Saw Diabetes Nurse, feeling very distressed

[mariavontrapp]

I really need some encouragement right now. I've been Type 2 for 10 years but have had a worsening of results over the last year (due to a vaccine reaction). I've been on insulin and metformin for the last four months.
A couple of months ago I got myself a Libre 2. I have used it to inform my eating and exercise decisions and have brought my "time in range" up to 88% (the target is 70%+). However, the nurse was not at all pleased, said I was micromanaging and that I would just make myself anxious. The opposite is true, having some control lessens my anxiety. I wasn't sure what the point of the appointment was so I said to her that the goal for me was to lessen my chance of diabetes complications. Her reply was that diabetes is progressive and I will inevitably have complications as time goes on. I felt really sickened by this.
I think her goal is to get me on more and more medication. Is it true that more medication will have a greater benefit than any diet/lifestyle changes I make? I'm feeling completely disheartened and confused.

 

[Lakeslover]

You have done exactly the right thing in my opinion. I’m also type 2 and self fund a libre. It’s great for helping you understand what the effects of different food and exercise are. In my opinion it would only be a problem if the results showing on your libre caused you to be constantly anxious or feel overwhelmed. It has the opposite effect on me, like you I feel more in control and therefore more calm.

you have done really well to get your time in range that high.

Unfortunately some nurses are not Up to date with the modern way of thinking, and don’t understand good control can be achieved. Probably not surprising as the number of their patients that take control and chive good results are probably low.

keep doing what you are doing and keep Coming here for support.

 

[Outlier]

I like to be in control of my life decisions and health too. This has helped me get my blood glucose down to non-diabetic levels and be off all diabetes-related medication. Lots of us here do similarly. If someone has to stay on a lower level of meds, it is still control. Stay with us and have a good read around - knowledge is power! Your decisions are yours to make, and if you find a decision has taken you in a direction you didn't want, then you are free to make another with that added knowledge.

Your nurse alas is typical, but there are a few more knowledgeable medics. I hope you find one of these soon, as a bit of professional backup is great. But not all of us find it (I haven't yet but others here have). Don't allow discouragement - channel your defiance, your intelligence, your willingness to discover. We will be here for you.

 

[mariavontrapp]

You have done exactly the right thing in my opinion. I’m also type 2 and self fund a libre. It’s great for helping you understand what the effects of different food and exercise are. In my opinion it would only be a problem if the results showing on your libre caused you to be constantly anxious or feel overwhelmed. It has the opposite effect on me, like you I feel more in control and therefore more calm.

you have done really well to get your time in range that high.

Unfortunately some nurses are not Up to date with the modern way of thinking, and don’t understand good control can be achieved. Probably not surprising as the number of their patients that take control and chive good results are probably low.

keep doing what you are doing and keep Coming here for support.

Thank you so much Lakeslover, I really appreciate your encouragement and glad to know I'm not the only one using the libre in this way

 

[mariavontrapp]

I like to be in control of my life decisions and health too. This has helped me get my blood glucose down to non-diabetic levels and be off all diabetes-related medication. Lots of us here do similarly. If someone has to stay on a lower level of meds, it is still control. Stay with us and have a good read around - knowledge is power! Your decisions are yours to make, and if you find a decision has taken you in a direction you didn't want, then you are free to make another with that added knowledge.

Your nurse alas is typical, but there are a few more knowledgeable medics. I hope you find one of these soon, as a bit of professional backup is great. But not all of us find it (I haven't yet but others here have). Don't allow discouragement - channel your defiance, your intelligence, your willingness to discover. We will be here for you.

Oh yes, I love this reply! I have allowed her to belittle me. I'm going to channel my defiance!

 

[JoKalsbeek]

I really need some encouragement right now. I've been Type 2 for 10 years but have had a worsening of results over the last year (due to a vaccine reaction). I've been on insulin and metformin for the last four months.
A couple of months ago I got myself a Libre 2. I have used it to inform my eating and exercise decisions and have brought my "time in range" up to 88% (the target is 70%+). However, the nurse was not at all pleased, said I was micromanaging and that I would just make myself anxious. The opposite is true, having some control lessens my anxiety. I wasn't sure what the point of the appointment was so I said to her that the goal for me was to lessen my chance of diabetes complications. Her reply was that diabetes is progressive and I will inevitably have complications as time goes on. I felt really sickened by this.
I think her goal is to get me on more and more medication. Is it true that more medication will have a greater benefit than any diet/lifestyle changes I make? I'm feeling completely disheartened and confused.

