2nd Official Dn Visit After Great Hba1c

bigsi1984

Well-Known Member
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88
Type of diabetes
Type 2
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Hey guys,

I had my first follow up with the DN yesterday. I got my first HbA1c done since diagnosis and have previously posted about a great result; 85 to 41 in three months and lost just shy of 3 stone. All LCHF and exercise. I got my results over the phone as DN was on holiday and so this is the first time I’ve seen her since the result.

She was happy enough with my result but within 5 minutes of sitting down I got the following:

‘Your blood pressure has come down along with your sugars and your cholesterol is mostly the same as last time. So I don’t think you need a statins just yet’.

I asked what she meant by ‘yet’ given that my levels are all in normal ranges, to which she replied:

‘You definitely will need statins at some point because you’re high risk. So it’s just a matter of when. I mean if you kept losing weight and kept your sugars down and your cholesterol was more normal then I don’t know. But let’s assume you will need them, just not now’.

I left feeling pretty deflated. Obviously managing my diabetes is a life long thing regardless of my numbers but it felt like she had to put something on the agenda. Stress I could do without.

I didn’t bother to say that I would like to take the same approach as I have with my T2 and see how I get on under my own steam. It seemed pointless. When I first met her she seemed very supportive and even talked about reading this forum. But since my diagnosis my mum has been diagnosed T2 and has the same DN. She told my mum not to pay attention to forums as it was mostly rubbish.

Here are my latest results, comments and opinions welcome:

Higher figure refers to results in April

Blood pressure: 120/80 (down from 135/85)
Weight: 157kg (down from 174kg)
HbA1c: 41 (down from 85)
Total cholesterol: 4.4 (Normal range 0-5)
Trigs: 0.95 (down from 1.43)
HDL: 1.36 (up from 1.33)
LDL: 2.61 (up from 2.42)
Ratio: 3.24 (down from 3.31)
Liver function SERUM ALT: 63 (down from 72)

Thanks
 

Guzzler

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Fantastic job there! When you actively lose weight this can skew your cholesterol figures but you're doing fantastic. Don't let the DN bring you down. Read up on cholesterol and statins then make a judgement call.

Tell your Mum about your success and about this forum, she can lurk or take an active role, we will welcome her.
 
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Pipp

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Well done, @bigsi1984 .
I think (speaking from personal experience) some HCPs see size, overweight, no matter that you have lost lots, and don't consider how demoralising comments can be. If, according to the charts they have, (which to me some HCPs justify as 'following NICE guidelines) you are outside of the set parameters on weight, BMI etc, they go with the said guidelines. In your instance, her chart will tell her 'statins recommended'. We all have choices though. As @Guzzler says, read up, make your own mind up.
 

Rachox

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Well done! Brilliant results! Just blind her with science next time, tell her you go by ratios not just total cholesterol. @bulkbiker has helped me tremendously with interpreting lipid results. My total will be waving a red flag at my GP at my appointment on Friday but my ratios are good, so I’m confident to decline Statins (again!)
 

PenguinMum

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Hold fast @bigsi1984 you have done really well. I like you do not want to take statins just bcause of T2 diagnosis. As regards cholestrel can someone explain what the range of good ratios are?
 
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Terrytiddy

Well-Known Member
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835
Type of diabetes
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Hey guys,

I had my first follow up with the DN yesterday. I got my first HbA1c done since diagnosis and have previously posted about a great result; 85 to 41 in three months and lost just shy of 3 stone. All LCHF and exercise. I got my results over the phone as DN was on holiday and so this is the first time I’ve seen her since the result.

She was happy enough with my result but within 5 minutes of sitting down I got the following:

‘Your blood pressure has come down along with your sugars and your cholesterol is mostly the same as last time. So I don’t think you need a statins just yet’.

I asked what she meant by ‘yet’ given that my levels are all in normal ranges, to which she replied:

‘You definitely will need statins at some point because you’re high risk. So it’s just a matter of when. I mean if you kept losing weight and kept your sugars down and your cholesterol was more normal then I don’t know. But let’s assume you will need them, just not now’.

I left feeling pretty deflated. Obviously managing my diabetes is a life long thing regardless of my numbers but it felt like she had to put something on the agenda. Stress I could do without.

