New diagnosis (difficult conversation with nurse)

[LucyLark]

Hello!
I just got the phone call from the diabetes nurse at my surgery with my test results, and am worried I've already managed to make the relationship 'difficult'. I'm feeling a bit wobbly now and could do with some advice/support from you all.
Some background: I'm 52 (today! Yay, birthday diagnosis!) and had borderline GD 24 years ago with my first pregnancy. I controlled it with diet and never had another above normal reading. It didn't recur in my other 2 pregnancies, but I knew the chance of developing T2 later on was there...
Five years ago my son was diagnosed T1 at 15, so I've had a while to read up about diabetes in general. I was also an antenatal teacher for 20 years, so informed decision making and asking pertinent questions of medical professionals comes naturally (possibly too naturally! ) to me.
I've been feeling on and off rotten since March, when I got ill with something (possibly Covid-19, I don't know) which left me exhausted, achy, dizzy, brain-foggy and extremely thirsty. I get better, but the headaches, weariness, brain fog and thirst have come and gone over the last few months. Those symptoms could've been long tail Covid, or perimenopause, but it occurred to me about 2 weeks ago that I was feeling weirdly light-headed and BAD in an indefinable way, with tingly hands and feet (I have very painful carpal tunnel syndrome), and should perhaps check my bloods. Luckily, having a T1 son meant I could do readings; they were 16.8, 12.8 and 11.5 on three consecutive mornings.
Rang the surgery and got blood taken last week, with results given today. HbA1c of 89, so pretty definite.
The problem was that the nurse then started her spiel about how there's no such thing as a diabetes diet, just a healthy one, and that T2 developed in midlife and was 'down to lifestyle'.
Having done some reading here, I don't now think that's quite true, and said so (politely!). But it was upsetting: she knows nothing of me or my lifestyle; I have what would be called a 'normal healthy diet', and always have done. I don't tend to eat sweets, fizzy drinks, chocolate or cakes. I have wholegrain and veg heavy meals. I am overweight, but I eat better than most of my friends who aren't. Yes, I have a desk job, but is that categorised as 'lifestyle'? Maybe it is. But it really felt like saying T2 is 'down to lifestyle' is verging on blaming her patients for developing it, especially since my lifestyle/diet is 'normal for this society'. I could be just be in an ultra-sensitive state right now, having just heard the results, but I ended up putting the phone down on the call and crying. (I didn't shout and wasn't impolite, just disagreed politely but firmly that diabetes developed because of lifestyle rather than a predisposition.
Anyway, thank you for your collective wisdom here. It's been very useful over the last week. I've read and taken on board The Nutritional Thingy and have started making those changes. Hopefully I will start feeling better soon. I just worry now I've ruined my relationship with the nurse, who will mark me down as bolshy and difficult, and I'm not looking forward to my first face-to-face appointment.
(Sorry for the long first post!)

 

[carty]

Unfortunately nurses see so many people who are overweight because of lifestyle they just presume we diabetics all fit that category .I have taken a softly softly approach to my nurse I have been for a review today with all the usual questions Are you eating lots of fruit and vegetables ? I just replied that I eat lots of green veg but not a lot of fruit because some fruit has a lot of sugar in it .She said that I knew what I was doing and agreed with me ! Yipee
Carol

 

[LucyLark]

Unfortunately nurses see so many people who are overweight because of lifestyle they just presume we diabetics all fit that category .I have taken a softly softly approach to my nurse I have been for a review today with all the usual questions Are you eating lots of fruit and vegetables ? I just replied that I eat lots of green veg but not a lot of fruit because some fruit has a lot of sugar in it .She said that I knew what I was doing and agreed with me ! Yipee
Carol

Thank you for replying! I think I will just have to do this too! Be polite, take the tests, do what seems right according to my own research. I'm probably just focussing on this phone call rather than the upset of diagnosis.

 

[EllieM]

Just a reminder, you probably already know this, but T2 is caused by a genetic inability to process carbs in the quantity recommended in modern healthy diets (and the unhealthy ones generally have even more carbs) and weight gain is often caused by a combination of high blood sugars and high insulin levels, ie T2.

Be aware that there is a small possibility you have T1 instead of T2 (though I believe GD makes T2 more likely?), so if a lower carb diet initially puts you in remission but relatively quickly stops working you'll want to check out the T1/LADA possibility (ideally antibody plus c-peptide tests). Though T1s can happily count their carbs and just need to stop their spikes, it tends to be much easier for T2s to reduce the carbs altogether (a carb is a carb whether it's wholegrain or white bread).