Oh yeah, diabetes is progressive, and you're going to die a slow, painful death after heaps of complications. That just tells you how good she is at being a DN! If that's how all her patients end up, she's not doing a very good job at keeping people alive and healthy, now is she?

You keep doing what you're doing, and prove her wrong! Make that jaw drop at the next appointment, if there ever is one. Go with your gut on this. If that "micro managing" gives you control of your blood sugars -very well done by the way!- it also gives peace of mind on top of quality and quantity of life in the long run. Doesn't sound like anxiety to me.

You're rocking this. You are.

Hugs,
Jo

PS: Really. ROCKING IT.
PPS: Oh, you asked whether meds were better than diet/lifestyle changes... If you gave up and just went with meds only, you'd be doing exactly what the nurse expects and what she knows the outcome of: complications. So you stick with what your meter already told you is working.

 

[Nicola M]

Your nurse just sounds like she’s stuck in the old ways of not really checking blood sugars often and/or changing your diet/exercise habits to improve your control and it’s likely most of her patients do not take the initiative to improve their control like you have.

Personally I would ignore everything she said, although I am Type 1 I have similar TIR as yourself (if you don’t have many lows/highs above 14, less than 3%) and my last HbA1c was classed as non diabetic.

Keep doing what you are doing because it is clearly working and be proud of yourself because it isn’t easy to get to the point of having good control consistently. Complications are always a possibility (like with anything there’s no way to say there’s a 0% chance) but the chances are very very slim with your kind of control so it wouldn’t be something I’d be worrying or thinking about.

 

[mariavontrapp]

Oh yeah, diabetes is progressive, and you're going to die a slow, painful death after heaps of complications. That just tells you how good she is at being a DN! If that's how all her patients end up, she's not doing a very good job at keeping people alive and healthy, now is she?

You keep doing what you're doing, and prove her wrong! Make that jaw drop at the next appointment, if there ever is one. Go with your gut on this. If that "micro managing" gives you control of your blood sugars -very well done by the way!- it also gives peace of mind on top of quality and quantity of life in the long run. Doesn't sound like anxiety to me.

You're rocking this. You are.

Hugs,
Jo

PS: Really. ROCKING IT.
PPS: Oh, you asked whether meds were better than diet/lifestyle changes... If you gave up and just went with meds only, you'd be doing exactly what the nurse expects and what she knows the outcome of: complications. So you stick with what your meter already told you is working.

Thank you, I really like your perspective on this. If I do it her way, then the complications are to be expected!

 

[mariavontrapp]

Your nurse just sounds like she’s stuck in the old ways of not really checking blood sugars often and/or changing your diet/exercise habits to improve your control and it’s likely most of her patients do not take the initiative to improve their control like you have.

Personally I would ignore everything she said, although I am Type 1 I have similar TIR as yourself (if you don’t have many lows/highs above 14, less than 3%) and my last HbA1c was classed as non diabetic.

Keep doing what you are doing because it is clearly working and be proud of yourself because it isn’t easy to get to the point of having good control consistently. Complications are always a possibility (like with anything there’s no way to say there’s a 0% chance) but the chances are very very slim with your kind of control so it wouldn’t be something I’d be worrying or thinking about.

Thank you for this encouragement. Looks like you're achieving excellent control with your Type 1. I find the Time in Range stats very useful and motivating, and they are easier to understand than the HbA1C.

