http://www.ndruthsebastian.com/

Ruth Sebastian, Birmingham (2025)

14/11/2023

A day to talk about Diabetes more than any other.
There continues a lot of progress on treatment, education, research, and specialised Healthcare Professionals.

I bring the diagnosis topic, which becomes more evident when dealing with complex cases, with very high insulin resistance, unusual presentation at diagnosis, early complications... as just some examples.

What types of diabetes do we know?
- Type 1: autoimmune disease
- Type 2: due to advanced age or lifestyle related.
- Type 3: due to trauma or resection to the pancreas.
- MODY: other genetic forms
- LADA: similar to type 1 but of slower progression.

But... not all patients with type 2 diabetes are the same. We know that multiple genes are involved. And we also see that insulin production, insulin sensitivity, and other aspects of the system can be more dysfunctional in some presentations than others, meaning treatment needs be personalised. Five subtypes were proposed in 2018, as detailed in the following article;

E. Ahlqvist, P. Storm, A. Karajamaki, M. Martinell, M. Dorkhan, A. Carlsson et al. March 2018. Novel subgroups of adult-onset diabetes and their association with outcomes: a data-driven cluster analysis of six variables. The Lancet Diabetes & Endocrinology. Volume 6, Issue 5, p361-369. DOI: https://doi.org/10.1016/S2213-8587(18)30051-2

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10/11/2023

They can help, as part of a holistic plan with lifestyle changes.
🇪🇸
Inyectables para la pérdida de peso.
¿La solución final?

Recientes estudios muestran que tras parar las inyecciones, el peso se recupera.

Pueden ayudar, como parte de un plan holístico y cambio de hábitos.

03/11/2023

🇬🇧All healthcare professionals are involved in teaching colleagues and students. It is a basic part of our job.

I've seen all... from amazing places that make everyone feel welcomed and an important part of the team... to places where blaming, team-division, lies and manipualtion were at the core.

If we're not part of the change, we remain part of the problem.

🇪🇸Todos los profesionales sanitarios contribuimos a formar compañeros y estudiantes. Es una parte esencial de nuestro trabajo.

Lo he visto todo... desde sitios maravillosos que hacían a todos sentiese en casa y parte importante del equipo... hasta sitios donde culpar, división de equipo, mentiras y manipulación eran la base.

Si no somos parte del cambio, continuamos siendo parte del problema.

31/10/2023

If you are not motivated or disciplined enough, don't give up. It is okay if you failed before many times. Find ways to achieve success on your goals. Having others' support is often a resource we can use, either a friend, relative or colleague, or a professional service, like a sports coach, dietitian, psychologist, smoking cessation professional, or others, depending on your personal goal.

"Thank you, , for helping me reduce by 5 min my 10km distance in 2 months.

I know I am not the ideal runner... I often miss training or want to do less of whatever is in the plan.

But your positive attitude, insistence, regular messages reminding me of training, and your huge patience have allowed me to achieve my record and do well in the races.

شُكراً وَجيد!! 😀💪 "

25/10/2023

Recent sturdy research has tossed away something that is believed by many.

It was believed but not backed up by research, it was based on hypothesis.

I repeat again and again, we (healthcare professionals) need to give evidence based advice only!

We know that stress anxiety raise cortisol, and that cortisol has effects in the body. We know that there is an increased risk of chronic disease in people who suffered an abusive childhood.

Now, we also know that anxiety and depression (by themselves) do not increase the risk of most cancers, thanks to Dr Tuijl and everyone else involved for this very good research.

27/05/2023

Harvard Plate.
A basic tool to refer to when thinking about healthy balanced eating.
Have a look! Can you make every meal look like this?

🇪🇸 Plato de Harvard.
Una herramienta básica a la que referir cuando se piensa en una alimentación sana y equilibrada.
¡Échale un vistazo! ¿Puedes hacer que cada comida se parezca a este plato?

24/02/2021

👶🏽Last week I had my first paying “infant nutrition” client; a 2 year old who’s been refusing most food for months, and is severely constipated. She has been prescribed laxatives by the Dr (2 types, total of 3 doses a day). Mum and dad are struggling. Feeding time takes 2-3h each meal, and despite that, she barely eats.
On assessment, she is malnourished. Weight is at 60th centile, but weight to height is at 25th centile.
We discussed food and behaviours, and agreed on a week’s plan to help them increase variety of foods and textures.
I emailed them on the weekend to see how things were going. She’s accepting some of the new foods, but refusing others. I’m not convinced on how it is going.
We had a call on Monday. Yay! The little one is actually eating most of her food, and meal time has reduced to 1h. Mum feels a bit more confident to try to limit feeding time further, aiming for 30min. Drinking water is still a challenge. We discussed other foods to be tried this week and strategies to aid her drink more. She now goes to toilet twice a day, so we discussed reduction of laxative dose/frequency, and encouraged them to liaise with the Dr for further reassurance.
Maybe too early to sing victory? I feel it is a great success! I will continue to support them via email/phone these coming weeks, and we have a follow up in 3 weeks.
🥗🍚🍼🍴 (couldn’t choose a pic 😱 They’re all super cute!!🥰)

