1st appointment with Diabetic Specialist Nurse

[tigerlily72]

I had my very first meeting at the Diabetes clinic with the nurse this morning. I had an idea of what to expect thanks to this fabulous forum and it's members so a BIG thanks for that

I also took a notebook with a list of questions so I could ask anything that wasn't covered. A medical student was present and I was asked if this ok - which was fine as people have to learn "on the job".

She was very good, explaining most of what I already knew and that I now have Type 2 diabetes. She explained the role of sugar in the blood and how it's converted and also about the pancreas producing insulin etc.

The good news is that I DON'T need any meds to treat my diabetes and after I told her about the changes I'd already made she was really pleased and said I already had "good control" I was weighed and pleased that the scales at the surgery weighed me in at 3lbs less than my newly purchased digital scales at home Of course, I do still have a lot I need to lose and am under no illusions about that.

I can't get a meter or test strips - budgets and funding being the reason but I did ask. I guess I'll carry on with my Codefree meter and test strips. She did however recommend the Accu Chek Aviva as a "good" one as I didn't let on I already had a meter

I was told that unless anything changes I will get a full blood test and HbA1c annually as well as the retinal screening and that I would be contacted about the retinal screening by our local hospital soon.

I was given an information leaflet on the XPERT courses in my area but told they have limited availability and it may be next year before I can get on one, but to phone to enquire. If I want 3 months free subscription to Weight Watchers I need to contact my Dr who will apparently write a letter. I think I am going to go with this in order to motivate me as I've found a Weightwatchers class running on a Saturday morning about a 15 min walk away from home.

Unfortunately, my blood pressure is HIGH - it was 162/100 - she said my target was 140/80, So I have to visit the surgery to re-test it and take a couple of readings in about 2 wks time. I've had high blood pressure in the past and was put onto medication by a previous Dr which gave me a dry throat/mouth and I ended up with a bad cough. So, I'm hoping I can sort this with lifestyle changes.

I was told to aim for a BG of between 4-7 mmols prior to eating breakfast and no more than 9 two hours after eating, although I thought it should be no more than 8.5 mmols. I did query this, but she said that as I was newly diagnosed this would be my aim. I'm still going to aim for < 8.5 mmols though!

My cholesterol was 4.3 and she said to try and get this below 4 which she thinks I can do, given the changes I've already made.

Oh, and I had the flu jab there and then. I'm very needle phobic but my hubby who came with me said I should as I probably wouldn't go back for it if I went away to think about it. However, I nearly fainted and had to lie on the bed for around 20 mins (it may have been longer) - how embarrassing!

My feet were also checked - she used a plastic probe type of thing with a thin wire on it. And the good news was my feet are absolutely fine

Apologies for the long post but I hope that it will also help others so they know what to expect and it's not as daunting or scary as you may think. I found her positive and in no way patronising etc.

 

[himtoo]

that is a very good post and thank you for sharing such a positive response to a DSN visit.

i wish you all the best for your upcoming year !!

 

[ButtterflyLady]

I had my very first meeting at the Diabetes clinic with the nurse this morning. I had an idea of what to expect thanks to this fabulous forum and it's members so a BIG thanks for that

I also took a notebook with a list of questions so I could ask anything that wasn't covered. A medical student was present and I was asked if this ok - which was fine as people have to learn "on the job".

She was very good, explaining most of what I already knew and that I now have Type 2 diabetes. She explained the role of sugar in the blood and how it's converted and also about the pancreas producing insulin etc.

The good news is that I DON'T need any meds to treat my diabetes and after I told her about the changes I'd already made she was really pleased and said I already had "good control" I was weighed and pleased that the scales at the surgery weighed me in at 3lbs less than my newly purchased digital scales at home Of course, I do still have a lot I need to lose and am under no illusions about that.

I can't get a meter or test strips - budgets and funding being the reason but I did ask. I guess I'll carry on with my Codefree meter and test strips. She did however recommend the Accu Chek Aviva as a "good" one as I didn't let on I already had a meter

I was told that unless anything changes I will get a full blood test and HbA1c annually as well as the retinal screening and that I would be contacted about the retinal screening by our local hospital soon.

I was given an information leaflet on the XPERT courses in my area but told they have limited availability and it may be next year before I can get on one, but to phone to enquire. If I want 3 months free subscription to Weight Watchers I need to contact my Dr who will apparently write a letter. I think I am going to go with this in order to motivate me as I've found a Weightwatchers class running on a Saturday morning about a 15 min walk away from home.

