Had my consult with Endo, he said I was not a diabetic & would issue a letter to that effect

[Ronancastled]

Firstly one of these
Secondly, this is very self indulgent so skip to the tl;dr if you want the synopsis.

I've waited nearly 2 years for this appointment, had my homework done & notes with me which I didn't need to refer to.
He was brash, massively confident, probably younger than me & left me a bit awe struck which I was not expecting.
He was a purely Private Consultant, only drafted in by the Irish version of the NHS to clear the public backlog.

First question "are you double jabbed".
Second question "why are you here wasting my time & the health service budget, you're not diabetic".
Well that knocked me back but I soon hit my stride & gave him chapter & verse about my diagnosis, weight loss, anxiety, insomnia, improving PPs, test meals, 75g OGTT success & finally my CGM trial.

He lit up & was absolutely gushing, said 3 or 4 times he couldn't stop smiling behind the mask.
Told me I hadn't just made his day, I'd made his last 3 months worthwhile.
He wanted to know how I had figured it out & I told him about being an engineer using research & metrics.
I mentioned Prof Taylor & he finished my sentences, spoke about the 2 year follow up to Direct & he knew maximal insulin flow rates by each month of remission.
He Spoke about other trials I wasn't even aware of, lifestyle changes beating pharmaceutical each & every time.
Got really engaged when I mentioned the Swedish Obesity Subjects trial.
Then we both got melancholic about how few T2s take the diagnosis seriously, he noted a huge difference between those who were college educated & those who left prior to A levels.
I mentioned the standard lab panel not including fasting insulin & he rolled his eyes, apparently they've been pushing for it for years but the accountants say no.
I mentioned Kraft & he said the health service have no time for pre pre pre diabetes.

So he asked a question twice through all this conversation & I just ignored it initially, "What do you want me to do for you ?"
I could see what he was hinting at so I braved the unmentionable, I asked "can a diagnosed diabetic have their diagnosis removed".
He was unequivocal, "Based on your figures you are clearly not diabetic & I will issue a letter to that effect immediately if you wish".
Maybe through shock, or maybe through advice on this forum about being taken off the register I told him I would email his office if I needed it officially.
Then he told me that the health/travel/life insurers had changed the wording on their forms, they no longer ask "are you diabetic", they now ask "have you ever been diagnosed diabetic", very clever if true.
He did say it would work in my advantage to state diabetes when pension/annuity time comes.

So, the most important question I had I left to the end, "How long can my remission last".
He was blunt & said the average person will relapse, he thinks 5 years is exceptional, 10 years is almost unheard of in his experience but did state I was a unique case.
He put the 20 year remission seen the Swedish Obesity Subjects trial completely down to bariatric surgery which he is a big fan of, was quick to tell me I'd qualify once my BMI hit 35.
Then he decided to weigh me, I was 95kg (with shoes on) against 125kg at diagnosis & then he laughed saying he's only seen that weight loss with bariatric surgery.
So we calculated my bmi as 31 which is still clinically obese, I boasted that I had stopped my weight loss purposely but then he went completely left field.
He offered Ozempic as a further tool to weight loss, I asked him straight up if my current BG would result in complications, he was again unequivocal, stating no, quoting how my background retinopathy had disappeared.

Then he dramatically changed the subject, apparently I fall back into the system where the GPs marked me as "routine" & I don't get referred again for maybe 4 years unless my A1c escalates back to 6.5%(48).
He stressed that all his time was taken up by patients who are not pro-active & I am a complete outlier.
Sadly he said that he only meets someone like me once every 3 months if even, again another smile behind the mask.
Another left field remark was he'd put Metformin into the water supply like fluoride if he was allowed, told you he was brash.

Anyway, I'm still part of the club, I'm not requesting the letter, as great as my figures are I know if I started eating 300g of carbs of day I'd be back where I started.
This is a club I never want to leave, I'll update my sig accordingly but once a T2 always a T2.

tl;dr Endo said I was not diabetic, will change my diagnosis if I wish, I've decided against, I wish to remain a T2

 

[SuNuman]

I left school at 16 with barely enough CSE’s to write on my CV. My mum died from kidney failure (plus heart disease) due to diabetes when I were 20. My sister has just had (few weeks back now) a below the knee amputation; I disagree it takes A level education to make you realise the importance of taking your diagnosis seriously.

 

[Dandelade]

Firstly one of these
Secondly, this is very self indulgent so skip to the tl;dr if you want the synopsis.

I've waited nearly 2 years for this appointment, had my homework done & notes with me which I didn't need to refer to.
He was brash, massively confident, probably younger than me & left me a bit awe struck which I was not expecting.
He was a purely Private Consultant, only drafted in by the Irish version of the NHS to clear the public backlog.

First question "are you double jabbed".
Second question "why are you here wasting my time & the health service budget, you're not diabetic".
Well that knocked me back but I soon hit my stride & gave him chapter & verse about my diagnosis, weight loss, anxiety, insomnia, improving PPs, test meals, 75g OGTT success & finally my CGM trial.