15/11/2020

Yesterday, 14th November, was World Diabetes Day. I had the patients and colleagues in my mind. I didn’t know what to write about this very important day. Diabetes sucks, and for many people it never goes away. But I love working with people that has diabetes; It is challenging and super rewarding. Treatment doesn’t stop improving, and I wish one day type 1 was reversible. My good wishes go to everyone with diabetes, you heroes! 👏🏼👏🏼👏🏼
Ayer, 14 noviembre, fue el Día Mundial de la Diabetes. Tenía a los pacientes y mis compañeros en la mente. No sabía qué escribir sobre este día muy importante. La diabetes es un roll, y para mucha gente no desaparece. Pero me encanta trabajar con personas que tienen diabetes; es difícil y súper gratificante. Los tratamientos no dejan de mejorar, y deseo que algún día la de tipo 1 sea reversible. Mis buenos deseos van para todos aquellos con diabetes, ¡héroes! 👏🏼👏🏼👏🏼

08/11/2020

Most people who I spend time with knows that I usually have nuts with me. I basically love them! They are a very nourishing food; high in protein, omega 3/6, vitamins, minerals and fibre. They are great.
They are also good for low carb, low GI or ketogenic diets. However, you need to be aware of the portion size. They are high in calories! 1 small handful (~25g) a day is the recommended portion.
I’m sure I’ll post about nuts again because they are awesome. 😀
Note also that they are not the best food to have just before high intensity exercise. 👩🏻‍⚕️🥙
La mayoría de gente con la que paso tiempo sabe que suelo tener frutos secos conmigo. Básicamente, me encantan! Son un alimento muy nutritivo; alto en proteína, omega 3/6, vitaminas, minerales y fibra. Son geniales.
También van bien para dietas bajas en carbohidratos, cetogénicas o de bajo índice glicémico. Pero ten en cuenta la ración. ¡Son altos en calorías! 1 puñado pequeño (~25g) al día es la ración recomendada.
Estoy segura de que pondré más posts sobre los frutos secos porque son una maravilla.
Ten en cuenta que no son un buen alimento a tomar justo antes de hacer ejercicio de alta intensidad. 👩🏻‍⚕️🥙

10/10/2020

Whatever we eat, let’s do it with joy, taking time, and focusing on what we eat. If the food is not the healthiest choice, at least the experience can be a healthy one, practicing mindfulness and gratitude. Bon appetite!
Comamos lo que comamos, hagámoslo con gusto, tomándonos tiempo, y concentrándonos en lo que comemos. Si el plato no es la más sana elección, al menos hagamos que la experiencia sí lo sea, practicando mindfulness y gratitud. Que aproveche!

10/10/2020

I speak to people about food all day (food and insulin). It’s my job! Some people are trying very hard to improve their relationship with food and themselves. Comments about what others eat can be hurtful for people battling with their diet, and it can cause a huge step-back. Accepting each other and supporting each other to live a fulfilling life helps us all. Everyone is in their own stage of that path with their own barriers to overcome. In other words: letting others eat whatever they eat and keeping opinions to oneself, unless genuinely trying to help, is a good call :) 🥙🥟🙏🏼🍽
Hablo con gente todo el día sobre comida (comida e insulina). ¡Es mi trabajo! Algunas personas están intentando muy duro mejorar la relación con ellos mismos y con su alimentación. Comentarios sobre lo que otros comen pueden ser muy dolorosos y causar un paso atrás enorme. Aceptarnos y apoyarnos unos a otros para vivir una vida más plena nos ayuda a todos. Cada uno está en una fase del camino con diferentes obstáculos que superar. En otras palabras: dejar que otros coman lo que sea que coman, y guardarse las opiniones, al no ser que de verdad se tenga la intención de ayudar, es una buena acción :) 🥙🥟🙏🏼🍽

30/09/2020

I continue to be fascinated by how gut, brain and diet are so closely linked.
There is now growing evidence that yoga and CBT can have a beneficial effect on IBS symptoms. Also, research shows that people with IBS usually have a different representation of gut microbiota to people without IBS, and a larger percentage of people with IBS suffer anxiety and/or depression.
It’s not all in the diet. A holistic assessment and intervention is essential to try to reduce IBS symptoms.
Please get in touch if you have any questions. Here to help 🍏🥙👩🏻‍⚕️
No dejo de estar fascinada por cómo el intestino, el cerebro y la alimentación están tan cercanamente relacionados.
Hay evidencia creciente de que yoga y TCC puede tener un efecto beneficioso en los síntomas de síndrome de intestino irritable (SII). Recientes estudios también muestran que las personas con SII tienen una distribución de microbiota a personas sin SII, y que personas con SII tienen más prevalencia de ansiedad y/o depresión.
La respuesta no está sólo en la dieta. Una evaluación e intervención holística es esencial para tratar de reducir los síntomas de SII.
No dudes en contactar si tienes cualquier duda. Aquí para ayudar 🍏🥙👩🏻‍⚕️

Ruth Sebastian

14/11/2023

10/11/2023

03/11/2023

31/10/2023

25/10/2023

27/05/2023

24/02/2021

15/11/2020

08/11/2020

10/10/2020

10/10/2020

30/09/2020

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