# Confused



## lesley from Chelmsford (Oct 28, 2016)

Morning all..just want to know how long after eating should I test my blood to see if it affects my BG readings...as I'm trying to see what I can and can't have that suits me.


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## Mark T (Oct 28, 2016)

I usually go for 1 hour after, but it depends on what you have eaten.

This might be of interest: http://loraldiabetes.blogspot.co.uk/2006/11/when-to-test-one-hour-or-two-hour.html


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## lesley from Chelmsford (Oct 28, 2016)

Mark T said:


> I usually go for 1 hour after, but it depends on what you have eaten.
> 
> This might be of interest: http://loraldiabetes.blogspot.co.uk/2006/11/when-to-test-one-hour-or-two-hour.html


Thank you..just eaten one slice of toast wholemeal bread


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## Mark T (Oct 28, 2016)

lesley from Chelmsford said:


> Thank you..just eaten one slice of toast wholemeal bread


Do you know what you were before you had the toast?


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## lesley from Chelmsford (Oct 28, 2016)

Mark T said:


> Do you know what you were before you had the toast?


Yes I was 16.1


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## Mark T (Oct 28, 2016)

lesley from Chelmsford said:


> Yes I was 16.1


What I've worked to is that you want the difference between before and after to be less than 4.  Given you were quite high anyway I suspect it might spike higher than this.


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## Lilian (Oct 28, 2016)

It also depends on what you had on the toast.    Butter would make it slightly lower GI.    From my experience I usually spike about 1 hour afterwards.      It is not so much the GI but the GL.


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## lesley from Chelmsford (Oct 28, 2016)

Mark T said:


> What I've worked to is that you want the difference between before and after to be less than 4.  Given you were quite high anyway I suspect it might spike higher than this.


Yes very high this is why I'm trying to see what's best to eat as I'm struggling with this at the moment


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## lesley from Chelmsford (Oct 28, 2016)

Lilian said:


> It also depends on what you had on the toast.    Butter would make it slightly lower GI.    From my experience I usually spike about 1 hour afterwards.      It is not so much the GI but the GL.


I shall do it after an hour thank you for your reply


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## Mark T (Oct 28, 2016)

Lilian said:


> It also depends on what you had on the toast.    Butter would make it slightly lower GI.    From my experience I usually spike about 1 hour afterwards.      It is not so much the GI but the GL.


Low sugar peanut butter is good too.  I found that toasted burgan combined with either butter or peanut butter wasn't too bad for me.  The worst I had was when I had a packet mix porridge which sent me towards the 20's!


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## lesley from Chelmsford (Oct 28, 2016)

Mark T said:


> Low sugar peanut butter is good too.  I found that toasted burgan combined with either butter or peanut butter wasn't too bad for me.  The worst I had was when I had a packet mix porridge which sent me towards the 20's!


I shall try the peanut butter tomorrow....I ate a meat pie yesterday and that sent me up in to the 20s and I panicked it gets me to the stage where I scared to eat


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## Lilian (Oct 28, 2016)

If that was your breakfast Lesley, may I suggest you add some protein to it, or cut out the bread altogether and have say a couple of scrambled eggs, a couple slices bacon and some fried mushrooms.     Instead of the beef being in a pie why not just a beef stew with vegetables.   If you fancy a bit of pastry just have a pastry topping.    Little things like that make a lot of difference.    You don't necessarily have to change the food you like, just adapt it.


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## lesley from Chelmsford (Oct 28, 2016)

Lilian said:


> If that was your breakfast Lesley, may I suggest you add some protein to it, or cut out the bread altogether and have say a couple of scrambled eggs, a couple slices bacon and some fried mushrooms.     Instead of the beef being in a pie why not just a beef stew with vegetables.   If you fancy a bit of pastry just have a pastry topping.    Little things like that make a lot of difference.    You don't necessarily have to change the food you like, just adapt it.