He lit up & was absolutely gushing, said 3 or 4 times he couldn't stop smiling behind the mask.
Told me I hadn't just made his day, I'd made his last 3 months worthwhile.
He wanted to know how I had figured it out & I told him about being an engineer using research & metrics.
I mentioned Prof Taylor & he finished my sentences, spoke about the 2 year follow up to Direct & he knew maximal insulin flow rates by each month of remission.
He Spoke about other trials I wasn't even aware of, lifestyle changes beating pharmaceutical each & every time.
Got really engaged when I mentioned the Swedish Obesity Subjects trial.
Then we both got melancholic about how few T2s take the diagnosis seriously, he noted a huge difference between those who were college educated & those who left prior to A levels.
I mentioned the standard lab panel not including fasting insulin & he rolled his eyes, apparently they've been pushing for it for years but the accountants say no.
I mentioned Kraft & he said the health service have no time for pre pre pre diabetes.

So he asked a question twice through all this conversation & I just ignored it initially, "What do you want me to do for you ?"
I could see what he was hinting at so I braved the unmentionable, I asked "can a diagnosed diabetic have their diagnosis removed".
He was unequivocal, "Based on your figures you are clearly not diabetic & I will issue a letter to that effect immediately if you wish".
Maybe through shock, or maybe through advice on this forum about being taken off the register I told him I would email his office if I needed it officially.
Then he told me that the health/travel/life insurers had changed the wording on their forms, they no longer ask "are you diabetic", they now ask "have you ever been diagnosed diabetic", very clever if true.
He did say it would work in my advantage to state diabetes when pension/annuity time comes.

So, the most important question I had I left to the end, "How long can my remission last".
He was blunt & said the average person will relapse, he thinks 5 years is exceptional, 10 years is almost unheard of in his experience but did state I was a unique case.
He put the 20 year remission seen the Swedish Obesity Subjects trial completely down to bariatric surgery which he is a big fan of, was quick to tell me I'd qualify once my BMI hit 35.
Then he decided to weigh me, I was 95kg (with shoes on) against 125kg at diagnosis & then he laughed saying he's only seen that weight loss with bariatric surgery.
So we calculated my bmi as 31 which is still clinically obese, I boasted that I had stopped my weight loss purposely but then he went completely left field.
He offered Ozempic as a further tool to weight loss, I asked him straight up if my current BG would result in complications, he was again unequivocal, stating no, quoting how my background retinopathy had disappeared.

Then he dramatically changed the subject, apparently I fall back into the system where the GPs marked me as "routine" & I don't get referred again for maybe 4 years unless my A1c escalates back to 6.5%(48).
He stressed that all his time was taken up by patients who are not pro-active & I am a complete outlier.
Sadly he said that he only meets someone like me once every 3 months if even, again another smile behind the mask.
Another left field remark was he'd put Metformin into the water supply like fluoride if he was allowed, told you he was brash.

Anyway, I'm still part of the club, I'm not requesting the letter, as great as my figures are I know if I started eating 300g of carbs of day I'd be back where I started.
This is a club I never want to leave, I'll update my sig accordingly but once a T2 always a T2.

tl;dr Endo said I was not diabetic, will change my diagnosis if I wish, I've decided against, I wish to remain a T2

That’s awesome well done you!

I’m fascinated by the science behind it all and will look up some of the things you’ve mentioned I haven’t heard of. Anyone have links?

Also I’d be really interested in the steps you took in your journey and the effect it had - have you already wrote them in a blog?

 

[Dandelade]

I left school at 16 with barely enough CSE’s to write on my CV. My mum died from kidney failure (plus heart disease) due to diabetes when I were 20. My sister has just had (few weeks back now) a below the knee amputation; I disagree it takes A level education to make you realise the importance of taking your diagnosis seriously.

It’s all about mindset and willingness to learn isn’t it? I’m sorry to hear about your Mam and sister Su but it sounds like your proactiveness is working and you’re making great progress in your other posts.

 

[LaoDan]

Congratulations!

 

[zand]

Did you not bother to try to lose weight until you were diagnosed T2? As a woman and caring about how I looked I had done many 800 cal diets in the 25 years with battling with weight gain pre diagnosis, all they did was wreck my metabolism.

How come you were referred to an endo? I thought that was only for T1s?

Sour grapes maybe, but some of us do the work and don't get the results. It doesn't mean we don't have A-levels! It just means our bodies are more complicated than yours. Sorry, feeling grouchy today. B12 deficiency due to metformin and still waiting for follow up appointment with GP!

Congratulations on your results.

 

[Ronancastled]

Sour grapes maybe, but some of us do the work and don't get the results..

Sorry for coming over sounding boasting, a lot of it was fresh in my head & I had no record so needed to get it down quick.
I presume these Endos tailor their chat to the patient they are dealing with.

