Saw Doctor and Very Disappointing re; HbA1c

[daddys1]

Hi, I had my 3 month HbA1c, the first since being diagnosed, as far as I am concerned really great results which I have already reported on previously on the forum.

Diagnosed at 46 now down to 41 in 3/4 months, out of the diabetic range and my cholesterol could not be better. We have 1 person a basically trained nurse for blood tests only.

Had asked the surgery do we have a diabetic nurse was told no, you just see the Doctor. So made an appointment to see my Doctor who was very pleased with my results but seemed vague, it wasn't until I said no one has looked at my feet that he said only Dr name? looks after all diabetic patients here. That was the first I was told. He said I need to see him.

So made an appointment and went on Tuesday to see the diabetic Doc.

Yes the diabetic Doc. was very pleased with my figures, accepted that a LCHF was appropriate for some and also said he was aware that some of his other patients were doing the same. I also mentioned Trudy Deakin and her New Book Eat Fat and he laughed, said yes it does not surprise me, just not in excess, but when I mentioned self testing, he really did frown and was not happy, gave me a lecture on why it was unnecessary, but I managed to convince him in my case it was. I still will have to pay for my testing.

But then I then went on to ask about having my feet looked at, as they have not been seen by the nurse. He said just keep checking them and if there is a problem then come in immediately, he then said that they would be looked at on the annual yes ANNUAL review. So I said, annual, and he replied yes we will only test you annually now. I didn't no what to say as I have been in there sometime, so I thought I would be better just go rather than start arguing at that moment.

I am just so disappointed as the HbA1c is a real marker for anyone trying to reduce their numbers. I think I am just going to go back in 6 months and ask if I can have a further blood test and my feet looked at.

Has anyone else experience this?

Neil

 

[DeejayR]

I wouldn't worry. You're managing your diabetes very well. I feel the NHS is desperate to cut costs at ground level and will use any excuse they can find to cast off all but very dependent patients. I've never been seen more than once a year and have no idea when my next surgery visit will be. I've written to the doctors who are labelled as diabetic specialists (and whom I've never met) explaining what I'm doing but got no reply. I have specific issues with my feet but the diabetes "nurse" (who I think is peripatetic) simply looked at her check list and poked my toes and pronounced my feet healthy.
I'm not complaining -- I'm trying to be a realist and am happy to go with the forum instead. You're doing really well, so keep it up.

 

[millysue]

Daddys1,
Have you had your eyes tested?

 

[PepperTed]

Why do you feel your feet need to be checked more often? If you do self-checks at home, problems shouldn't really develop without you noticing. You could also pay for a chiropodist to look at them privately, which would be roughly £30.

 

[Totto]

I am to have eyes and feet checked every third year I think as long as there are no signs of problems so if I were you I shouldn't worry. Blood seems to checked as soon as there is a reason for any test, they'll chuck in a HbA1c too.

Feet are a problem by the way but as my control is better than perfect - not my words - my loss of feeling in parts of my back paws are to be looked at by a neurologist sometime.

 

[daddys1]

I wouldn't worry. You're managing your diabetes very well. I feel the NHS is desperate to cut costs at ground level and will use any excuse they can find to cast off all but very dependent patients. I've never been seen more than once a year and have no idea when my next surgery visit will be. I've written to the doctors who are labelled as diabetic specialists (and whom I've never met) explaining what I'm doing but got no reply. I have specific issues with my feet but the diabetes "nurse" (who I think is peripatetic) simply looked at her check list and poked my toes and pronounced my feet healthy.
I'm not complaining -- I'm trying to be a realist and am happy to go with the forum instead. You're doing really well, so keep it up.

Hi, Yeah thanks for that, I know I can get my averages from my meter but not quite the same as the HbA1c test. I have also started testing less because I know where I am with some foods.

As for the feet, I do have a bit of Neuropathy of the feet, I wanted my pulses tested but it appears I will have to wait, I did have a bout of very cold feet a few weeks ago, most unusual for me, but I seem to have sorted that now, just would have felt happier with a check.

Maybe you are right, just don't worry.

