Some doctors are incredibly unaware of the basics of diabetes

[PaulDK]

While walking around my town today, I noticed I was getting symptoms that ended up being related to high blood sugar. Unfortunately I didn't have any lancets left so I asked a paramedic for help who was patrolling. He asked what my last highest glucose reading was, and I said "The highest I've seen it is 12.5mmol." He said this was perfectly normal. Total nonsense of course, and no lancet to boot.

Today I saw my GP in the same area, and a similar discussion took place. Because my fasting glucose is OK, but my postprandial glucose is extremely high, even 2 hours after eating, a majority of the time, and because I experience the pizza effect when someone normal wouldn't, I thought for sure the doc might do more investigation to help complete the puzzle for me. Unfortunately they also said 12.5mmol is healthy, and they even said ketoacidosis isn't a real thing.

As things stand I'm stuck with a GP who knows nothing about what's normal and what's high in blood sugar, and I can't change it. And of course only the docs word matters. That same doctor also misdiagnosed my mother with anxiety when she actually passed away with brainstem cancer. This is highly frustrating as the average person can find out better information in mere minutes. Has anyone else experienced doctors with poor diabetes knowledge? Were you able to resolve the stalemate situation resulting from it?

I have had similar experiences with doctors ... even the diabetes clinic I used to attend gave me dietary advice that didn't help much. I was diagnosed about 20 years ago. My diabetes got gradually worse. I developed problems in my feet and could hardly walk so I took matters into my own hands about 10 years ago and researched the matter myself ... with a bit of will power diabetes is reversible ... nowadays I am pretty healthy and enjoying life again. Here's my diet:
I eat mainly natural foods that are … low sugar … low fat … low salt … high fibre … low GI … mostly plants ... with lots of water. I also exclude eggs and dairy products
I also exercise in the morning ... 2x30 squats, 60 press-up, stretching exercises ... and walk in the afternoon or evening.
Hope this helps ... get back to me if you have any queries

 

[TheGreatGateway]

"According to my Hba1c and fasting glucose I'm not diabetic (5.1% and 5.2 mmol average) but I'm terrified that these spikes are causing me harm and that I actually do have diabetes after all, especially as it takes ages for my post meal glucose to decline. What's going on?"

@TheGreatGateway - isn't that you?

If my HBA1c was 32, with a BG of 5.7 average I would not be on this forum. I would be too busy celebrating with my friends and family about how good my blood glucose regulation was, and how I got 10 years of my life expectancy back .

Understood that the high BG spike is something to worry about - you could go to an endocrinologist and have a good discussion about that with the specialist? With your BG readings with you. There is no way your ordinary GP is going to get into the details of your readings, especially when you do not, as yet, have a medical condition, even though we all get where you are coming from.

Absolutely - don't go to a doctor you do not trust and get along with! If s/he misdiagnosed your mother - change your GP for sure!

From what I've heard, Hba1c is an average, rather than a diagnostic tool. Also I've heard people without diabetes don't exceed a much smaller glucose value 30-45 minutes after eating. It will take a long time to see my GP again due to waiting times, but I may ask if they've heard of the glucose challenge thingy, as most of my symptoms and strange readings are postprandial. Until then I will just have to keep watching out for those spikes and note them accordingly.

 

[HSSS]

From what I've heard, Hba1c is an average, rather than a diagnostic tool. Also I've heard people without diabetes don't exceed a much smaller glucose value 30-45 minutes after eating. It will take a long time to see my GP again due to waiting times, but I may ask if they've heard of the glucose challenge thingy, as most of my symptoms and strange readings are postprandial. Until then I will just have to keep watching out for those spikes and note them accordingly.

Hb1ac is the main method of diagnosis. It has largely replaced the glucose tolerance test which I think you refer to. People without diabetes can still have spikes after carb heavy meals, but they return to normal far quicker and spike less than those of us with diabetes.

 

[HSSS]

Somewhere out there are libre traces for non diabetics - I’ve seen them linked to in here. You may or may not find them reassuring.

 

[Member496333]

Point of note: it’s thought that metabolic derangement is so rife these days that the line between non-diabetic and non-diagnosed diabetic is blurred. The HbA1c diagnosis criteria is so woefully inadequate for early detection of insulin dysfunction and glucose dysregulation that I dread to think how many fall through the cracks. In medicine, ‘normal’ is not much more than a frame of reference.

 

[Tophat1900]

Point of note: it’s thought that metabolic derangement is so rife these days that the line between non-diabetic and non-diagnosed diabetic is blurred. The HbA1c diagnosis criteria is so woefully inadequate for early detection of insulin dysfunction and glucose dysregulation that I dread to think how many fall through the cracks. In medicine, ‘normal’ is not much more than a frame of reference.

They look at Hba1c as though it is the guiding light, but never look at insulin levels.

 

[porl69]

Point of note: it’s thought that metabolic derangement is so rife these days that the line between non-diabetic and non-diagnosed diabetic is blurred. The HbA1c diagnosis criteria is so woefully inadequate for early detection of insulin dysfunction and glucose dysregulation that I dread to think how many fall through the cracks. In medicine, ‘normal’ is not much more than a frame of reference.

Have to agree on this BUT the differences between the types of diabetes is totally misunderstood thanks to the nation press etc

 

[Member496333]

They look at Hba1c as though it is the guiding light, but never look at insulin levels.

Indeed. Hyperinsulinemia can precede glucose dysregulation by years or even decades, yet typically, no one tests for it. Not even upon diagnosis of hyperglycaemia! Obviously it’s unreasonable to expect every GP to be a world authority on diabetes, but this really should be basic stuff by now. It does my swede in

EDIT: and then we get the NHS complaining how much it costs to treat T2DM. My annual reviews at the surgery feel like I’m there to teach them

 

[Tophat1900]

Indeed. Hyperinsulinemia can precede glucose dysregulation by years or even decades, yet typically, no one tests for it. Not even upon diagnosis of hyperglycaemia! Obviously it’s unreasonable to expect every GP to be a world authority on diabetes, but this really should be basic stuff by now. It does my swede in

It should be part of a yearly basic health check and for those on diagnosis. It is imo ridiculous to see so many people show here on gliclazide and no one has tested insulin levels. So people with insulin resistance are put on a drug that has detrimental out comes for those with insulin resistance. It would surely be a cost saving test and one that doesn't speed up insulin resistance.

You are right, can't expect hcps to know everything, but this is basic stuff that would be so easy to advise on. I had to ask my gp to do it and he had no clue what a c-peptide test was...lol