starts with some of the dietary advice dispensed by her own charity.

Here’s a link to Diabetes UK’s ’10 steps to eating well’. Some of the advice is good, but one piece of advice is especially bad, I think. It is this:

2. At each meal include starchy carbohydrate foods
Examples include bread, pasta, chapatis, potatoes, yam, noodles, rice and cereals. The high fibre varieties of starchy foods will also help to maintain the health of your digestive system and prevent problems such as constipation. The amount of carbohydrate you eat is important in controlling your blood glucose levels.

My objection is this: diabetics’ primary problem is that they tend to run blood sugar levels that are too high, and this can lead to complications such as eye disease and blindness, nerve damage, kidney disease and the need for amputation. Proper regulation of blood sugar is important. Why then, would diabetics be advised to include foods at every meal which are known to be generally disruptive for blood sugar?

What important nutrients in starchy foods such as bread, rice and pasta that cannot be gained more healthily elsewhere? Answer: there are none. The advice tells us that:

The amount of carbohydrate you eat is important in controlling your blood glucose levels.

 

And Diabetes UK are bang on the money here. The more carbohydrate people eat, the higher blood sugar levels tend to be, and the greater the need for medication and likelihood of complications. I’ve lost count of the number of people who have seen dramatic improvements in their blood sugar control and need for medication by cutting back on or cutting out starchy carbohydrate from their diets. The effects are consistent and predictable.

If Baroness Young wants diabetes sufferers to get better care, I reckon she should start with getting her own house in order.

50 Responses to If UK’s leading diabetes charity wants better care for diabetics, it should start by getting its own house in order

  1. f_watt 23 February 2012 at 3:35 pm #

    I have a friend with diabetes, but have been too afraid to tell him to give up starchy carbohydrates – his doctor has not recommended it. He is very overweight though, and eats carbohydrate in great quantity. To a diabetic person, would you recommend cutting down gradually, or going cold-turkey?

  2. Asclepius 23 February 2012 at 8:02 pm #

    Follow the money. How many people make money from the diabetes business (including charities and pharma)? My dad used to tell me a story about the man who invented the ‘reuseable match’. Business was good for the first year! I don’t think Dieabetes UK will make the same mistake.

  3. John Walker 24 February 2012 at 10:21 am #

    When you think about it, aren’t most of these diseases/conditions merely ‘managed’. Diabetes, hypertension, angina, kidney malfunction, etc.. The list goes on. Instead of ploughing millions into prescription drugs for these conditions, wouldn’t it benefit the NHS more if they expended some of that money on finding cures or preventions? Of course I realise the giant drugs companies wouldn’t like that, but I really don’t suspect they have any influence of financial interest, one way or the other! Really? Not much! Before we know it, they will convince the Government to force feed us statins, via the water supplies, just as they do with fluoride. Disgusting I call it!

  4. John Walker 24 February 2012 at 10:25 am #

    To the person with a friend who has diabetes, buy your friend one of the many books on ‘bread’ and ‘wheat’ . let him read it, and then discuss with his Doctor. I am slowly giving up bread! I don’t want diabetes, type 2 or type 1… or any other type.

  5. Anders 24 February 2012 at 12:30 pm #

    At last someone has said it! Dr Briffa is my hero! I’ve been diabetic for 47 years and in all that time the BDA have been giving wrong dietary advice.
    I also have a problem with their research projects, but that’s another story.

  6. Jane Dawson 24 February 2012 at 12:50 pm #

    All of my diabetic testing kit is supplied by the drug company Roche, as are a lot of the medications and I believe they sponsor the Diabetes UK website. Doesn’t that say it all ?

    It’s absolutely outrageous to give advice that will make diabetics worse – but of course they have no interest in making them better.

  7. Linda Collier 24 February 2012 at 1:25 pm #

    Or show f.watts’s friend John’s blog site!

  8. Surrey Nutrition 24 February 2012 at 3:46 pm #

    Totally agree with you. Managing the intake of starchy carbohydrates is the key. When will these organisations get the message that sugar is the enemy?

  9. Tom McAnea 24 February 2012 at 3:57 pm #

    As a GP I’m often counselling diabetic patients re lifestyle and reducing risk of complications. I talk about glycaemic index and specific food effects on insulin and blood glucose. My question is, why does the ‘conventional’ advice persist in offering this view (of regular CHO) , rather than talking about how disruptive CHO can be on blood sugar?