In any case, take a deep breath, your nurse sounds moderately clueless, you probably know more than she does about diabetes, though remember that T2 and T1 are by no means the same.

Good luck, lots of virtual hugs.

 

[Resurgam]

Unfortunately a healthy diet with lots of wholegrain and veges is exactly the same as one full of sugar and pastry etc if you are diabetic.
If you are eating starches and sugars, even from the so called healthy sources, you are overwhelming the ability to deal with the glucose they result in.

 

[LucyLark]

Just a reminder, you probably already know this, but T2 is caused by a genetic inability to process carbs in the quantity recommended in modern healthy diets (and the unhealthy ones generally have even more carbs) and weight gain is often caused by a combination of high blood sugars and high insulin levels, ie T2.

Be aware that there is a small possibility you have T1 instead of T2 (though I believe GD makes T2 more likely?), so if a lower carb diet initially puts you in remission but relatively quickly stops working you'll want to check out the T1/LADA possibility (ideally antibody plus c-peptide tests). Though T1s can happily count their carbs and just need to stop their spikes, it tends to be much easier for T2s to reduce the carbs altogether (a carb is a carb whether it's wholegrain or white bread).

In any case, take a deep breath, your nurse sounds moderately clueless, you probably know more than she does about diabetes, though remember that T2 and T1 are by no means the same.

Good luck, lots of virtual hugs.

Thank you so much! This is very helpful! It really helps to think of it like that, and I will keep an eye out for possible T1.

 

[Lynne1967]

Hello!
I just got the phone call from the diabetes nurse at my surgery with my test results, and am worried I've already managed to make the relationship 'difficult'. I'm feeling a bit wobbly now and could do with some advice/support from you all.
Some background: I'm 52 (today! Yay, birthday diagnosis!) and had borderline GD 24 years ago with my first pregnancy. I controlled it with diet and never had another above normal reading. It didn't recur in my other 2 pregnancies, but I knew the chance of developing T2 later on was there...
Five years ago my son was diagnosed T1 at 15, so I've had a while to read up about diabetes in general. I was also an antenatal teacher for 20 years, so informed decision making and asking pertinent questions of medical professionals comes naturally (possibly too naturally! ) to me.
I've been feeling on and off rotten since March, when I got ill with something (possibly Covid-19, I don't know) which left me exhausted, achy, dizzy, brain-foggy and extremely thirsty. I get better, but the headaches, weariness, brain fog and thirst have come and gone over the last few months. Those symptoms could've been long tail Covid, or perimenopause, but it occurred to me about 2 weeks ago that I was feeling weirdly light-headed and BAD in an indefinable way, with tingly hands and feet (I have very painful carpal tunnel syndrome), and should perhaps check my bloods. Luckily, having a T1 son meant I could do readings; they were 16.8, 12.8 and 11.5 on three consecutive mornings.
Rang the surgery and got blood taken last week, with results given today. HbA1c of 89, so pretty definite.
The problem was that the nurse then started her spiel about how there's no such thing as a diabetes diet, just a healthy one, and that T2 developed in midlife and was 'down to lifestyle'.
Having done some reading here, I don't now think that's quite true, and said so (politely!). But it was upsetting: she knows nothing of me or my lifestyle; I have what would be called a 'normal healthy diet', and always have done. I don't tend to eat sweets, fizzy drinks, chocolate or cakes. I have wholegrain and veg heavy meals. I am overweight, but I eat better than most of my friends who aren't. Yes, I have a desk job, but is that categorised as 'lifestyle'? Maybe it is. But it really felt like saying T2 is 'down to lifestyle' is verging on blaming her patients for developing it, especially since my lifestyle/diet is 'normal for this society'. I could be just be in an ultra-sensitive state right now, having just heard the results, but I ended up putting the phone down on the call and crying. (I didn't shout and wasn't impolite, just disagreed politely but firmly that diabetes developed because of lifestyle rather than a predisposition.
Anyway, thank you for your collective wisdom here. It's been very useful over the last week. I've read and taken on board The Nutritional Thingy and have started making those changes. Hopefully I will start feeling better soon. I just worry now I've ruined my relationship with the nurse, who will mark me down as bolshy and difficult, and I'm not looking forward to my first face-to-face appointment.
(Sorry for the long first post!)

