# diabetes nurse increasing carbs due to weight loss



## riche1972 (Oct 21, 2014)

Hi Everyone,
I am a carer for a man with learning difficulties and he displays aggressive behaviours.
He was diagnosed in January this year with Type 2, i have had him on a healthy low carb, low fat diet and taking metformin.  His agressive behaviours had decreased.
His weight has continued to fall, so the managers are panicking!
They have spoken with the diabetes nurse who has told them to feed him an extra three snacks a day inc crisps, crumpets, teacakes, cereals and sausge sandwiches! his aggressive behaviours are escalating!
That cant be good for him, can it??? i will point out i live with a insulin dependent type 2 diabetic, so am well versed in carbs!!

Confused!


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## Northerner (Oct 21, 2014)

Hi riche, welcome to the forum  I would absolutely agree with you that the advice is nonsense. Such a diet will just push his blood sugar levels up and down all day and this will have a very detrimental effect on his moods and overall health 

What may be better to consider is a low-carb, high fat diet, rather than low fat. Many studies are now showing that fat is not the danger to health it has been portrayed as for so long, and it is in fact carbohydrates (particularly of the type 'recommended' to your patient) that will have a much greater impact on health.

Can you seek help from a dietician, rather than the diabetes nurse? She sounds as though her knowledge is not very up to date, unfortunately


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## riche1972 (Oct 21, 2014)

The problem is no one will listen to me!! 

I run the unit he is in but the managers make the decisions, they do not understand what the extra carbs will do to him, I know he's losing weight but he's very active! 
He was having a large bowl of porridge b/f, roasted veg with couscous and chicken lunch, cottage pie with swede and carrot mash dinner ( two snacks of a banana and a yoghurt).

However, now they have intervened he's eating all the extra carbs I explained above, including Skips (sugar!!!) tea cakes and cereal mid afternoon!  I cannot believe what I am witnessing!


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## KookyCat (Oct 22, 2014)

What if you suggested a written diet plan pilot.  So if he's losing weight, and they're concerned it would suggest his net calories are lower than his needs, especially if he's very active, which as Northener said might be the low fat component.  It would be a lot of work at first but if you could analyse the calories his previous diet had and then add in healthy snacks with more fat (nut butters, avocado and other healthy fats) to show an increase in calories without altering the saturated fat too much, might they be persuaded to let you pilot the new diet to prove his weight will stabilise without the extra carbs?

It's very tricky of course because I imagine they're concerned about the weight loss and taking the advice of a medical professional seems like a good idea.  However, I hope they're also concerned about his general well being and clearly having more stable moods is much better for his quality of life.  Would a food and mood diary be helpful?  Many years ago I did voluntary work with children with severe behavioural issues and they all had food and mood diaries because the lead psychologist was very attuned to the effects of food on their behaviour.  So basically it was a diary with foods eaten and then any issues with behaviour with times noted for both.  Unsurprisingly sweets, caffeine and refined carbs tended to correlate highly with poor behaviour for most of the kids.  I was thinking it might help you to demonstrate that his moods correlate with carb intake.

Good luck with it, I'm glad he has you in his corner, many vulnerable people don't have such good support


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## Northerner (Oct 22, 2014)

Just another thought: you say he is losing weight and they are concerned about this, but is he actually underweight? Do you know what his BMI is? Something else to consider is that feeding him extra carbs that make his blood sugar levels high might actually cause him to lose more weight, as he would be peeing the excess sugar out in his urine 

KookyCat's suggestion sounds very good


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## riche1972 (Oct 22, 2014)

Thanks for the replies!  I like your idea Kooky  cat and I am determined to keep fighting his corner. 
Northern that is exactly what I thought!  I think his blood sugars are out of control so hes losi g more weight.  Sadly if he ends up being finger pricked etc he will end up in hospital care due to his aggressive behaviours...sad really.


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## HOBIE (Oct 22, 2014)

Well done for bothering to try & look after him  It sounds very right what you are doing & it shows how much ignorance there is still about(your bosses). Really good luck .


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