Nutrition For Blokes

Over the years since diagnosis I learned from many people. I have mentioned some here in past posts, particularly Jennifer, who wrote the Test,test,test advice, and Quentin, who is a guy in New Zealand who wrote on alt.support.diabetes with an amazing knowledge of the various foods that are good for us, which micronutrients are available in different foods and how they can help us.

Unfortunately, in 2005, Quentin had a second diagnosis some years after his type 2 was diagnosed. He has an aggressive form of multiple myeloma, a terrible condition which he has found is unaffected by diet. Despite that he is defying the odds and he is still with us, although he is very ill. My wife and I spent a pleasant afternoon and evening with him in early 2006 when we were on a holiday to the North Island. He was happiest when showing us around his small but very productive garden, describing the fruits and vegetables he was growing and what their benefits were.

After that diagnosis many of his friends urged him to write a book on nutrition. It was published earlier this year, with a very limited circulation in New Zealand; a few of us in other parts of the world also bought it direct from him. He aimed it at men in his country and titled it “Nutrition for Blokes”. I bought my own copy from Quentin as soon as it was available.

A friend of mine, Jenny Ruhl, has just let me know that Quentin’s book is now available via the web. If anyone is interested in obtaining it, here is the web-site: Nutrition for Blokes



Just for the record, I have no financial interest of any sort in Quentin or his book. However, I thoroughly recommend his book to all, not just to "blokes".

Cheers, Alan
Everything in Moderation - Except laughter

Be Smart, Be Skeptical

The internet is a wonderful and empowering tool for us in this modern age. I am very grateful that it was available to me as a source of knowledge when I first decided to learn about diabetes. There is no way I would have been able to educate myself in the same way from courses, libraries and local support groups. Apart from the time involved, I simply would not have had the motivation to go out and find all of those sources. The internet made it simple and easy. However, the net also has it’s dangers. All of us realise that there is a lot of nonsense on the web and that we must filter the good from the bad. However, sometimes that becomes more difficult when we are reading "real people" on support forums.

On medical support forums there is a tendency to accept all new people as genuine. When someone arrives telling their story, or seeking help, our natural reaction is to believe them and offer our support and assistance or accept their story of success or woe.

Over a few years of wandering the web and the net, reading and posting on medically-oriented groups, I have found that cyber-space has a population of fringe-dwellers; kooks and fanatics who have discovered their divine purpose in life is to convert us to their own beliefs. That belief can be a cure for all our ills with herbal potions or vegan diets or magnetic rings or even stranger gizmos; or the one true religion; or the dangers of ingesting everything from artificial sweeteners to drinking water to eating meat.

Often they are easy to pick. The most common are dupes of snake-oil salesmen; either trying to convince others to reassure their own wavering beliefs, or sucked into yet another multi-level-marketing scheme for yet another wonderful cure. As the FCA warns us, Be Smart, Be Skeptical (click on any link after you've read the opening page). However, sometimes they are more cunning or devious, using search engines to alert them whenever key words appear on the net. For example, if you post a message to your favourite web forum with "aspartame" or "stevia" in the title or text you have a pretty good chance of getting a response quickly telling you of the terrible dangers of the first or the wonderful benefits of the latter. Usually from someone who has never posted to your forum before.

Similarly, if you include "PCRM" or "PETA" or "Vegan" or "Dr Neil Barnard" or "McDougal" in your title or text you can almost guarantee that a new person will arrive, usually in a separate thread, giving a glowing report of the benefits of a Vegan diet. They may remain for a week or two, then they disappear forever. Until the next time those words are used and another new person appears. Almost certainly the person posting is a figment of the author’s imagination, created to spread the word.

I have used the anti-aspartame and PCRM kooks as examples, but there are many others.

There is so much of value we can learn from the net, but always treat free medical advice as worth the price you paid for it until you have checked it with your doctor. For all other advice on the web use your common sense and logic.

Be smart, be skeptical.

Cheers, Alan

How Often Should We Test?

Over the past few years there have been some truly abysmal scientific research papers published on the futility of frequent self-testing by type 2 diabetics. Three that come to mind are The Fremantle Diabetes Study from Western Australia, Self-monitoring in Type 2 diabetes: a randomized trial of reimbursement policy from Canada; and Impact of self monitoring of blood glucose in the management of patients with non-insulin treated diabetes: open parallel group randomised trial from the UK.

All of these papers have three things in common: they were published in countries where the government subsidises test strip supplies to diabetics, and thus has an interest in cutting health budget costs; they considered testing more than once a day to be "frequent"; and they did not educate the subjects being studied on how to interpret test results with a view to adjusting their lifestyle to improve results. I previously discussed the UK paper by Farmer et al in Self-Testing and Type 2 Management a year ago. Those same comments apply to all those papers.

The ignorance of the mainstream medical establishment concerning the benefits that can be gained from systematic self-monitoring of blood glucose appals me. Worse than that, many doctors and diabetes educators seem to feel that "obsessive" testing is much more dangerous to our health than the possibility of amputation, blindness or kidney failure so they actively discourage newly diagnosed diabetics from testing more than a couple of times per day - and usually only for fasting or pre-meal.

That fear of obsession is misplaced. I believe that it is partly due to two things. The first is the ignorant assumption that extra tests only lead to extra worry. My experience has been that, after newly-diagnosed type 2s discover that they can actually improve their test results by modifying their diet or lifestyle, worry is reduced. Action conquers fear. To me, the tests that lead to worry are those ordered by the doctors; the tests their patients do religiously for fasting and pre-meal that tell the patient nothing and that the doctor barely glances at during the next consultation.

The second reason is the equally ignorant assumption that those doing the extra tests will continue doing them frequently forever.

I always test with a purpose, to either learn or confirm knowledge. When I first read Test, Test, Test I put it into practice - totally. For a short period I tested before EVERY meal and snack, then at one hour after the last bite and then at two hours. On some days I tested over 20 times; that period also taught me how to achieve Painless Pricks.

But that was just the start. Very quickly I found that some tests became very predictable. I quickly dropped my pre-meal tests as unnecessary when I could predict them with good accuracy. Then, as I discovered that my own peak post-prandial time is one hour after I finish eating, I dropped the two-hour tests unless the one-hour was unusual. Within a couple of weeks I was testing fasting and my peak post-prandial after every meal or snack, usually 6-8 times daily.

With time those tests became predictable too, as I slowly modified my diet from disastrous (as taught to me by the dieticians) to low-spike using Test, Review, Adjust. Within a few months I was testing only 1-4 times daily.

Now that my personal data base of food BG effects is fairly comprehensive I only test for "maintenance", to check that things haven't changed. For several days I may not test at all, others I may test 3 or 4 times if trying a new recipe or menu.

I consider the invention and development of the blood glucose test meter one of the true miracles of modern science for diabetes self-management; a wonderful benefit for all diabetics. But, sadly, after over three decades of continual development and improvement of meters the medical establishment still has not come to terms with the correct ways to educate patients in their use.

Cheers, Alan
Everything in Moderation - Except Laughter