  10. Frederica Huxley 24 February 2012 at 6:34 pm #

    As an aside, what about pushing ‘low fat’ and diet sodas and foods on diabetics? Just a wee bit counterproductive.

  11. jayney goddard 24 February 2012 at 7:33 pm #

    I’ve been spitting (lo-carb) feathers all week about this too. Erring on the side of kindness, perhaps the thought that med students get such a tiny amount of time spent on nutrition means that their appreciation of it’s overwhelming importance to health is compromised? Dr Briffa is of course a notable exception, however most docs, med students and (shockingly) diabetes nurse specialists I talk to have no understanding of the complexities of diabetes – or indeed any great appreciation of the differences between the various types. They certainly have little understanding of the role of diet and lifestyle in the management of the conditions that come under the ‘diabetes’ umbrella. So, this is probably an urgent medical educational issue. Diabetes – particularly type 2 – is a ticking time bomb which has the full potential to bankrupt the NHS in a few short years, if action is not taken to change people’s lifestyles. The tragic thing is that type 2 is treatable – in a very short time.

  12. Katherine 24 February 2012 at 7:36 pm #

    I have diabetes, Type 1, and if I cut carbs out I lose too much weight. We’re not all unhealthy, overweight, over eaters! I’m also vegetarian, so how do I keep weight on without loading up on fats or keeping lower glycaemic carbohydrates in my diet? Counting carbs is how most diabetics figure out how much insulin to use, it can still be low dose if you watch what you eat.

  13. Trish Cherry 24 February 2012 at 7:38 pm #

    I wrote to these people 12months ago to say why I did not want to renew my support of them. For all the reasons that you mention here. They replied that they would change their advice until the NHS said to and until the Carbohydrate thing is proved. I have not renewed my support of them. My husband has Type Two D and because I follow the Harcombe Diet I know what to give him. His Diabetic Advisor said that My husband is in very good condition considering that he has Type 2 And also CPD and when we showed her what he eats she said that she wished she could get other patients to eat like that. It really is time for the Medical Authorities to look into this whole Starchy foods thing.

  14. terry 24 February 2012 at 7:55 pm #

    I’ve been recently diagnosed with Diabetes 2. I went along to a NHS presentation, where they do indeed say that moderate amounts of carbs are OK.
    I now eat brown wholemeal/organic bread as a staple. I’ve cut down my sugars drastically and moved over to substitutes… If I cut out starches totally , I feel hungry all the time, never feel “full”… What the hell can I eat? So essentially, it’s get rid of processed ‘white foods’?
    Is there any definitive web site out there with quality advice available? I’ve even seen some sites claiming D2 can be reversed by a raw diet – or gastric band surgery!

  15. Stella 24 February 2012 at 10:04 pm #

    Hallelujah! I have been saying this for years, yet my sister’s NHS ‘diabetic specialist dietician’ still tells her to eat high carb!!!!!!!! When I was at school our home economics (food technology) teacher demonstrated the sweetness of bread by getting us to hold a small cube of bread in our mouth and wait for a few minutes to show how it changes to glucose…..give it a try…..you would almost think it had changed into a cube of sugar.

  16. Ronnie Plant 24 February 2012 at 10:59 pm #

    Diabetes UK is supposedly a charitable organisation. How can this be so? Visit their A G M or other meetings and note that the running of the ‘CHARITY’ has been hijacked by the Pharma Chemical Drug manufacturing industry and the medical profession. Where do vested interests begin or end?

  17. Neil 24 February 2012 at 11:15 pm #

    For Terry who needs some quality advice. Have a look at this website, I think you will love it.
    http://www.diabetes-warrior.net

    Neil

  18. Deborah 25 February 2012 at 1:22 am #

    As a child, in the 50′s, I remember a diabetic friend of my parents refusing potatoes bread etc, then 30 + years ago my nephew, aged only 1 yr, was diagnosed as diabetic. The dieticians of that time, in East Anglia, said give the child virtually no carbohydrate but he he could have as much meat fish eggs vegetables and fruit as he wanted. At the time that is pretty much what my family ate anyway. When did this sensible advice change to the complete opposite with such disastrous consequences?

