Any Advice Please

[chestershepherd]

Ok Guys and Girls
I was diagnosed with type 1 diabetes in august2008 and put on insulin .3 weeks later consultant said I was type 2 and put on metformin. On my visit to consultant in dec 2008 my hbac1 was excelent and that he was confident i was tyep 2 diabetic.. On my next visit in March 2009 .Saw a aide of the consultant who said my hbc1a had dropped to 6.9 and was excellent and to reduce my dosage of metformin to 500g once a day .Instead of 1000g a day.
In June 2009 after a period of bad health the gp sent me to see a consultant again same aide as before who told me i was no longer type 2 and now type 1 as my hbc1a had raised to 14.2 and they started me on insulin. This has resulted me in losing my job as a train driver.
My argument with my doctor is surely if my levels where so good why In march 2009 . Why did they reduce my dosage of metformin? I thinks its a bit strange to say the least. I have asked for a c peptide test or if there is any other test which could be done to determine if i am type 1 or type 2 as the treatment insulin or metformin will have a great impact on my life. Any suggestions anyone on where i go from here.

 

[noblehead]

It would seem that when you were taking 1000g of metformin you had a good hba1c, can't understand why the consultant would change this.

Hope the test goes your way and you can return to your duties.

Good luck

Nigel

 

[fergus]

A bit baffling to say the least. Firstly, HbA1c's of 6.9 and above aren't excellent, they are higher than they ought to be. To then have your medication reduced, with the almost inevitable further rise in HbA1c, seems negligent to me.
HbA1c of 14.2 is very high indeed and suggests significant insulin resistance and/or lack of beta cell function. I think you are absolutely right to insist on a c-peptide test to definitively measure your ability to produce insulin. Only then will you be able to know whether or not you need additional insulin to bring your blood glucose back into line.
Best of luck,

fergus

 

[noblehead]

Fergus,

I agree that 6.9 isn't excellent, but it is a **** site better than 14.2!

The 6.9 reading is on the right lines, in time it may have reduced further on the 1000g dose, couldn't see why they changed this to 500g.

Nigel

 

[ebony321]

i disagree with saying 6.9 isnt an excellent HBA1C.. that is an average of 8mmol, which is in the guidelines most diabetics are given which is between 5-9!!!

i'd be **** proud t own a HBA1C that low,

i see alot of people saying figures like that are too high, everyone has different standards and im sure chester has alt more to worry about without people telling him/her their HBA1C isn't excellent when he/shes been told is is by her medically trained diabetes specialist.

i dont want to have a go, but i get thing slike this alot and i guess yu could say im passionate about it.

so well done chester and i hope you get to the bottom of it all and get your HBA1c back down to the brilliant percentage it was previously!! x

 

[chestershepherd]

Ok
Thanks everyone for the time you have taken to reply, Thats answered a few points in the sense why lower my dosage of metformin when it was obvioulsy working and lowering my levels over time . I have managed to get an app with the consultant to question him on this. I dont quite think that consultants realise the impact wrong dignosis has on people for me its been devastating in the fact that after 22 years with the same company I face the sack this friday unless I can remain on metformin.

 

[chestershepherd]

It would seem that when you were taking 1000g of metformin you had a good hba1c, can't understand why the consultant would change this.

Hope the test goes your way and you can return to your duties.

Good luck

Nigel

Thanks for that and i dont understand either but hope to get answers soon

 

[chestershepherd]

A bit baffling to say the least. Firstly, HbA1c's of 6.9 and above aren't excellent, they are higher than they ought to be. To then have your medication reduced, with the almost inevitable further rise in HbA1c, seems negligent to me.
HbA1c of 14.2 is very high indeed and suggests significant insulin resistance and/or lack of beta cell function. I think you are absolutely right to insist on a c-peptide test to definitively measure your ability to produce insulin. Only then will you be able to know whether or not you need additional insulin to bring your blood glucose back into line.
Best of luck,

fergus

Thanks for that it does seem negligent to me also but consultant has told me it is not worth doing a c peptide test. Have requested a review meeting with him in 2 weeks to discuss this

 

[chestershepherd]

i disagree with saying 6.9 isnt an excellent HBA1C.. that is an average of 8mmol, which is in the guidelines most diabetics are given which is between 5-9!!!

i'd be **** proud t own a HBA1C that low,

i see alot of people saying figures like that are too high, everyone has different standards and im sure chester has alt more to worry about without people telling him/her their HBA1C isn't excellent when he/shes been told is is by her medically trained diabetes specialist.

i dont want to have a go, but i get thing slike this alot and i guess yu could say im passionate about it.

so well done chester and i hope you get to the bottom of it all and get your HBA1c back down to the brilliant percentage it was previously!! x

cheers ebony i hope so also

 

[chestershepherd]

Hi Ebony and everyone else who replied to my thread the past 8 months have been traumatic to say the least. When I last saw my consultant he told me my Pancereas had stopped working and that was it and to realise that. My point of view was that when his assistant lowered my dose of metformin to 500g a day things started to go wrong , he was very blase saying well thats life its just a coincidence well after much persuading he agreed to do a c peptide and anitbody test and guess what Insulin resistance was 128 and c-peptide 1245 so shows panceras are working and producing some insulin . So now on 2000g on metformin and 30g Gilpos a days.

So my message is go with your gut instinct if you think you not getting the right treatment push for answers . The health service is excellent and I am in no way putting them down but sometimes they do get it wrong like in my case. The result being lost my job after 20 years service , selling my flat and on half pay. All because I got diagnosed on a Bank Holiday weekend and procedures where not carried out properly everyone just wanted to get home .

In a space of 2 years I have been told I am type 1 then 8 weeks later type 2 in hindsight the patient is defo type 2 the consultant said then 8 months later type 1 again because of reduced metformin . Now they wont class me as a type 1 or 1 lol consultant just said take tablets and see what happens. And if they are and train drivers who need advice then please feel free to contact me I have become a expert in RSSB standards and guidelines in realtion to train driving and diabetes.

 

[moonstone]

What's also irritating about the whole scenario is how they have got the basics so wrong - a type 1 has an autoimmune attack underway, whereas a type 2 doesn't, whether they need insulin or not. They're different diseases. How they can tell you you're swinging between one and the other is beyond me. I hope for your sake you can get your job back? Unfair dismissal? With investigations still underway they should surely have simply signed you off sick until you had a definitive diagnosis? Of course they have a legal duty to ensure passengers are safe so you'd have had to stop driving trains on insulin, but they also have duties towards their employees in different ways.