Experience With Doctors

[elmer_dinkley]

I received a letter from my surgery asking me if I would attend a special diabetes clinic. It was sponsored by Takeda producers of Pioglitazone. This would be run by a private health care company. I was dubious to say the least, as a supporter of the NHS I worried my normal diabetes visits where being outsourced to a private company who would drug push the sponsors product. I was reassured this would not be the case and surprisingly it wasn't. finally someone at my surgery listened to my problems with metaformin. A horrible 18 months of stomach pain, diarrhea, mood swings, unable to lose weight and generally feeling terrible. My levels have gone back to where they started, so she ran through all the drug options. the 2 she suggested was one that hasn't got a licence in my area and (GLP-1) agonists . After all this my doctor over ruled it and requested an appointment. His attitude was nothing more than arrogant " I am the diabetes specialist at the surgery" he told me as he still pushed metaformin on me. Admitting that the ones recommended where expensive. I did mention as he is my named doctor and the specialist its the first time I have ever seen him. I have modified my diet massively but still my sugars rise. Unfortunatly my size gives them the easy way out and I get the cut back on sugary foods and drinking, both I have pretty much stopped. He finally prescribed Alogliptin despite my reservation on hypos. His parting shot was " you may need to test to keep an eye on levels" . I have been testing after last meal and first thing to get a fasting blood sugar level. Is this enough. Sorry to sound so moaning but the feeling my illness is running away from me with no signs of bringing it under control is depressing.

 

[DavidGrahamJones]

A horrible 18 months of stomach pain, diarrhea, mood swings, unable to lose weight and generally feeling terrible.

I initially put up with exactly those symptoms for 5 years, with my then GP saying that it was better than the side effects of poorly controlled BG. Not very helpful. I now eat less than 50gms of carb a day and the side effects that were life changing all those years ago really are a thing of the past. I wonder if diet alone has improved matters.

. . . . she ran through all the drug options. the 2 she suggested was one that hasn't got a licence in my area and (GLP-1) agonists . After all this my doctor over ruled it and requested an appointment. His attitude was nothing more than arrogant

I assume she was your DN? When it comes down to money I can sort of understand a GPs arrogance, but really they should be concealing that sort of impression.

Unfortunatly my size gives them the easy way out and I get the cut back on sugary foods and drinking, both I have pretty much stopped.

Keep a food diary and take it with you, worked a treat with my GP, she knew instantly that I was taking it seriously. No ifs or buts. I could say "This is what I eat, what's the problem, over to you doc".

you may need to test to keep an eye on levels

Was he not an advocate of type IIs monitoring. I really wish one of these GPs could explain why they think it's such a good idea to wait until an HbA1c is done to find out if ones life style changes diet and/or exercise have made a difference.

Sorry to sound so moaning but the feeling my illness is running away from me with no signs of bringing it under control is depressing.

No need to apologise, it was only a little moan anyway. Diet and exercise help a lot but there could be a time when additional help in the form of medication is required. The GP has several options and it seems your DN has already gone through them. The problem then is funding and I think it's worth baring mind that GP surgeries are decreasing in number because of several factors including staffing (GPs and ancillary staff) and also the cost of running a practice. See if you can find out what your surgery pays for Indemnity Insurance since patients have been able to get hold of their records. It's an eye opener.

 

[elmer_dinkley]

Genius David, many thanks the food diary idea is brilliant. As a big fat lad I have always had the first look diagnosis
. She wasn't a DN she works for a private health care company who are running this clinic. My surgery doesn't have a diabetic nurse at the moment he left and they are still training a new one it seems. The doctor is known for an attitude and thinks everyone who complains is pushing for sick notes. I run 2 companies and have another job, so I sicknote is the last thing I want. I have not been able to exercise properly because of the stomach cramps and loose bowel movements. With my bloods running a bit high I have lost 16lb in 3 weeks. Before I was diagnosed I lost 20lbs. since being on metaformin my weight has stayed the same. I did ask what would be the effects of doing this for a couple of months to see if the weight loss effected my condition, he wasnt impressed lol. Thanks buddy, your reply has made me feel a little better about this

 

[bulkbiker]

Hi @elmer_dinkley you say you have cut back on sugary foods and booze but have you thought about cutting back on all carbs?
Has worked wonders for many and got us off all meds. Just a thought once you get into the swing of it it's pretty easy and delicious.

 

[elmer_dinkley]

Hi @elmer_dinkley you say you have cut back on sugary foods and booze but have you thought about cutting back on all carbs?
Has worked wonders for many and got us off all meds. Just a thought once you get into the swing of it it's pretty easy and delicious.

Hi, yes I have cut back on carbs, replacing most things with a low carb alternative. Booze has never been an issue, I don't realy drink and have probably had 4 pints in 3 years. A daily chocolate bar has gone along with the coffee / pastry breakfast. frustratingly it was working for a while then the bloods increased and wouldn't come down. The doctor offered me a dietitian but I by his reaction to me saying I am cutting carbs I declined it. sounds bad but I don't think they can tell me anything I don't know.
cheers for the advice, I am glad you lot are out there

 

[Guzzler]

It makes you wonder why the practice employs a private company then ignores their advice. I realise that it may come down to their legal requirements to provide services and the funding for drugs but this state of affairs wastes far more money than it saves and serves patients poorly.