 

[zand]

Sorry for coming over sounding boasting, a lot of it was fresh in my head & I had no record so needed to get it down quick.
I presume these Endos tailor their chat to the patient they are dealing with.

You didn't. I suppose I am just jealous that some people get appointments with consultants whilst others don't. I just wish I had known about low carbing 35 years ago. I did discover it on my own pre diagnosis ( I was diagnosed 10 years ago) but by then my IR was so bad that it was too late to stop T2. I am pleased that it's 'out there ' now to help people earlier on in T2 development. I guess I was born too soon.

Well done on your achievements. You have inspired me to try harder even if I don't get the same outcome.

Thanks for posting.

Edit. You did say the endo was brash and it was mostly his comments I was reacting to.

 

[Ronancastled]

Edit. You did say the endo was brash and it was mostly his comments I was reacting to.

Yep, there is a superhero complex in that profession.

 

[Ronancastled]

I disagree it takes A level education to make you realise the importance of taking your diagnosis seriously.

I agree & knew his comment would offend but just trying to relate truthfully

 

[zand]

Yep, there is a superhero complex in that profession.

Yes...so maybe it's a good thing I have never been referred! The last thing I need is yet another doctor telling me to eat less and exercise more and refusing to believe my food and exercise diary.


I am pleased you refused the letter, it's good to still have the checks.

 

[Ronancastled]

Yes...so maybe it's a good thing I have never been referred! The last thing I need is yet another doctor telling me to eat less and exercise more and refusing to believe my food and exercise diary.

Guy I met with was young & clued on.
He spoke about a new injectable on phase 3 trials in the US that will be a game changer in his eyes.
Said it beats Ozempic on every marker, plus there are many others coming down the track.
I don't take meds for BG so I haven't studied what's on offer but he made it sound like there was a sea change coming.

 

[Dollylolly]

Guy I met with was young & clued on.
He spoke about a new injectable on phase 3 trials in the US that will be a game changer in his eyes.
Said it beats Ozempic on every marker, plus there are many others coming down the track.
I don't take meds for BG so I haven't studied what's on offer but he made it sound like there was a sea change coming.

Yup with all the side effects too no doubt

Congrats though and we don’t need to be A level compliant to understand our T2 so I do think he’s wrong there.

 

[Ronancastled]

Yup with all the side effects too no doubt

I hopped on that but he was quick to respond that the side effects of high glucose were far greater.

Congrats though and we don’t need to be A level compliant to understand our T2 so I do think he’s wrong there.

Knew that would grate but was just the messenger.
A dangerous generalisation in my book

 

[Oldvatr]

Anyone who has read an endocrinology study report will need an A level - mainly chemistry and physics, and an O level in biology. Also an endo-speak to English dictionary and thesaurus. If not requiring such knowledge then A levels are useful but not essential to managing this condition(s). Understanding media reports needs a simple mindset - they have their own agendas that are not the same as ours, and they lie. Simple.

 

[Mr_Pot]

For many of us on here A levels would have been 40 or 50 years ago and largely forgotten. It is the job of professionals to communicate in ways their audience will understand.

 

[Ronancastled]

For many of us on here A levels would have been 40 or 50 years ago and largely forgotten. It is the job of professionals to communicate in ways their audience will understand.

Think his point was that in his experience educated people with an analytical bias take their diagnosis more seriously.

 

[SuNuman]

It’s all about mindset and willingness to learn isn’t it? I’m sorry to hear about your Mam and sister Su but it sounds like your proactiveness is working and you’re making great progress in your other posts.

Thank you. 100%. I’m not going down their path. X

 

[Lamont D]

Well done Ron.

As someone who tried relentlessly to get a referral, because I was getting symptoms that were not T2.
I had the experience of a n endo, who didn't have a clue.
My next referral, and @zand, I'm not T1 and I'm not Diabetic.
He was so clued up on Hypoglycaemia and thrilled to spend time for me, to get the tests necessary for diagnosis.
I was also threatened to be taken off the register for diabetic checks. My doctor was quick to point this out, that would mean that I would have to pay for prescriptions and the important checks for my eyes and the annual diabetic meeting with my dsn.
When I told my endo what my doctor wanted to do, he first said how can you afford the necessary testing for a food diary, the test strips, the glucometer stabbers and the necessary prescription costs, especially with the drug that he prescribed.
He wrote a terse letter to immediately stop the withdrawal and my GP apologized.

If your endo, does go down this non diabetic diagnosis road. It's a triumph but it can have consequences.

 

[lucylocket61]

Then we both got melancholic about how few T2s take the diagnosis seriously, he noted a huge difference between those who were college educated & those who left prior to A levels.

First, how arrogant and incorrect and supercilious of him.

Second, all the diabetics I know take it seriously, but are ground down eventually to to helpless apathy by the way the medical advice makes them progressively worse, and low carb is often actively discouraged.

Thirdly, forum rules do not allow me to express adequately what I think of his views on academic attainments and intelligence being in any way connected.