Neil

 

[daddys1]

Why do you feel your feet need to be checked more often? If you do self-checks at home, problems shouldn't really develop without you noticing. You could also pay for a chiropodist to look at them privately, which would be roughly £30.

Hi, Good idea I think I may do that, as I need a couple of nails looking at.
Thank you
Neil

 

[daddys1]

Daddys1,
Have you had your eyes tested?

Hi there,

Yes I have thanks, it was classed as exceptionally minor on the day 2 tiny spots by the Optician, then I think it goes to 2 other and they all confer, it therefore come back as clear.
I am told I will get that again in 12 months.

Neil

 

[Totto]

But the diabetes GP said if there is a problem come in immediately and there is a problem. Why don't they want to check you pulses? I have had mine checked twice in the last six months.

 

[graj0]

I am just so disappointed as the HbA1c is a real marker for anyone trying to reduce their numbers. I think I am just going to go back in 6 months and ask if I can have a further blood test and my feet looked at.

Has anyone else experience this?

Neil

Hi Neil,

it's good that your HbA1c returned a good number, well done. However, it doesn't show the peaks and troughs of the last 3 months. I've just had a telephone conversation with my GP because although I presented the symptoms of a water infection, by the time I was able to get to the surgery to supply a sample, there was no sign of any bacteria but she did mention very high levels of sugar. I'm not sure how much I should worry but the GP wasn't that concerned because if there had been an infection prior to the sample, a 24hr thing, it could have raised the sugar in the water. It just didn't tie up too closely with my own tests.

Sometimes I get the feeling that our care by different GPs or even different parts of the country are very different. I wish I had an answer. As for taking blood for HbA1c, mine has now gone to once a year from twice a year, no consultation, that's what I think they call a "fait a complet". My GP is more than happy for me to test, she didn't even blink (if I could have seen her, telephone appointment). When it comes to feet, I pay for a podiatrist to keep them in good health, worth the money in my mind.

I wonder if the care thing is really like a post code lottery, perhaps we should add our post codes to our signatures?

 

[millysue]

Hi there,

Yes I have thanks, it was classed as exceptionally minor on the day 2 tiny spots by the Optician, then I think it goes to 2 other and they all confer, it therefore come back as clear.
I am told I will get that again in 12 months.

Neil

Have you had the diabetic retinopathy eye test?
They put drops in your eyes wait 10 minutes then take photo of each eye. They can detect problems BEFORE you would notice it.
If you haven't had it done yet, ask you gp.

 

[Lamont D]

Hey Neil,
I have to have a yearly merry go round with the foot and eye test, simply because they are good indicators of how you are controlling your condition.
You are really doing well so no real concern at all.
I have the yearly check now for the tenth time yesterday and after totally confusing her with my condition. She seemed fairly happy how well I was doing.

Just keep an eye on your feet and if you feel you need to do something, do it!

 

[julifriend]

As a diabetic you should be able to self-refer yourself to the podiatrist at your local hospital. That's what I did in November when I had problems with corns on my feet. The podiatrist also did the usual diabetes foot tests at the same time even though I'd had my annual checks in August.

 

[daddys1]

But the diabetes GP said if there is a problem come in immediately and there is a problem. Why don't they want to check you pulses? I have had mine checked twice in the last six months.

Hi Totto, I would have just felt more comfortable having a full test of the feet, as I said I was suffering very cold feet which I could not get warm even in bed I do mean severely cold, very painful, which seems like bad circulation, but I have started wearing slippers which I had never done before, nor had I had cold feet, but that seems to have sorted the problem, but I do believe it's a circulation thing.

Thank you

Neil

 

[daddys1]

Hi Neil,

it's good that your HbA1c returned a good number, well done. However, it doesn't show the peaks and troughs of the last 3 months. I've just had a telephone conversation with my GP because although I presented the symptoms of a water infection, by the time I was able to get to the surgery to supply a sample, there was no sign of any bacteria but she did mention very high levels of sugar. I'm not sure how much I should worry but the GP wasn't that concerned because if there had been an infection prior to the sample, a 24hr thing, it could have raised the sugar in the water. It just didn't tie up too closely with my own tests.