 

[kitedoc]

Hi @elmer_dinkley, Do you ever get the impression that doctors sometimes do not like new ideas?
1) After 50 years on insulin my classification and choice of doctor has evolved: I expect:
To be listened to , so that for example side-effects such as you described to your doctor would be taken seriously and attended to.
To have a doctor who keeps up to date or at least admits if he/she does not know and makes efforts to find out or refer me to someone who does
acceptance by him/her that patients learn from many sources including other health professionals and that ideas from such sources may have merit. Even if they do not, quietly pointing out why an idea might have been misinterpreted or frankly unwise is better than having any thought outside his/or her control berated.
2) Have you thought how much stress may be playing a part in your challenges with BSLs ? you have what sounds like a heavy workload. Is it worth it ? Stress makes our bodies more resistant to the insulin whether the body's own or to that injected.
3) whilst diet and weight loss have led to reversals of type 2 diabetes of some folks (as I am sure many here will attest to) there is no clear idea as to how long such reversals will last. And many persons have described how with diet etc their type 2 diabetes has progressed over years to needing more medications.
The above are thoughts to ponder and are not medical advice or opinion. Your DSN and a proper doctor are your main allies.
Best Wishes !!

 

[elmer_dinkley]

just an update on Alogliptin. 5 days in and looking good. I am testing after last meal and first thing in the morning and the levels are steadily reducing. None of the effects as I had with metaformin,. such a shame that I had to throw a paddy for the surgery to do something and I know there is a lot of people worse off than me with their condition. Thanks for the help everyone

 

[Lampman]

just an update on Alogliptin. 5 days in and looking good. I am testing after last meal and first thing in the morning and the levels are steadily reducing. None of the effects as I had with metaformin,. such a shame that I had to throw a paddy for the surgery to do something and I know there is a lot of people worse off than me with their condition. Thanks for the help everyone

I am pleased to hear you have found something that is starting to work for you. It is good advice to monitor your food intake and by testing after meals you may begin to see the worst culprits and perhaps change them to something else. Another thing I found by doing that is the time of day some things are eaten may be critical too. I cannot look at carbs in the morning at all, but later in the day is not so bad. You will only find out by testing everything! Your food diary will be your friend as well as providing evidence for doubting doctors. Good luck!

 

[JJFDiabetic]

Genius David, many thanks the food diary idea is brilliant. As a big fat lad I have always had the first look diagnosis
. She wasn't a DN she works for a private health care company who are running this clinic. My surgery doesn't have a diabetic nurse at the moment he left and they are still training a new one it seems. The doctor is known for an attitude and thinks everyone who complains is pushing for sick notes. I run 2 companies and have another job, so I sicknote is the last thing I want. I have not been able to exercise properly because of the stomach cramps and loose bowel movements. With my bloods running a bit high I have lost 16lb in 3 weeks. Before I was diagnosed I lost 20lbs. since being on metaformin my weight has stayed the same. I did ask what would be the effects of doing this for a couple of months to see if the weight loss effected my condition, he wasnt impressed lol. Thanks buddy, your reply has made me feel a little better about this

Dear Elmer
Please think about getting a second opinion from a second doctor or local A&E. Pain is the bodies way of letting you know some thing is wrong. I also have a heart condition and a while ago I got a cramp in my calf. I went to the doctor and he sent me for blood tests to check if something serious was wrong. Heart conditions tend to get doctors thinking in that direction. It turned out to be just a huge cramp. The reason I am telling you this is that the doctor may use your size and condition (Diabetes) as an excuse not to test for some other conditions. I do not want to frighten you but have it rechecked out. A pain that is stopping you exercise is not something to right off as nothing. There are a lot of things it could be. Cancer UK have a saying "If something feels wrong have it checked out." Lad your heath is not a thing to play with. Hope this helps. If it was me I would.

 

[kpol2016]

Good morning
Sorry to hear of your lack of support from your GP. I had the same problems with metaformin. Even ended up in hospital with it !
The hospital belly doctor(sorry can not remember his field) told me that the issues caused by metaformin seemed to keep him busy. Local GP and DN were understanding, and I reduced my level of metaformin and reduced my carbs. On a visit to local hospital diabetic clinic, they mention Slow Release metaformin, which seems to nearly stopped the side effects(I still stop taking it once in a while, to give my tummy a rest) but it seems to be working. Lowering my carb intake has aslo helped, last reading hbc1a(?)was 57 (was 54 !) down from 80 plus last year! Low carb is the way, it also reduces the insulin you need aswell(down by approx 20 %), NHS are slowly coming round. Remember it is your body, so you need to do what you think is best. You are the best diabetic specialist for yourself. Take care.

 

[videoman]

Good Morning I hope; the service from my GP surgery has gone from good to bad;they pass you over to doctors you do not know and then prescibed medication with out explaination and the letter that should have arrived ,did not arrive buy private courer 3 days later and the told that my GP will asses me with a telephone examination,why .So much for a better NHS service

 

[Terrytiddy]

Hi @elmer_dinkley good that you stood up for yourself. How's your progress coming on now? have you thought about doing Low Carb High Fat (LCHF)? I did this with very low carbs (20g a day then 5g a day) I also do fasting every day. I lost 4 stone in 3 months. Reduced my HbA1c from 82 to 41 and got Blood glucose down from 16,6 to 4.7 average over 30 days. My Dr was shocked to say the least at my results as they are not keen on LCHF way of eating.