 

[Lainie71]

I really need some encouragement right now. I've been Type 2 for 10 years but have had a worsening of results over the last year (due to a vaccine reaction). I've been on insulin and metformin for the last four months.
A couple of months ago I got myself a Libre 2. I have used it to inform my eating and exercise decisions and have brought my "time in range" up to 88% (the target is 70%+). However, the nurse was not at all pleased, said I was micromanaging and that I would just make myself anxious. The opposite is true, having some control lessens my anxiety. I wasn't sure what the point of the appointment was so I said to her that the goal for me was to lessen my chance of diabetes complications. Her reply was that diabetes is progressive and I will inevitably have complications as time goes on. I felt really sickened by this.
I think her goal is to get me on more and more medication. Is it true that more medication will have a greater benefit than any diet/lifestyle changes I make? I'm feeling completely disheartened and confused.

I think your DN needs to channel her mind into a different career. You are doing just fine and I think knowledge is power and taking control of ones health is really important. They are there to advise not twist your arm back. That's not to say that meds don't help, I just prefer to be my own boss for as long as I can. Having a meter and knowing what foods I am okay with or not, gives me some control over my type 2. When I was diagnosed I was given the list of things that diabetics get and yes I was shocked. I asked what do I do now, I was then told by the gp that I take a tablet! My reply was pretty blunt and I was not impressed, I then came here and the rest is history!

 

[aylalake]

I am another who self-funds a CGM and it has been a game-changer, used in conjunction with a glucose meter.
I have a new DN who used to be a carer, visiting people in their home, washing them, giving them their meds etc.
I know her as a customer of mine as well, and I was horrified to see her in her new role. The first thing she did was attempt to put the blood pressure cuff OVER my CGM, despite my asking her to use the other arm.

Then she told me to go back to the NHS Eatwell plate.
No no and no!

@mariavontrapp you are doing so well, and you are definitely not alone on this journey.

 

[Antje77]

A couple of months ago I got myself a Libre 2. I have used it to inform my eating and exercise decisions and have brought my "time in range" up to 88% (the target is 70%+). However, the nurse was not at all pleased, said I was micromanaging and that I would just make myself anxious. The opposite is true, having some control lessens my anxiety.

Well done!

I'm the same as you (even if T1), micromanaging is a good thing for me, I would be very anxious if I weren't allowed to monitor closely and take the steps I think best.
It's not the same for everyone, we're all different. Some people would get very unhappy with so much information, and for them it would probably be better to not monitor this closely.

The diabetes nurse seems to think all people are exactly the same, with the same needs, which is plain ridiculous.

 

[mariavontrapp]

I am another who self-funds a CGM and it has been a game-changer, used in conjunction with a glucose meter.
I have a new DN who used to be a carer, visiting people in their home, washing them, giving them their meds etc.
I know her as a customer of mine as well, and I was horrified to see her in her new role. The first thing she did was attempt to put the blood pressure cuff OVER my CGM, despite my asking her to use the other arm.

Then she told me to go back to the NHS Eatwell plate.
No no and no!

@mariavontrapp you are doing so well, and you are definitely not alone on this journey.

Sigh. The Eatwell plate! I agree the CGM is a game-changer. It's like suddenly being able to see

 

[mariavontrapp]

Well done!

I'm the same as you (even if T1), micromanaging is a good thing for me, I would be very anxious if I weren't allowed to monitor closely and take the steps I think best.
It's not the same for everyone, we're all different. Some people would get very unhappy with so much information, and for them it would probably be better to not monitor this closely.

The diabetes nurse seems to thing all people are exactly the same, with the same needs, which is plain ridiculous.

Yes exactly. We're all different but they treat us like a machine

 

[Jaylee]

Sigh. The Eatwell plate! I agree the CGM is a game-changer. It's like suddenly being able to see

Hi,

An HbA1c is like an “average speed check” on the motorway.
The fingerprick test akin to a speed camera..
The sensor closer to a “dash cam.” If using a driving analogy…

As you are on insulin.
It’s worth bypassing your nurse & seeing an endocrinologist to push & get the Libre on repeat prescription..?

 

[Antje77]

Yes exactly. We're all different but they treat us like a machine

It depends.
Just like all diabetics are different, all HCP's are different as well, and there are some very good ones around who are capable of understanding that different people have different needs.
I was lucky from the start with a GP practice nurse (misdiagnosed as a T2 for the first two years) who was delighted with all my testing and experimenting, and then again with a wonderful endo after my re-diagnosis.