The meat pie was for my dinner I had 6 chips with it and a bit of salad


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## Lilian (Oct 28, 2016)

lesley from Chelmsford said:


> The meat pie was for my dinner I had 6 chips with it and a bit of salad


You did say that the meat pie was your previous night's meal Lesley, but what you have the night before reflects on your blood glucose in the morning.     It does not sound over the top to be 16 in the morning so maybe it is a reflection on something else you had during the day before.     That one piece of toast might have raised your blood glucose by say 4 so if you start with 16 it will go up to 20, but if you started with say 6 it would only have gone up to 10.    So it is the whole picture as well as individual meals / snacks.     It could mean you need the help of a bit more, or different, medication.


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## lesley from Chelmsford (Oct 28, 2016)

Lilian said:


> You did say that the meat pie was your previous night's meal Lesley, but what you have the night before reflects on your blood glucose in the morning.     It does not sound over the top to be 16 in the morning so maybe it is a reflection on something else you had during the day before.     That one piece of toast might have raised your blood glucose by say 4 so if you start with 16 it will go up to 20, but if you started with say 6 it would only have gone up to 10.    So it is the whole picture as well as individual meals / snacks.     It could mean you need the help of a bit more, or different, medication.


It confuses me I am very new to this so probably will take me time to adjust to it all....I'm not on medication yet Dr wants to see if I can manage it my self for the next 3 months...I'm also having trouble getting My sugar levels down in my urine that's a mission on its own


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## Lilian (Oct 28, 2016)

May I strongly suggest Lesley that you ask your doctor / nurse whether there are any EXPERT courses in your area and if so to get you on one as soon as possible.    They are invaluable and are so informative and in such a way everyone can understand.    The principle is the same but one size does not fit all in practice.    To explain everything in one message is impossible.     There is a lot to learn but because the EXPERT course teach you the principles it makes it easier to understand and be able to adapt your diet and way of life to suit your particular body and needs.   I cannot recommend it too highly.


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## lesley from Chelmsford (Oct 28, 2016)

Lilian said:


> May I strongly suggest Lesley that you ask your doctor / nurse whether there are any EXPERT courses in your area and if so to get you on one as soon as possible.    They are invaluable and are so informative and in such a way everyone can understand.    The principle is the same but one size does not fit all in practice.    To explain everything in one message is impossible.     There is a lot to learn but because the EXPERT course teach you the principles it makes it easier to understand and be able to adapt your diet and way of life to suit your particular body and needs.   I cannot recommend it too highly.


I will do that Lillian thank you for all your  help have a nice weekend.


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## Mark T (Oct 28, 2016)

Lilian said:


> May I strongly suggest Lesley that you ask your doctor / nurse whether there are any EXPERT courses in your area and if so to get you on one as soon as possible.    They are invaluable and are so informative and in such a way everyone can understand.    The principle is the same but one size does not fit all in practice.    To explain everything in one message is impossible.     There is a lot to learn but because the EXPERT course teach you the principles it makes it easier to understand and be able to adapt your diet and way of life to suit your particular body and needs.   I cannot recommend it too highly.


That would be nice!  When I asked my surgery and the Diabetes Centre at Broomfield there were not any courses.  Possibly that might have changed in the last 4 years but I wouldn't hold my breath!

Lesley to give you some positives you are doing the right thing with testing.  It took me a few months to build up enough measurements to know what was good and what is bad.  So don't get too wound up about everything right now (because stress sends your numbers higher!).

Personally I think you GP is wrong, as the NICE criteria actually says to go straight to medication if your numbers are high.  But GP's are not specialists, so you can't expect them to know the guidelines inside and out.