Sometimes I get the feeling that our care by different GPs or even different parts of the country are very different. I wish I had an answer. As for taking blood for HbA1c, mine has now gone to once a year from twice a year, no consultation, that's what I think they call a "fait a complet". My GP is more than happy for me to test, she didn't even blink (if I could have seen her, telephone appointment). When it comes to feet, I pay for a podiatrist to keep them in good health, worth the money in my mind.

I wonder if the care thing is really like a post code lottery, perhaps we should add our post codes to our signatures?

Hi Graj0, Certainly my Doctor was not happy with the testing, stated quite clearly in his view there was no medical requirement to test. As I explained I had just changed a Granola which I sprinkle on my Yogurt but the new one really spikes me, which I would not have known had I not been testing even though the carbs are similar.

I do like your idea of putting out post codes in our signitures would be interesting toi see the results.

Cheers, Neil

 

[daddys1]

Have you had the diabetic retinopathy eye test?
They put drops in your eyes wait 10 minutes then take photo of each eye. They can detect problems BEFORE you would notice it.
If you haven't had it done yet, ask you gp.

Hi Millysue, Yes I have had the eye test I was all clear, 2 tiny spots but classed as all ok. Ive also had the Desmond Course It's just the next HbA1c has been put off for a year and the foot test.
Neil

 

[daddys1]

Hey Neil,
I have to have a yearly merry go round with the foot and eye test, simply because they are good indicators of how you are controlling your condition.
You are really doing well so no real concern at all.
I have the yearly check now for the tenth time yesterday and after totally confusing her with my condition. She seemed fairly happy how well I was doing.

Just keep an eye on your feet and if you feel you need to do something, do it!

Hi Nosher8355, Yes I know I am doing well and when I see what other have to put up with I can feel guilty how some do suffer.The thing is I was hoping to lose some further weight and try and get the HbA1c down into the mid to low 30s. Although I will get some sort of idea where I am, with my own testing, which I have reduced somewhat, I will have to wait so long before I have real idea of the trend.

This doctor when I was Diagnosed as Pre, all he said was lose weight don't drink so much and you can reverse this and not become diabetic, and my diet was a slightly enhanced Desmond diet with lots of fish I added fruit which I was not on before and there was lots of carbs. I lost a stone (9 months) but moved into into diabetic range.

Once diagnosed as diabetic, although just borderline at 46 and fasting of 9.2, asked if I could still reverse this he said you will not reverse now you are in this range come back in 3 months.

Now I have moved out of the diabetic range I go back and see him and my reward for doing so well is, see me in a year.

I think what every one has stated on here I will be seeing someone re the feet.

Thanks, Neil

 

[daddys1]

As a diabetic you should be able to self-refer yourself to the podiatrist at your local hospital. That's what I did in November when I had problems with corns on my feet. The podiatrist also did the usual diabetes foot tests at the same time even though I'd had my annual checks in August.

Hi Julifriend, I'm interested how you did this referring yourself directly to the local hospital, did you just go and inquire at your local Hospital then, I expect your Doctor would be notified.

Neil

 

[julifriend]

Hi Julifriend, I'm interested how you did this referring yourself directly to the local hospital, did you just go and inquire at your local Hospital then, I expect your Doctor would be notified.

Neil

All I did was phone the podiatry department at the local hospital, state I was a diabetic and said I wanted to self-refer myself for treatment. They put me on their waiting list and about 6 weeks later I got a letter saying I could phone to make an appointment. I did that and saw them about a week after that. The podiatrist said I wouldn't need to self refer again if I went and saw them within the next 6 months. All I would need to do is phone for an appointment. I have no idea if they've informed my GP or not.

My understanding is that podiatry services should be available free to anyone. I go to a hospital in West Berkshire, but walking past Northampton General earlier this week noted a sign outside their podiatry department which said that any member of the public could self refer themselves to their podiatry service.

 

[daddys1]

Hi @julifriend ,

Thank you very much for that I will investigate immediately,

I'm Cambridgeshire and would normally be Hinchinbrooke, they have just been handed back to the NHS after a private firm failed to make a profit out of the hospital.

I'll check it out. After that it would be Addenbrookes.

Thanks once again Neil