I didn’t bother to say that I would like to take the same approach as I have with my T2 and see how I get on under my own steam. It seemed pointless. When I first met her she seemed very supportive and even talked about reading this forum. But since my diagnosis my mum has been diagnosed T2 and has the same DN. She told my mum not to pay attention to forums as it was mostly rubbish.

Here are my latest results, comments and opinions welcome:

Higher figure refers to results in April

Blood pressure: 120/80 (down from 135/85)
Weight: 157kg (down from 174kg)
HbA1c: 41 (down from 85)
Total cholesterol: 4.4 (Normal range 0-5)
Trigs: 0.95 (down from 1.43)
HDL: 1.36 (up from 1.33)
LDL: 2.61 (up from 2.42)
Ratio: 3.24 (down from 3.31)
Liver function SERUM ALT: 63 (down from 72)

Thanks
Hi @bigsi1984 how could you be deflated after them results?:happy: You have to understand that some GP's an Dn are "programmed":wacky: they see certain figures, over weight, blood sugars, cholesterol and go into automatic response mode! You must loose weight, you must go on statins, you must do carbs, you must do Metformin, you must do Gliclazade buzz, buzz, buzz. You have done great mate and have shown them that you do not need all the "hype" hold your head up high and show them that you mean business and prove them all wrong. :):singing::smug:
 

bulkbiker

BANNED
Messages
19,576
Type of diabetes
Type 2
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Diet only
Hey guys,

I had my first follow up with the DN yesterday. I got my first HbA1c done since diagnosis and have previously posted about a great result; 85 to 41 in three months and lost just shy of 3 stone. All LCHF and exercise. I got my results over the phone as DN was on holiday and so this is the first time I’ve seen her since the result.

She was happy enough with my result but within 5 minutes of sitting down I got the following:

‘Your blood pressure has come down along with your sugars and your cholesterol is mostly the same as last time. So I don’t think you need a statins just yet’.

I asked what she meant by ‘yet’ given that my levels are all in normal ranges, to which she replied:

‘You definitely will need statins at some point because you’re high risk. So it’s just a matter of when. I mean if you kept losing weight and kept your sugars down and your cholesterol was more normal then I don’t know. But let’s assume you will need them, just not now’.

I left feeling pretty deflated. Obviously managing my diabetes is a life long thing regardless of my numbers but it felt like she had to put something on the agenda. Stress I could do without.

I didn’t bother to say that I would like to take the same approach as I have with my T2 and see how I get on under my own steam. It seemed pointless. When I first met her she seemed very supportive and even talked about reading this forum. But since my diagnosis my mum has been diagnosed T2 and has the same DN. She told my mum not to pay attention to forums as it was mostly rubbish.

Here are my latest results, comments and opinions welcome:

Higher figure refers to results in April

Blood pressure: 120/80 (down from 135/85)
Weight: 157kg (down from 174kg)
HbA1c: 41 (down from 85)
Total cholesterol: 4.4 (Normal range 0-5)
Trigs: 0.95 (down from 1.43)
HDL: 1.36 (up from 1.33)
LDL: 2.61 (up from 2.42)
Ratio: 3.24 (down from 3.31)
Liver function SERUM ALT: 63 (down from 72)

Thanks

Your nurse is I'm afraid talking drivel and is obviously completely unaware of more recent thinking on cholesterol. Unfortunately not unusual these days.
Your total is fine (as you know already although completely unimportant).
Your Triglyceride HDL ratio is 0.95/1.36 = 0.6985 which is absolutely spectacular (under 0.87 is best) and is currently thought to be the most important as an indicator of possible CVD .. any HCP who would recommend statins based on your results should be struck off immediately.
 

DavidGrahamJones

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I got my first HbA1c done since diagnosis and have previously posted about a great result; 85 to 41 in three months and lost just shy of 3 stone.

Absolutely brilliant! Well done!

I left feeling pretty deflated.

You shouldn't do.

You definitely will need statins at some point because you’re high risk. So it’s just a matter of when.