  19. frances 25 February 2012 at 2:17 am #

    Katherine…There is a book called Nourishing Traditions by Sally Fallon that you might find helpful..it has become my bible for eating. You can find it on Amazon cheap enough. Frances

  20. John Walker 25 February 2012 at 10:09 am #

    Katherine…
    I don’t think anyone would suggest you overeat, and are obese just because you are diabetic. As far as I know I am not suffering from diabetes, but I am overweight. (I don’t need a BMI test to tell me either! I just loo in a mirror) So I gave up sugar and starch. (More or less) Special occasions, I might have a spud or a round of bread, and I never did eat rice, except as a pudding. You choose to be a vegetarian, then you must be eating more carbs of one sort or another. I don’t know where you can get your important minerals from, but probably you do know. The weight is another issue, but perhaps the book mentioned above might help. You won’t have to eat it! :) Good luck.

  21. Dr Shirley Mcilvenny 25 February 2012 at 1:17 pm #

    If you’re frustrated with the lack of ‘evidence based medicine’ regarding carbs and diabetes just look at Barry Marshalls story. It took him 20 years to convince the medical establishment that Helicobacter P. was responsible for ulcers – he was laughed out of many conferences before his research was accepted and eventually received a Nobel prize. We are having great success with low carb diets and diabetes and replacing them with healthy fresh veggies, healthy oils and protein. We will prevail – it’ll willl just take a bit more time

  22. John Walker 25 February 2012 at 3:16 pm #

    Doctor Shirley,
    I wish I had your confidence.
    Even in BBC fiction, the ‘Fat is unhealthy’ myth is being pumped. (‘Hustle’, the penultimate episode.) I know this is escapist fiction, but the message is clear. Fat is BAD.. Until the Established ‘authorities’ recognise this for the myth that it is, people will continue to be ‘poorly’ and bullied into believing it’s their fault for eating too much. Even Jasper Carrot scathed obese people by ‘cracking a joke’. ‘I’ll tell you why you’re fat… You eat too much.’ He got the biggest round of applause on the night! Which shows the state and extent of current popular belief. I suppose Carrot isn’t slim because of his genes? Hmmm! I wonder how much he eats, and if he knows the truth. Maybe it’s been a ‘Celebrity’ well-kept secret, that low carb is the way! :D)

  23. PeggyC 26 February 2012 at 1:24 am #

    Katherine, My son is type 1 and manages his weight and blood glucose very well by eating mostly meat, eggs, fish, cheese, and non starchy vegetables. He rarely eats bread, pasta or any other of the carbs that spike glucose. I would think being a vegetarian and type 1 is a recipe for disaster down the road. You might want to rethink. Check out Dr. Richard K. Bernstein’s website and book. He has been type 1 since he was 12 and is now in his 70s, I believe. No offense to Dr. Briffa (with whom I totally agree on this and most issues), but Dr. Bernstein probably knows more than anyone about how to control blood sugar and avoid the nasty complications that can happen to a diabetic.
    Dr. Briffa, Sad to say this problem is not only in the UK. Here in the U.S. diabetes “experts” and the ADA are constantly pushing carbs and telling diabetics to make sure they eat their carbs at every meal. A couple of idiots who should know better published articles in which they said diabetics should eat the same high (45-65%) carb diet that everyone else does. And in India, where my brother lives, it is the same. He went with his diabetic GF to her doctor, who specializes in diabetes, and he had the ADA pamphlet handy and advised her to eat a plenty of carbs. Luckily my brother knows better and is initiating a dialogue with this young doctor, who professes to have an open mind. Let’s hope he does!

  24. Dr John Briffa 26 February 2012 at 10:39 am #

    Peggy C

    No offense to Dr. Briffa…but Dr. Bernstein probably knows more than anyone about how to control blood sugar and avoid the nasty complications that can happen to a diabetic.

    No offence taken, and I think you’re right about Dr Bernstein.

  25. mamaprophet 27 February 2012 at 9:32 pm #

    Terry.. perhaps if you eat more protein you will feel fuller therefore you won’t need to eat so many carbs.

  26. helen 28 February 2012 at 10:17 pm #

    http://www.diabetes-solution.net/
    the information on this web site is all any diabetic needs ………..enough said
    and type 2 diabetes is totally down to over consumption of carbohydrates.