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## Lilian (Oct 28, 2016)

It might be helpful to get a book giving carb count.    There is one Carbs & Cals and they have an app called the same for a smart phone if you have one.    For example a small steak pie (244g) is about 53g carbs and 75g chips is 30g so about 80g carbs.    If you had had say a quarter of a large chicken including the skin, with the salad and some real mayonnaise your carbs would have been negligible and you would have felt just as full and for longer, but your blood glucose would not have risen anywhere near and would have recovered quicker.     I do agree with Mark though, I am wondering why they have not given you any medication to help at all.     However when my husband was diagnosed a few years ago they did not give him any medication, he went on low carb diet, cut out bread, potatoes etc. brought his blood sugar down and has had no problem since.   Still on no medication but able to eat a pie now and again, and a bit of cake occasionally, without his HbA1c rising.    In fact we think he is no longer diabetic.


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## grovesy (Oct 28, 2016)

If I was to have a pie I would not have potatoes in any form, just other vegetables!
I would only test your bloods not your urine! The readings in the urine lag behind and would be above 10 in the bloods before showing in the urine!
According to the local CCG website newly diagnosed Diabetics should be offered an education course, I looked on there site recently!


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## Ralph-YK (Oct 28, 2016)

I've two hours after eating for testing a lot. I get a higher peak at 1 hour on a lot of food. Test before as well. That way you can see any changes.

Courses:
There's Desmond course too. Where you are dictates what you get. Some areas have there own provision, instead of either Desmond or Expert.
Nice quidlines say you should be offered something, mentioning things like skills and knowledge to manage your diabetes.

[Edit]. That is: I've heard two hours a lot.
[Edit] *sighs*  I'm blaming autocorrect. The Expert course refered to above should be Xpert I believe


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## trophywench (Oct 28, 2016)

Lesley - it is ALL carbohydrates which increase our blood glucose - not only the sweet tasting ones - sugar itself is merely another carbohydrate.  Hence sugar (and fruit of course has sugar in it in the form of fructose - but your body couldn't care less what type of sugar it is - it still increases your BG) flour (so anything containing flour eg pastry bread cake etc) rice (whether long, medium or long grain) potatoes (every single type) - are the first list of things to cut down on, cos they contain the highest proportion of carbohydrate.

You'll probably see stuff telling you oh bread's OK and so is rice, as long as you eat brown bread and brown rice.  Well is isn't necessarily so at all, it's not that simple unfortunately!  How much of each thing that each of us can manage to eat - will be different - and the absolutely only way to discover what's good or bad for YOU personally to eat - will be your meter results gleaned from testing before and after you eat X amount of that thing and seeing what happens.

Years ago there was an advert for eggs on TV - the slogan was 'Go to work on an egg' - and it's still true - you'll have more energy and remain feeling full for far far longer after eating an egg than from eating a bowl of cereal (whatever cereal it is, including porridge) or toast for your brekkie.  The same applies to any protein, at any time of day. (fish, meat, eggs, cheese - there's also protein in 'legumes' like peas and beans BUT they also have carb in them, so care is needed)

Butter on the toast does slow down it's digestion and thus the speed at which the carb reaches your bloodstream (by which time the body has converted it to glucose) and that's the same thing with 'brown' varieties of flour, rice etc.  It just slows it down so the release of that carb/glucose doesn't happen so quickly which helps somewhat for anyone still producing their own insulin, which you should be at this stage.  However you would still most likely have to cut down the actual amount of it, since the carbohydrate is still there - it hasn't magically disappeared by just keeping its overcoat on!  (a bit like a toddler pretending not to be there - by hiding under the bedclothes LOL)

So protein won't affect your BG and neither will fats or green veg inc cauliflower - whatever you have with them is a matter of choice and testing.

Good luck!


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## lesley from Chelmsford (Oct 28, 2016)

Mark T said:


> That would be nice!  When I asked my surgery and the Diabetes Centre at Broomfield there were not any courses.  Possibly that might have changed in the last 4 years but I wouldn't hold my breath!
> 
> Lesley to give you some positives you are doing the right thing with testing.  It took me a few months to build up enough measurements to know what was good and what is bad.  So don't get too wound up about everything right now (because stress sends your numbers higher!).
> 
> Personally I think you GP is wrong, as the NICE criteria actually says to go straight to medication if your numbers are high.  But GP's are not specialists, so you can't expect them to know the guidelines inside and out.