Hi, I often read messages but have never replied before but I read yours and have complete sympathy. I know exactly what you mean as I did and felt something very similar. As a health professional you're aware that you often have a script, that is generally perpetuated/accepted by whichever body you work for, and the nurse you spoke to may not have even been thinking just repeating what she's been advised is the accepted thinking for the thousandth time. Please don't take it to heart or think that being diagnosed with T2 is your fault - it isn't it is an autoimmune disease. Thankfully there are many brilliant people devising new and wonderful ways in which to help ourselves - diet being the main one. You already have a wealth of understanding as your son is T1 - trust yourself and your knowledge and research. I'm sure the Nurse was not surprised at your reaction and has probably had other people do the same and thought no more of it. She may not even remember it when you see her but if she does it will probably be more out of concern. Best of luck in the future xx

 

[Oldvatr]

Thank you for replying! I think I will just have to do this too! Be polite, take the tests, do what seems right according to my own research. I'm probably just focussing on this phone call rather than the upset of diagnosis.

Think this is good advice you are giving yourself. If you had said Bolshoi instead of Bolshy then you could have danced rings around that nurse.

I remember having similar conversations with health visitors and nurses, but generally I have results that back me up, and we now agree to disagree, and I have in several occasions been advised to carry on as I am since it seems to be working. I think provided you can show improvement then they normally back off. Well done so far, and continue to be polite - they are used to angry exchanges and can normally deal with those via the practice manager, but polite refusal gets them every time and it catches them unawares.

 

[xfieldok]

Forget your nurse. Concentrate on getting yourself fit again. Get yourself a meter. Ignore your weight for now. If you concentrate on your numbers, the weight will probably drop off.

Your sweet revenge will be your nurse's face as your numbers tumble.

 

[TeddyTottie]

Hello!
...and am worried I've already managed to make the relationship 'difficult'.

Not to worry, you are very unlikely to have much to do with her, if your GP practice is anything like mine!

And no matter how engaged your healthcare is or is not, if you read round this forum and adopt low-carb eating, there’s a great chance you can normalise your BG and then you will only see her annually at most. Even in the face of overweening empirical evidence to the contrary, she is likely to carry on telling you the same old same old. Just smile and look smug.

 

[LucyLark]

Thanks all! You've been very kind and helpful. I shall go about my birthday now feeling slightly more cheerful!
(Even without a cake to celebrate! First carb-less trip to a restaurant: I will resist the hand-cut chips and eat all the cheese instead... )

 

[MrsA2]

@LucyLark
Don't beat yourself up. There's many a thread on here about diabetes nurses and health care that don't understand.
Heres an interesting podcast from Dr Unwin who is one of the first to change his point of view and is trying to spread the word among his colleagues. The NHS will get there, just maybe not in our lifetime
https://podcasts.google.com/?feed=a...IucnNz&ep=14&episode=QnV6enNwcm91dC00OTcxMjI3

 

[TeddyTottie]

@LucyLark
...just maybe not in our lifetime

Our loooong, reinvigorated, active, not-curtailed, not beset with complications, healthy lifetimes. Because we have ignored the NHS and taken responsibility for ourselves.

Such is my hope and belief.

Acts of god not withstanding!

 

[NicoleC1971]