 

[jjraak]

However, the nurse was not at all pleased, said I was micromanaging and that I would just make myself anxious

Maybe she's got a point....mmmhh

I mean all those warning signs when driving get me anxious

The ”slow down , school crossing ahead '.."no entry, one way street" endless traffic lights & zebra crossing, "don't park here, cars will be towed"....and don't get me started on car speedometer, I mean having to check all that while you drive just so you're not injured in an accident or get punished with fines, etc, or worse..


I mean, it's not like we all just spend, spend, spend, then are horrified 6 months later, when we check our account and find the bank have charged us for all the unpaid bills & bounced debits...

....mmh well maybe your nurse, perhaps.

Sensible people take note of things, are aware of their strengths AND what suits THEM.

An adage I liked was
"What gets measured,
Gets Improved. "
Not always true, but in our case, certainly better than just accepting it getting worse, because.......

Want to know things to avoid, check the warning before any harm's done....do it.

Not sure it's for you ?
Then just say no.

But please let those who want that security, just DO IT .

Good on you .
Outdated, archaic nonsense from far too many, who should know better.

Now must go, got an appointment for the surgery, tomorrow, hoping my results aren't too bad and i can stop some of my treatments.

All goes well, no more leeches for me..
But if it's bad news, dreading having to up my meds to include eye of newt & toe of frog ..

Laters.

 

[jaywak]

I was told by a doctor when I was in my 30s , ok I was not looking after my diabetes as well as I should , that I would not live to be 40 , I am now aproaching 65 and never felt better and have been told by one consultant that he didn't know what I was doing but to carry on doing it and by another that he thought I was one of the best controlled if not the best controlled type 1 s he had come across , just listen to your own body if it feels right just do it .

 

[LivingLightly]

I was told by a doctor when I was in my 30s , ok I was not looking after my diabetes as well as I should , that I would not live to be 40 , I am now aproaching 65 and never felt better and have been told by one consultant that he didn't know what I was doing but to carry on doing it and by another that he thought I was one of the best controlled if not the best controlled type 1 s he had come across , just listen to your own body if it feels right just do it .

Likewise. I developed type 2 diabetes some 20 years ago. Recently, my GP told me I'm among the best controlled type 2s he's encountered. (In marked contrast to the practice nurse's advice, I'm afraid.)

mariavontrapp:
Is it true that more medication will have a greater benefit than any diet/lifestyle changes I make?

IMO, the way a type 2 diabetic eats is more powerful than additional anti-diabetic medicines, other than insulin. All carbohydrates end up in your bloodstream as glucose, which makes your diabetes worse. If you keep to your low carb way of eating then, as your general health picks up, your BG levels should gradually improve.

Well done for taking the initiative and acquiring a Libre 2. It's your body and your decisions are yours to make!

 

[jjraak]

Her reply was that diabetes is progressive and I will inevitably have complications as time goes on. I felt really sickened by this.

Assuming she's right, I mean we WILL all age, right....?

Many of us try to fight the signs of it in the hope we slow down the damage aging does to our skin, bodies & minds

Oils, lotions & potions.
Gym, exercise & diets
Yoga, meditation & sudoku

Sure your DN hasn't just let themselves 'GO' because aging is inevitable, have there ?

Same thing really, in my eyes.

Checking our bloods is just a part of taking better care of ourselves, and if we can't stop the damage, then at least we can try slowing it down , even if it is just a bit.

That simple fact alone, to my mind, is worth the effort of trying.

Win/Win in my book.


Since reading some extracts from Jenny Ruhr blood #101

Does Type 2 Diabetes Always Get Worse?

Most dctors think all people with Type 2 develop complications but this research shows it isn't true.

www.bloodsugar101.com

I see tackling my BG blood levels, like a journey through a really long corridor.

One with the danger that each bump into the walls creates bruising, leading to damage further down the line

I can stumble along, walking it in the dark, hoping I stay away from the corridor walls, with the risk of daily bumps & bruising..(don't test )
OR
I can take a torch so I can see exactly where I'm going & what lies ahead, hopefully limiting the amount of daily bumps & bruises i get (testing with a meter)

Seems an obvious choice to me, but others are free to make their own way, however they see fit.