That's what I thought because the day she diagnosed me I was very high 25.5 she told me to come back to her at the end of January then she will decide whether to put me on meds


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## lesley from Chelmsford (Oct 28, 2016)

Lilian said:


> It might be helpful to get a book giving carb count.    There is one Carbs & Cals and they have an app called the same for a smart phone if you have one.    For example a small steak pie (244g) is about 53g carbs and 75g chips is 30g so about 80g carbs.    If you had had say a quarter of a large chicken including the skin, with the salad and some real mayonnaise your carbs would have been negligible and you would have felt just as full and for longer, but your blood glucose would not have risen anywhere near and would have recovered quicker.     I do agree with Mark though, I am wondering why they have not given you any medication to help at all.     However when my husband was diagnosed a few years ago they did not give him any medication, he went on low carb diet, cut out bread, potatoes etc. brought his blood sugar down and has had no problem since.   Still on no medication but able to eat a pie now and again, and a bit of cake occasionally, without his HbA1c rising.    In fact we think he is no longer diabetic.


That is good news with your husband...I am of all potatoes now and rice and pasta...wholemeal bread seems to be ok for me.


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## lesley from Chelmsford (Oct 28, 2016)

trophywench said:


> Lesley - it is ALL carbohydrates which increase our blood glucose - not only the sweet tasting ones - sugar itself is merely another carbohydrate.  Hence sugar (and fruit of course has sugar in it in the form of fructose - but your body couldn't care less what type of sugar it is - it still increases your BG) flour (so anything containing flour eg pastry bread cake etc) rice (whether long, medium or long grain) potatoes (every single type) - are the first list of things to cut down on, cos they contain the highest proportion of carbohydrate.
> 
> You'll probably see stuff telling you oh bread's OK and so is rice, as long as you eat brown bread and brown rice.  Well is isn't necessarily so at all, it's not that simple unfortunately!  How much of each thing that each of us can manage to eat - will be different - and the absolutely only way to discover what's good or bad for YOU personally to eat - will be your meter results gleaned from testing before and after you eat X amount of that thing and seeing what happens.
> 
> ...





trophywench said:


> Lesley - it is ALL carbohydrates which increase our blood glucose - not only the sweet tasting ones - sugar itself is merely another carbohydrate.  Hence sugar (and fruit of course has sugar in it in the form of fructose - but your body couldn't care less what type of sugar it is - it still increases your BG) flour (so anything containing flour eg pastry bread cake etc) rice (whether long, medium or long grain) potatoes (every single type) - are the first list of things to cut down on, cos they contain the highest proportion of carbohydrate.
> 
> You'll probably see stuff telling you oh bread's OK and so is rice, as long as you eat brown bread and brown rice.  Well is isn't necessarily so at all, it's not that simple unfortunately!  How much of each thing that each of us can manage to eat - will be different - and the absolutely only way to discover what's good or bad for YOU personally to eat - will be your meter results gleaned from testing before and after you eat X amount of that thing and seeing what happens.
> 
> ...


thank you....I am eating more salad and veg now and cut out potatoes all together and testing a lot more food now..I'm on a mission I will do this.


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## lesley from Chelmsford (Oct 28, 2016)

Mark T said:


> That would be nice!  When I asked my surgery and the Diabetes Centre at Broomfield there were not any courses.  Possibly that might have changed in the last 4 years but I wouldn't hold my breath!
> 
> Lesley to give you some positives you are doing the right thing with testing.  It took me a few months to build up enough measurements to know what was good and what is bad.  So don't get too wound up about everything right now (because stress sends your numbers higher!).
> 
> Personally I think you GP is wrong, as the NICE criteria actually says to go straight to medication if your numbers are high.  But GP's are not specialists, so you can't expect them to know the guidelines inside and out.