Hello!
I just got the phone call from the diabetes nurse at my surgery with my test results, and am worried I've already managed to make the relationship 'difficult'. I'm feeling a bit wobbly now and could do with some advice/support from you all.
Some background: I'm 52 (today! Yay, birthday diagnosis!) and had borderline GD 24 years ago with my first pregnancy. I controlled it with diet and never had another above normal reading. It didn't recur in my other 2 pregnancies, but I knew the chance of developing T2 later on was there...
Five years ago my son was diagnosed T1 at 15, so I've had a while to read up about diabetes in general. I was also an antenatal teacher for 20 years, so informed decision making and asking pertinent questions of medical professionals comes naturally (possibly too naturally! ) to me.
I've been feeling on and off rotten since March, when I got ill with something (possibly Covid-19, I don't know) which left me exhausted, achy, dizzy, brain-foggy and extremely thirsty. I get better, but the headaches, weariness, brain fog and thirst have come and gone over the last few months. Those symptoms could've been long tail Covid, or perimenopause, but it occurred to me about 2 weeks ago that I was feeling weirdly light-headed and BAD in an indefinable way, with tingly hands and feet (I have very painful carpal tunnel syndrome), and should perhaps check my bloods. Luckily, having a T1 son meant I could do readings; they were 16.8, 12.8 and 11.5 on three consecutive mornings.
Rang the surgery and got blood taken last week, with results given today. HbA1c of 89, so pretty definite.
The problem was that the nurse then started her spiel about how there's no such thing as a diabetes diet, just a healthy one, and that T2 developed in midlife and was 'down to lifestyle'.
Having done some reading here, I don't now think that's quite true, and said so (politely!). But it was upsetting: she knows nothing of me or my lifestyle; I have what would be called a 'normal healthy diet', and always have done. I don't tend to eat sweets, fizzy drinks, chocolate or cakes. I have wholegrain and veg heavy meals. I am overweight, but I eat better than most of my friends who aren't. Yes, I have a desk job, but is that categorised as 'lifestyle'? Maybe it is. But it really felt like saying T2 is 'down to lifestyle' is verging on blaming her patients for developing it, especially since my lifestyle/diet is 'normal for this society'. I could be just be in an ultra-sensitive state right now, having just heard the results, but I ended up putting the phone down on the call and crying. (I didn't shout and wasn't impolite, just disagreed politely but firmly that diabetes developed because of lifestyle rather than a predisposition.
Anyway, thank you for your collective wisdom here. It's been very useful over the last week. I've read and taken on board The Nutritional Thingy and have started making those changes. Hopefully I will start feeling better soon. I just worry now I've ruined my relationship with the nurse, who will mark me down as bolshy and difficult, and I'm not looking forward to my first face-to-face appointment.
(Sorry for the long first post!)

Happy Birthday by the way! I hope you are getting to grips with this a little? Having the ability to argue with medical professionals is a good thing btw; if someone can't cope with your questions then I'd change doctors/nurses.
My own dad got diagnosed with t2 a while back (I am t1) and didn't tell me for 6 months because he felt guilty that he had brought it upon himself whereas I had the morally superior kind of diabetes. This is rubbish and the perception that ll type 2s are as Jeremy Vine puts it 'walking deficient, doughnut eaters' is unhelpful. You may have been following the healthy diet recommended by the NHS but could still end up overweight and diabetic just because your body can't cope with the amount of 'healthy' whole-grains you are eating i.e. too many carbs (for your individual tolerance) = too much insulin = insulin resistance and weight gain because insulin is an anabolic hormone. For some this leads to type 2 diabetes too.
You could ask for a c peptide test to check out if you are true type 2 (tests for insulin production) but it does sound as if you might be.
Either way check out this forum for good stories on how people have reversed their diagnosis but be prepared to revise your ideas on what a healthy diet for a diabetic is and best of luck! Imagine that nurse's reaction when you come back with great numbers and can tell her how you did it (sadly this won't be a story she often hears from the new type 2s).

 

[copilost]

I don't tend to eat sweets, fizzy drinks, chocolate or cakes. I have wholegrain and veg heavy meals.

they don't believe you. it's so frustrating and i get that people aren't always honest (and who can blame them?) but it makes it an uphill struggle with your own health management. if you lose weight or BG comes down its because you haven't been eating the cakes/biscuits/sweeties you don't eat! aargh! so you have to stop expecting the professionals to get it (mostly they won't) and start taking care of yourself on your terms. it's really hard, but not disrespectful of the professionals, they can't be expected to know as much about you as you do. deep breath, you got this. (also i'm learning this for myself so better at the talk than the walk but good to share, thank you)

 

[Daibell]

Hi. Don't beat yourself up about the nurse and being disrespectful to her. Nurses and GPs are professionals and part of their job is to provide valid health advice backed up by good science and they are paid for that. I've no time for those who provide bad advice and won't listen to the patient to learn. My nurse is superb and talks about low-carb despite bad PHE advice to the contrary. She listens and is obviously prepared to learn from each patient. My diabetes GP however is typical of the more arrogant health professional and doesn't have my respect as a result.

 

[TriciaWs]

The good thing is that diabetic nurses change jobs, more so in my practice but even in areas with more stable medical care she will move on.
Meanwhile she might back off a little when your new way of eating improves your blood sugars?

I saw a GP first who agreed I could try diet instead of metformin; the diabetic nurse thought he'd forgotten and tried to get them prescribed but did listen when I repeated the conversation with him - I am sure she thought it was temporary but then was sold on low carb 3 months later.