  27. John Walker 29 February 2012 at 1:28 pm #

    ‘The Truth About Exercise’, (BBC 2, 28. Feb 9pm) promised to be interesting. Dr. Moseley rarely disappoints, but this time he did. He showed us some interesting facts about exercise and some revealing new ideas, but the FAT is BAD for you message was still being pushed out loud and clear. If qualified Doctors and researchers won’t accept the truth, then who will; and when will anything ever change? Now scientists are discovering how to ‘grow’ edible meat in the laboratory, from stem cells, what’s the betting that eventually, they will be ‘making’ low-fat meat? Sometimes I am relieved I am at the short end of life!

  28. mamaprophet 29 February 2012 at 5:26 pm #

    John Walker, I totally agree, I was so frustrated about the fat issue, when are the professionals going to see the truth, how much more evidence do they need, everyone agrees there is an epidemic of obesity in America can’t they see that their advice is not working.

  29. John Walker 29 February 2012 at 5:58 pm #

    Indeed! I try not to ‘scream’ at the Television set, but it takes enormous control! :)

  30. LynLev 1 March 2012 at 9:09 pm #

    Tom McAnea said:
    “My question is, why does the ‘conventional’ advice persist in offering this view (of regular CHO) , rather than talking about how disruptive CHO can be on blood sugar?”

    Maybe the answer is that there are so many vested interests now – the low fat advice and products would need to be thrown out, as low carb must be high fat to keep the calories up. Mind you calories are another hotly debated issue in some quarters.
    Also there might be many law suits against governments by people who took their advice and who got fat on the low fat diet or worse still got type 2 diabetes along with many of its worst outcomes like obesity, kidney damage, blindness and amputations.
    I am a type 2 diabetic low carb vegetarian and have kept my HBA1C levels to 5.5% on this diet. I try to keep to 20 gms of carb per meal – give or take. It takes time to develop a range of meals but there are plenty of recipe books now around for low carbs – I just check the carb levels for each dish as some are not as low carb as I need.
    The best advice I found was on http://www.bloodsugar101.com/ there is a book, blog and facebook page to go with the site.

  31. Rosy 3 March 2012 at 1:06 am #

    I so agree. My husband has had type 1 for46 years. His attempts (aftermuch pressure from Diabetes specialist nurses in worthing area) to use nw CHO counting led to his fist near hyp and vomitting attack in a public place today. Diabetes UK does nothing to support Diabetics with fighting systems which ay not suit their individual work lifestyle. They also ignored y complaint email 3 months ago about their lack of action concerning discriminatory new laws regarding driving licences fr people with diabetes. Their website is even more user friendly for professionals than ordinary people who fund their organisation in the 1st place.

  32. Andrea 5 March 2012 at 6:44 pm #

    Great to hear Dr. Briffa on the radio in discussion with a dietician. She sounded distinctly uncomfortable and offered no clarity to Diabetes UK stance on CHO.

  33. Barbara 5 March 2012 at 8:06 pm #

    I have just heard Dr. Briffa on the radio today and I could weep with happiness at his comments. I have believed for ages that the ‘healthy’ carbs in my diets are contributing to my inability to control my glucose levels. When I try to discuss this with the diabetic nurse she just dismisses my worries and never listens. I’m due to see her in 20 minutes and this time I won’t be browbeaten into shutting up about what I think!

  34. Dina 5 March 2012 at 8:44 pm #

    Sadly, for some reason this episode of You and Yours is not available on iPlayer. Does anyone know where it might be possible to hear it, or is there a transcript available?

  35. Dina 5 March 2012 at 8:53 pm #

    I appear to be wrong about the iPlayer! I am about to listen to it now…

  36. Trish Cherry 5 March 2012 at 10:21 pm #

    The thing is though that you can really please yourself what diet you follow. I believe wholely in the low carb stance, the only way to prove it is to do it! Try it now until your next appointment, then see the nurses face when your sugar levels prove you are right! You have every bit a right to eat what you believe in as those who waste the nurses time not doing anything about their weight or sugar problems. I have my husband on a rationed amount of carbs, and our nurse says that she wishes a lot of her other patients would co operate like we do. In reality he/she doesn,t mind at all what you are eating as long as they see positive outcomes. The only way to get the message accross is to show them that it works! The proof of the pudding!!!!

