Chat with doctor - BG and CVD views

[LittleGreyCat]

Went to see the Diabetes lead at our practice yesterday to discuss Metformin.

A couple of interesting things:

(1) She said that currently they are not fixating on BG because they see the highest risk factors with diabetics as being CVD and that the cause of retinal damage, for example, is down to high blood pressure.
I got the impression that if your HbA1c was a bit high but your blood pressure was good then they would be more than happy.
I did point out that for the 80% of diabetics who are overweight or obese then blood pressure may be the highest risk area, but for the 20% who are not there may be other factors more important. I guess this gives some insight into where the NHS sees the main effort should be targetted, and perhaps also why a carb rich but calorie low diet is seen as a good way to go.

(2) I noted, when she displayed the historical data on her screen, that my HbA1c was trending better every year, but was not trending better every test. I noticed that my autumn readings (showing the diet and exercise results of the summer) were always better than my spring readings (showing my diet and lack of exercise results over winter).
This does show up one shortcoming of the diet and exercise regime - if your exercise is curtailed by bad weather or other issues (more likely over winter) then your BG can suffer.

Cheers

LGC

 

[noblehead]

She said that currently they are not fixating on BG because they see the highest risk factors with diabetics as being CVD and that the cause of retinal damage, for example, is down to high blood pressure.

Both bp and bg are equally important so I would focus on both

 

[ButtterflyLady]

I agree both BG and BP are important. In my experience it's been much easier to control my BP than my BG.

I got hypertension years earlier than diabetes. It was able to be corrected very quickly with one drug. If anyone is finding that they need more than one BP-lowering drug, this can indicate a sleep disordered breathing syndrome, which would also need to be treated to help prevent diabetes complications and CVD.

 

[borofergie]

Both bp and bg are equally important so I would focus on both

I agree - it's very difficult to decouple them. There's a reason why diabetics suffer from a much higher incidence of CVD.

A very shortsighted view IMHO. :thumbdown:

 

[Unbeliever]

It is probably easier for tthem to focus on BP than to cope with bg. My opthalmologist and his staff have no problems with my bp at the hospiital but mty practice want to focus on the Bp. This becomes a self -fulfilling prophecy.
Even when facing procedures in the hospital which have a 1 in 25 chance of blinding me i have bp of 120/65. n the surgery it is 200/180. Merely because I don't trust them.
they know this and say it is because the focus is on my bp when I am there but elsewhere when I go to the hospital.
So why does the nurse persist in pursuing the matter when the drs in the practice accept my home readings? And the hospital readings are available too?
The manufacturers and distribuors of both my home monitors guarntee that they are correct to within 3 per cent. With my readings and also as I am already taking medication as a protective measure because of the retinopathy I thnk bp is hardly likely to
pose a major threat. No, the diabees nUrses are the major threat.
Ignorance coupled with obstinacy is a lethal combination.

 

[borofergie]

So why does the nurse persist in pursuing the matter when the drs in the practice accept my home readings? And the hospital readings are available too?

I do wonder about the margin of error on those squeezy-bulb GP BP tests. I get huge variations when I test my own at home using my rather expensive digital BP testing machine.

 

[Unbeliever]

I tend to just look at rends on mine. I use one of them o check the other. he hosptal readings are in line with my own home readings - although i understand that home readings are suposed o be 10% lower than hose used by Drs,
I can feel my bp rising when I go through the doors of he surgery. And a red mist forming in front of my eyes....
I cannot help feeling that hose ambulatory ests must be so alien hat they don't actually prove anyhng. I can give myself white coat syndromwe merely because I am awre hat I will be making a noe of a resading.
if my readings are in he low teens over the mid sities even allowing for a 3% error i can't see why i would need o worry.

 

[ButtterflyLady]

Maybe your doctor should tell the nurse to chill out about it. The doctor is the boss, not the nurse. (Actually you are the boss, but that's another story) :wink:

 

[Unbeliever]

Maybe your doctor should tell the nurse to chill out about it. The doctor is the boss, not the nurse. (Actually you are the boss, but that's another story) :wink:

Unfortunately they leave everything connected wih diabetes to the nurse. The only time any of them will speak to you about diabetes at all is during the annnual review..

I went back to that particular doctor last year with a query arising from the review she had done. She made me feel like a mass murderer or maybe like someone who has a rabbit caught in the headlights. She did eventually try to help me
but did her best to refer me back to the Nurse and strongly indicated that I should take any queries to Nurse in future .

I explained that I was reluctant to do this as Nurse had given me very bad advice on a couple of occasions and I felt unable to trust her. She hen suggested i try Nurse's sidekijk who had just attended a course and was now considered "diabetes trained" I just looked at her. She became flustered and said or I could see her of course, or any of the others!

This is NOT true!Unfortunately for me I am a kindhearted person and can't bear to impose suffering on the defenceless...
So I didn't pursue the matter.

No point anyhow . Its Practice policy,