The worst conversation I had was with the dietitian - I opted for her instead of the old style desmond course that touted lots of brown carbs at each meal as I thought 30 mins of her would be easier than a whole day. She objected to the idea that I might know something about diabetes and food, and my body, even through I'd already got my HbA1c down into the low 40s before I saw her. She very firmly told me that I had to eat fruit and have brown carbs at every meal otherwise I was risking heart disease and cancer.
I declined a second appointment without any hassle as by then my GP and diabetic nurse had noted the rapid improvement in my diabetes and were happy with what I was doing.
Since then I've only had an issue with a locum, who tried to blame a sudden spike in my cholesterol on my diet (well over a year later) when I suggested it might be the new pills he'd put me on.
I stopped the pills and my cholesterol dropped.

 

[Bex72]

Hello!
I just got the phone call from the diabetes nurse at my surgery with my test results, and am worried I've already managed to make the relationship 'difficult'. I'm feeling a bit wobbly now and could do with some advice/support from you all.
Some background: I'm 52 (today! Yay, birthday diagnosis!) and had borderline GD 24 years ago with my first pregnancy. I controlled it with diet and never had another above normal reading. It didn't recur in my other 2 pregnancies, but I knew the chance of developing T2 later on was there...
Five years ago my son was diagnosed T1 at 15, so I've had a while to read up about diabetes in general. I was also an antenatal teacher for 20 years, so informed decision making and asking pertinent questions of medical professionals comes naturally (possibly too naturally! ) to me.
I've been feeling on and off rotten since March, when I got ill with something (possibly Covid-19, I don't know) which left me exhausted, achy, dizzy, brain-foggy and extremely thirsty. I get better, but the headaches, weariness, brain fog and thirst have come and gone over the last few months. Those symptoms could've been long tail Covid, or perimenopause, but it occurred to me about 2 weeks ago that I was feeling weirdly light-headed and BAD in an indefinable way, with tingly hands and feet (I have very painful carpal tunnel syndrome), and should perhaps check my bloods. Luckily, having a T1 son meant I could do readings; they were 16.8, 12.8 and 11.5 on three consecutive mornings.
Rang the surgery and got blood taken last week, with results given today. HbA1c of 89, so pretty definite.
The problem was that the nurse then started her spiel about how there's no such thing as a diabetes diet, just a healthy one, and that T2 developed in midlife and was 'down to lifestyle'.
Having done some reading here, I don't now think that's quite true, and said so (politely!). But it was upsetting: she knows nothing of me or my lifestyle; I have what would be called a 'normal healthy diet', and always have done. I don't tend to eat sweets, fizzy drinks, chocolate or cakes. I have wholegrain and veg heavy meals. I am overweight, but I eat better than most of my friends who aren't. Yes, I have a desk job, but is that categorised as 'lifestyle'? Maybe it is. But it really felt like saying T2 is 'down to lifestyle' is verging on blaming her patients for developing it, especially since my lifestyle/diet is 'normal for this society'. I could be just be in an ultra-sensitive state right now, having just heard the results, but I ended up putting the phone down on the call and crying. (I didn't shout and wasn't impolite, just disagreed politely but firmly that diabetes developed because of lifestyle rather than a predisposition.
Anyway, thank you for your collective wisdom here. It's been very useful over the last week. I've read and taken on board The Nutritional Thingy and have started making those changes. Hopefully I will start feeling better soon. I just worry now I've ruined my relationship with the nurse, who will mark me down as bolshy and difficult, and I'm not looking forward to my first face-to-face appointment.
(Sorry for the long first post!)

Hi Lucy Lark, I am with you completely. I also had an uncomfortable nurse phone call this week. It seems as if diet control of diabetes just exists online not so obviously with your gp or nurse. I'm taking my diabetes day by day and atm controlling with diet. I already had a good diet most of the time and love cooking so the transition wasn't a problem to do. I guess sticking to it is the issue over time. I have founds members of this group to be inspirational and it really has made all the difference to me. Belated happy birthday.

 

[LucyLark]

Thanks all! I really appreciate you taking the time to reply.
I had a great birthday - stayed away from the chips, had a glass of dry white wine, felt more cheerful than the morning.
Today I have been feeling very foggy and weary, and my hands are very painful, so I am hoping I will start feeling better soon if I stick at it. My T1 son has been very helpful, telling me the carb values of everything in sight!