  37. Emmeline1 6 March 2012 at 4:35 pm #

    I heard the debate on You and Yours on 5/03/2012. I can’t tell you how pleased I was to hear this important discussion on national radio. The Diabetes UK dietician was unable to defend her own organisation’s very weak argument! I read Dr Bernstein three years ago and after 27 years of Type 1 diabetes and a carbohydrate-rich diet, I made the change to a restricted carbohydrate diet and haven’t looked back. I had the obvious results: a reduction in insulin requirements, some weight loss and most significantly fewer hypoglycaemic episodes. Less insulin = less chance of hypo – it’s a complete no brainer. I agree that DUK’s advice is so unhelpful as to be unethical: why would anyone prescribe carbohydrate to people who cannot metabolise carbohydrate? Unfortunately it is not only DUK but the vast majority of NHS dieticians and doctors who continue to do this. Let’s hope that the debate stays alive until they admit they are wrong!

  38. Dave 6 March 2012 at 7:10 pm #

    If you want to hear the interview, try this:
    http://www.bbc.co.uk/programmes/b01cvk8g#p00pr23q
    Keep on keeping on Dr Briffa – you’re a star!

  39. Stella 6 March 2012 at 11:25 pm #

    I was very impressed with you Dr Briffa! The dietitian was so unprepared it was rediculous, so many ‘er, um,’ and a lot of incomplete sentences from her. Keep up the good work!

  40. terry 9 March 2012 at 12:31 am #

    i heard the broadcast on radio 4 and immediately changed to a low carb diet. Today my blood sugar reading has reduced considerably and hopefully will reduce further. It is so obvious but has been confused by being told it is necessary to have starch with each meal.

  41. Bobbydean 13 April 2012 at 6:18 pm #

    I don’t know where tp ask this. Dr B what are your thoughts on Victoza.I live lo carb paleo cant lose weight, have good bg control on halin n but it stops me from losing weight. Dr wants me to try Victoza?

  42. John Walker 13 April 2012 at 8:38 pm #

    That nutritionist was completely lost. Ill-prepared, not briefed, and completely at sea. Not surprising really.When evidence is scant, plain wrong and gleaned from bad studies, they can’t defend their stance. I feel sorry for them. To them, and anyone else who believes carbohydrates are a prime energy source, and better than fat, I would ask one thing. With all the new evidence, and all the controversy, doesn’t it even enter your minds to consider that you might be wrong?’

  43. Dina 13 April 2012 at 9:57 pm #

    I too have problems losing weight on a low-carb diet, but I assumed it was because I am on hypertension drugs (Atenolol and Liprisinil). I did really well on Atkins, but that was before I started these medications. I am prepared to make whatever changes are necessary, and I’m hoping that eventually I will be able to come off the drugs, but it’s a bit of a vicious circle…What is the answer?

  44. Dina 14 April 2012 at 12:56 am #

    I’ve just been doing some more reading, and apparently Allen and Lutz in “Life Without Bread” suggest that people over 45 and/or women may not benefit so much from a low-carb diet. As I fall into both those categories, O would be interested in Dr Briffa’s comments, and also those of the community on here…

  45. John Walker 14 April 2012 at 1:30 am #

    Me too Dina, but it is going. And the last time I had the Doc check, she thought her BP machine was faulty. When I explained I had lost 28 lbs she realised why my BP was down. She asked how I’d managed it. I told her I was ‘watching what I eat’! Which is true, but not in the way she would think. Her response was ‘Ahh… Cutting down on the fat and the calories then?’
    ‘Something like that!’ I said… I don’t think she’d have been pleased if I’d told her the full truth. She didn’t reduce or change my meds though.

  46. PhilT 27 April 2012 at 9:05 pm #

    Barbara Young appeared today on Radio 4 You and Yours http://www.bbc.co.uk/programmes/b01ghdnn and when asked by a phone-in caller why they didn’t promote low carb high fat diets for diabetics she floundered badly, just like the nutritionist that appeared against Dr John. They obviously haven’t learned and I bet someone will be getting nailed to the wall when she gets back to the office !

  47. Reb. Calland-Brereton 4 January 2013 at 10:03 pm #

    I came across this debate page whilst looking for an email address for the Diabetes charity. I wanted to inform them that I had just completed an 800 km walk and wished to donate the sponsorship money to their charity. There are five members in my family who are diabetics, which was a big enough incentive for me to walk ‘The Camino,’ France – Spain. Reading the above comments I am sad to say that I am no longer sure that I want to donate this hard earned money to this charity.

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