• Guest - w'd love to know what you think about the forum! Take the 2025 Survey »

Interesting reading - gp handbook info re diabetes

  • Thread starter Thread starter badcat
  • Start Date Start Date
Interesting read.. mentions "lifestyle" changes a lot but nowhere gives specific info... worse than useless perhaps?
 
I found it all very interesting, especially the section on blood pressure controls, the section on Aspirin, and the section on Metformin and heart benefits.

Metformin - from how I read it, this is beneficial for the heart COMPARED WITH other diabetes drugs. This could mean it is the other drugs causing heart problems whereas Metformin doesn't, rather than Metformin being beneficial in itself.

Blood pressure - it seems the 140/80 target appears too tight and more people die with BP under 110/70, and the bottom figure should be not much less than 70.

Aspirin should not be prescribed to diabetics, full stop.

I need to read it all again.
 
I'm astonished at the speed and blase nature of the insulin recommendations 7.5% + hba1C and bang = > insulin

Given how quickly that can be brought down by skipping carbs, its amazing that the advice doesn't even use the word carbohydrate anywhere. No wonder people end up in a state !
 
Makes for an interesting read. However this is from Spring 2013, has it not been updated at all since then?
 
I have the 2016 version as a pdf but I can't upload it as it is too large - any suggestions?
 
bulkbiker said:
But come on that's what doctors do.. give out pills like smarties...
Click to expand...
Sadly I also think thats what a lot of the population want their GPs to do too - the consternation at my Bridge club when someone was refused antibiotics for a viral infection was palpable - after all the person had waited over an hour to see the GP and in many members eyes (not mine) " deserved" to be given some antibiotics even tho theyd been told that they wouldnt do anything for a viral infection
 
badcat said:
after all the person had waited over an hour to see the GP and in many members eyes (not mine) " deserved" to be given some antibiotics
Click to expand...

It's surprising the number of people who don't understand that. Having said that, many decades ago, my GP, now long retired, used to prescribe antibiotics to prevent bacterial infections that would find it easier to get a hold while the body was fighting off the virus. I shall probably add that little gem to all the other cods wallop I've been given over the years.
 
Years ago we went to Luxor in Egypt, several times. Because of the issues with Pharaoh's Revenge our GP prescribed antibiotics as a preventative measure each time we went. They worked, or at least none of us was affected. The last time we went, no antibiotics, and all 3 of us succumbed.
 
There is a bit about us (bottom of page 64)


Diabetes that ‘goes away’

Some people, given the diagnosis of diabetes, radically change their lifestyle, lose weight and their HbA1c drops out of the diabetic range. What do you do? There is little guidance on this, but bear the following in mind: • They are at high risk of ‘relapsing’ and becoming diabetic again – in our practice we do an annual HbA1c to look for this (and BP, cholesterol, etc.). • They continue to need retinal screening. In order to ensure they are called for this use the code ‘Diabetes in remission’ (C10P) NOT ‘Diabetes resolved’ (212H) as this latter code doesn’t trigger recall. Do note that ‘Diabetes in remission’ does NOT exempt them from QOF – but should they not be getting QOFstyle care anyway? (National Diabetes Retinal Screening Programme, 2014).
 
Chook said:
There is a bit about us (bottom of page 64)


Diabetes that ‘goes away’

Some people, given the diagnosis of diabetes, radically change their lifestyle, lose weight and their HbA1c drops out of the diabetic range. What do you do? There is little guidance on this, but bear the following in mind: • They are at high risk of ‘relapsing’ and becoming diabetic again – in our practice we do an annual HbA1c to look for this (and BP, cholesterol, etc.). • They continue to need retinal screening. In order to ensure they are called for this use the code ‘Diabetes in remission’ (C10P) NOT ‘Diabetes resolved’ (212H) as this latter code doesn’t trigger recall. Do note that ‘Diabetes in remission’ does NOT exempt them from QOF – but should they not be getting QOFstyle care anyway? (National Diabetes Retinal Screening Programme, 2014).
Click to expand...

Chook - My medical records record my status as "‘Diabetes resolved", and I have been called for retinal screening in each of the 3 years since the change was made.

I'm not challenging what you wrote, just saying that in my personal instances it wasn't so.
 
DCUKMod said:
Chook - My medical records record my status as "‘Diabetes resolved", and I have been called for retinal screening in each of the 3 years since the change was made.

I'm not challenging what you wrote, just saying that in my personal instances it wasn't so.
Click to expand...

I didn't write it - I copied and pasted it from the bottom of page 64 of the handbook linked to in @Bluetit1802 's post further up this thread.

I don't know what will happen with me - my last HbA1c was 29 / 4.9 but the DN said I would still need to have appointments with her every six months. The only thing she did ask was whether I still wanted to take Metformin 'or not bother'.
 
Chook said:
I didn't write it - I copied and pasted it from the bottom of page 64 of the handbook linked to in @Bluetit1802 's post further up this thread.

I don't know what will happen with me - my last HbA1c was 29 / 4.9 but the DN said I would still need to have appointments with her every six months. The only thing she did ask was whether I still wanted to take Metformin 'or not bother'.
Click to expand...

Oh, I wasn't suggesting you did write it, but just pointing out that like all things diabetes, nothing is certain, across the landscape.

I still have an annual HbA1c, and know I can see my Doc whenever I need to (within normal appointment availability), and she is open to running any tests necessary to investigate concerns. I've never taken any meds, so that didn't apply in my world.
 
Back
Top