Unfortunately, my blood pressure is HIGH - it was 162/100 - she said my target was 140/80, So I have to visit the surgery to re-test it and take a couple of readings in about 2 wks time. I've had high blood pressure in the past and was put onto medication by a previous Dr which gave me a dry throat/mouth and I ended up with a bad cough. So, I'm hoping I can sort this with lifestyle changes.

I was told to aim for a BG of between 4-7 mmols prior to eating breakfast and no more than 9 two hours after eating, although I thought it should be no more than 8.5 mmols. I did query this, but she said that as I was newly diagnosed this would be my aim. I'm still going to aim for < 8.5 mmols though!

My cholesterol was 4.3 and she said to try and get this below 4 which she thinks I can do, given the changes I've already made.

Oh, and I had the flu jab there and then. I'm very needle phobic but my hubby who came with me said I should as I probably wouldn't go back for it if I went away to think about it. However, I nearly fainted and had to lie on the bed for around 20 mins (it may have been longer) - how embarrassing!

My feet were also checked - she used a plastic probe type of thing with a thin wire on it. And the good news was my feet are absolutely fine

Apologies for the long post but I hope that it will also help others so they know what to expect and it's not as daunting or scary as you may think. I found her positive and in no way patronising etc.

Most of what she said is correct but there are a few things I want to mention.

Annual blood tests - IMO this is not often enough. I can't remember what the NICE guidelines say but I have a feeling they say it should be 3 monthly until your HbA1c is under 48. The NZ guidelines say that, and they are based on the Scottish guidelines. Personally I think annual testing of diabetics and prediabetics is rubbish - IMO it should be 3 monthly until well under control, and then 6 monthly. I'm lucky in that I can ask for a blood test whenever I feel I need one, and I've never been told no.

Blood pressure - the NZ guidelines say under 130/80 is the diabetic target and it's 140/90 for everyone else. Personally I would be getting another test sooner than 2 weeks, and I would be considering medication. There are a number of different meds available so it should be possible to avoid bad side effects.

BG targets - Yes 8.5 is the correct (NICE guidelines) target, and I don't think she should be telling people that 9 is ok. But oh well. I actually have a target of being under 7.8, based on research showing this is safer.

Cholesterol - total cholesterol is a meaningless and misleading figure, you need to look at Triglycerides, HDL and LDL cholesterol levels. Your levels are likely to be satisfactory though.

You may want to ask for a printout of all your blood test results for your own info and future comparison. If you ask for blood tests in 3 months then you will have a good set of comparisons to make, showing how quickly you can turn things around through low carbing.

 

[tigerlily72]

Most of what she said is correct but there are a few things I want to mention.

Annual blood tests - IMO this is not often enough. I can't remember what the NICE guidelines say but I have a feeling they say it should be 3 monthly until your HbA1c is under 48. The NZ guidelines say that, and they are based on the Scottish guidelines. Personally I think annual testing of diabetics and prediabetics is rubbish - IMO it should be 3 monthly until well under control, and then 6 monthly. I'm lucky in that I can ask for a blood test whenever I feel I need one, and I've never been told no.

Blood pressure - the NZ guidelines say under 130/80 is the diabetic target and it's 140/90 for everyone else. Personally I would be getting another test sooner than 2 weeks, and I would be considering medication. There are a number of different meds available so it should be possible to avoid bad side effects.

BG targets - Yes 8.5 is the correct (NICE guidelines) target, and I don't think she should be telling people that 9 is ok. But oh well. I actually have a target of being under 7.8, based on research showing this is safer.

Cholesterol - total cholesterol is a meaningless and misleading figure, you need to look at Triglycerides, HDL and LDL cholesterol levels. Your levels are likely to be satisfactory though.

You may want to ask for a printout of all your blood test results for your own info and future comparison. If you ask for blood tests in 3 months then you will have a good set of comparisons to make, showing how quickly you can turn things around through low carbing.

My HbA1c was 44 (taken in Sept) so I guess that is why she said I would have an annual check. I guess if I have to go onto meds for the high blood pressure I may well request another FBG and HbA1c in the New Year.

She said that my other cholesterol results were good but didn't explain it in any further detail or give me figures. I should have questioned further but by then I'd already taken in a lot of information.

On that note I haven't tested myself this morning so I think I'll check what I am before I eat!

 

[Prem51]

@tigerlily72 Why have you now been diagnosed as T2 diabetes with an HbA1c of only 44? I thought you had to be at 48 or above to be diagnosed as diabetic.

 

[tigerlily72]

@tigerlily72 Why have you now been diagnosed as T2 diabetes with an HbA1c of only 44? I thought you had to be at 48 or above to be diagnosed as diabetic.

I had two fasting blood tests. The first was 8.1 and the second was 7.3.