Thank you mark


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## Lilian (Oct 29, 2016)

Lesley - you can refer yourself it seems.    

*How can I access your service?*
*Referral process*
You can refer yourself or be referred by a healthcare professional, such as your GP, using the contact details below.

*Where and when*
Our programmes are run throughout the Mid Essex area.

Appointments must be booked.

You must be registered before you’re offered a place on the course.

*How do I contact your service?*
Call us on: 01621 727354.

Write to us at: Expert Patient Programme, Healthy Living Department, St Peter’s Hospital, Spital Road, Maldon CM9 6EG.

I suggest you have them a phone call.    Good luck.


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## Ralph-YK (Oct 29, 2016)

Lilian said:


> Write to us at: Expert Patient Programme,


I'm sorry, I thought we were talking about a course for diabetes. I've asked and I don't know of EPP being involved in doing that.
I've done EPP and it wasn't anything to do with diabetes.


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## Lilian (Oct 29, 2016)

We run free courses to help you take control of your long-term health condition.

*What does your service do?*
We run programmes across Mid Essex for people with chronic conditions such as:


Arthritis
MS (multiple sclerosis)
ME (myalgic encephalomyelitis)
COPD (chronic obstructive pulmonary disease)
*Diabetes*
Asthma
Parkinson’s
Depression


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## Manda1 (Oct 29, 2016)

Did you say that your blood glucose was 25 when tested ? Mine was 26 and I was admitted to hospital and put on a drip all night to bring it down. I am now on metformin and gliclazide and these plus diet have got my levels down to average of 7." if I was you I would go back to the doctor for another consultation x


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## lesley from Chelmsford (Oct 29, 2016)

I am making an appointment on Monday Dr hasn't give me any meds was told to wait till the end of January then she will decide and yes I was 25.5 when she tested me


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## grovesy (Oct 29, 2016)

Good luck!


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## lesley from Chelmsford (Oct 29, 2016)

grovesy said:


> Good luck!


Thank you


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## Manda1 (Oct 29, 2016)

Good luck love x let us know how you get on x


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## Ralph-YK (Oct 29, 2016)

Lilian said:


> We run free courses to help you take control of your long-term health condition.
> *What does your service do?*
> We run programmes across Mid Essex for people with chronic conditions such as:
> 
> ...



Is that from here: http://www.provide.org.uk/expert-patient-programme/. Unfortuneatly it doesn't give any information.
That page mentions Challenging-pain workshops and Looking-after-me courses.  The other, main 'course' is the Self Management Course (Expert Patient Programme). Non of these are to do with diabetes, nor cover it.  People with diabetes get to go on them, as opposed to them being for or about diabetes.  The one I went on had a couple of despressed people, a couple of diabetics, heart patients and a couple of other conditions.


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## lesley from Chelmsford (Oct 29, 2016)

Manda1 said:


> Good luck love x let us know how you get on x


Thank you I will do x


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## PinkGrapefruit (Oct 29, 2016)

Whole earth peanut butter is yum on low carb home made microwave muffIns. http://wholeearthfoods.com/

I have this most breakfasts with maybe 8 blueberries, as i can't stomach an omelette at 0630.

I add some ground flax and mixed seed to this:

http://www.wholesomeyum.com/recipes/two-minute-toasted-english-muffin/


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## Lilian (Oct 29, 2016)

Ralph-YK said:


> Is that from here: http://www.provide.org.uk/expert-patient-programme/. Unfortuneatly it doesn't give any information.
> That page mentions Challenging-pain workshops and Looking-after-me courses.  The other, main 'course' is the Self Management Course (Expert Patient Programme). Non of these are to do with diabetes, nor cover it.  People with diabetes get to go on them, as opposed to them being for or about diabetes.  The one I went on had a couple of despressed people, a couple of diabetics, heart patients and a couple of other conditions.



I went on an Expert course that was purely for diabetics.      I guess the best thing is for Lesley to telephone them.     The one I went on actually took us round a local supermarket to show us how to pick the right foods, what to look for on the labels, what consisted of high carbs, what oils are best etc.    We had a session of playing food games, one showing exactly what diabetes is all about etc.    One evening a week for six weeks.    Some are in the day for people who cannot get out in the evening.


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## Lilian (Oct 29, 2016)

Maybe it is these I am thinking of:-    http://www.diabetes.co.uk/education/x-pert.html


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## Lilian (Oct 29, 2016)

Meanwhile Lesley, why not sign up to this - it is free - and watch the 10 videos.   You might find them very useful  
https://www.diabetes.co.uk/lowcarb/


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## lesley from Chelmsford (Oct 29, 2016)

Lilian said:


> Meanwhile Lesley, why not sign up to this - it is free - and watch the 10 videos.   You might find them very useful
> https://www.diabetes.co.uk/lowcarb/


I signed up to them yesterday going to take a look this evening.


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## Ralph-YK (Oct 29, 2016)

Lilian said:


> I went on an Expert course that was purely for diabetics.      I guess the best thing is for Lesley to telephone them.     The one I went on actually took us round a local supermarket to show us how to pick the right foods, what to look for on the labels, what consisted of high carbs, what oils are best etc.    We had a session of playing food games, one showing exactly what diabetes is all about etc.    One evening a week for six weeks.    Some are in the day for people who cannot get out in the evening.





Lilian said:


> Maybe it is these I am thinking of:-   http://www.diabetes.co.uk/education/x-pert.html


I've not been able to get to do Xpert (they stopped doing it in the area next to mine late last year, and my area does Desmond).
From what I know of it, it does sound very much like that's what you did Lilian. And it was this that I was referring to in my first post.
I believe it might be Xpert, not expert. Autocorrect is a devel.


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## Ralph-YK (Oct 29, 2016)

The name of the thread is confused. With all the different courses, and all the advice (and non advice) it is. I hope everyone is managing to work their way through it all.


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## Lilian (Oct 29, 2016)

Yes, you are perfectly correct Ralph - my bad.   It is X-pert.     From what I have been looking at it seems as if Xpert is the generic term covering all the different courses, e.g. DAPHNE  DESMOND and the other one, which looks like the first one I went to for people on diet alone or oral meds.


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## Ralph-YK (Oct 30, 2016)

Lilian said:


> Yes, you are perfectly correct Ralph - my bad.   It is X-pert.     From what I have been looking at it seems as if Xpert is the generic term covering all the different courses, e.g. DAPHNE  DESMOND and the other one, which looks like the first one I went to for people on diet alone or oral meds.


My understanding is Desmond is a different one to Xpert.  Desmond is 2 half days, doesn't include the carbohydrate awareness nor the looking at labels, and nothing about supermarkets.
Xpert is 6 sessions and includes both carbohydrates and label sessions.
In my neibouring area Xpert was replaced with a local provision. I was told because of money.  They dropped the carbohydrates and supermarket/labels. (One was run as a separate session, the other just looking at labels).
All three are completely separate and unrelated (although I was told the local 3 session + 2 separate sessions provided the same info as Xpert)

As for Daphne, I really don't know about that. Other than for type ones and is supposed to provide information on actually using insulin I believe.


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## Ralph-YK (Oct 30, 2016)

I've done Desmond & the local provision. Missed out on Xpert.


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## grovesy (Oct 30, 2016)

The trouble is some of the areas give their courses different names, and they also seem to have slightly different format! I have gleaned this from many years on this forum!


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## Lilian (Oct 30, 2016)

My son went on an X-PERT course at St. Margaret's hospital Epping about a year to 18 months ago (the six week one which included supermarket visit etc).    I went on a booster course about carbohydrate adjusting and various insulins earlier on this year, at the same place.      A few months ago the diabetes nurse told me I could refer myself again at any time if I feel I need to.    There were choices of other places to go to but the one in Epping suited me better timewise.


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