Even if she felt that you needed something to lower your cholesterol, there is nothing that says you must take that medication. In fact the NICE guidelines state exactly that for any prescribed drug, it's meant to be an agreement between patient and person prescribing the drug. I keep plugging the attached graph. It's a little old now but still valid. It might only have total cholesterol measured rather than HDL/LDL/Trigs but still relevant. Looking at the dotted red line it plots the number of deaths from a cardio vascular event against the total cholesterol, the number of deaths increase as you go above about 205 mg/dl (5.3 mmol/L - For total, HDL, and LDL cholesterol multiply mmol/L by 38.67), and increase as you go below 5.3 mmol/L.

She told my mum not to pay attention to forums as it was mostly rubbish.

So much rubbish that my condition has improved exponentially since follow the advice gleaned from their pages. I can accept that people like your DN is wrong, but I struggle with so called experts giving the same old advice that they did in the 1970s and be so unaware of what's going on. I need to find the DN who was up for an award, her story should be taken to your DN.

Edit: http://diabetestimes.co.uk/low-carb-nurse-advocate-up-for-top-health-award/ The URL says itall.
 

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bigsi1984

Well-Known Member
Messages
88
Type of diabetes
Type 2
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Other
Your nurse is I'm afraid talking drivel and is obviously completely unaware of more recent thinking on cholesterol. Unfortunately not unusual these days.
Your total is fine (as you know already although completely unimportant).
Your Triglyceride HDL ratio is 0.95/1.36 = 0.6985 which is absolutely spectacular (under 0.87 is best) and is currently thought to be the most important as an indicator of possible CVD .. any HCP who would recommend statins based on your results should be struck off immediately.

I didn’t know that about the trigs ratio. I’m going to do some reading today. Thanks for you help.
 
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bigsi1984

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Thanks for all the support guys. I am happy with the results. Just feel like certain NHS staff would be happy if we were all ‘chronically progressing’. Then they could feel smug and not undermined.
 
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alf_Josiah

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@bigsi1984
Fantastic results in a short period of time on weight. Well done.
Over my years dealing with nurses diabetic or not I have been given so much conflicting advice that I now ignore anything and everything they say. With regard to my diabetic treatment I listen to the specialist diabetic doctor only.
 

shelley262

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Congratulations amazing results and good cholesterol ratio too you’re clearly doing really well. Yes you would expect to feel that a medical well done may be in order without any caveats but I suppose they have a lot of patients who just keep returning with worse figures. Well done you for showing it’s possible
 
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purplesally

Active Member
Messages
34
Type of diabetes
Type 1
Hey guys,

I had my first follow up with the DN yesterday. I got my first HbA1c done since diagnosis and have previously posted about a great result; 85 to 41 in three months and lost just shy of 3 stone. All LCHF and exercise. I got my results over the phone as DN was on holiday and so this is the first time I’ve seen her since the result.

She was happy enough with my result but within 5 minutes of sitting down I got the following:

‘Your blood pressure has come down along with your sugars and your cholesterol is mostly the same as last time. So I don’t think you need a statins just yet’.

I asked what she meant by ‘yet’ given that my levels are all in normal ranges, to which she replied:

‘You definitely will need statins at some point because you’re high risk. So it’s just a matter of when. I mean if you kept losing weight and kept your sugars down and your cholesterol was more normal then I don’t know. But let’s assume you will need them, just not now’.

I left feeling pretty deflated. Obviously managing my diabetes is a life long thing regardless of my numbers but it felt like she had to put something on the agenda. Stress I could do without.

I didn’t bother to say that I would like to take the same approach as I have with my T2 and see how I get on under my own steam. It seemed pointless. When I first met her she seemed very supportive and even talked about reading this forum. But since my diagnosis my mum has been diagnosed T2 and has the same DN. She told my mum not to pay attention to forums as it was mostly rubbish.

Here are my latest results, comments and opinions welcome:

Higher figure refers to results in April

Blood pressure: 120/80 (down from 135/85)
Weight: 157kg (down from 174kg)
HbA1c: 41 (down from 85)
Total cholesterol: 4.4 (Normal range 0-5)
Trigs: 0.95 (down from 1.43)
HDL: 1.36 (up from 1.33)
LDL: 2.61 (up from 2.42)
Ratio: 3.24 (down from 3.31)
Liver function SERUM ALT: 63 (down from 72)

Thanks

Really feel for type 2's who have to rely on GP/DN. My consultant has asked me to explore with the GP why I am prescribed statins cos she doesn't think I need them
 
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Bluetit1802

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Really feel for type 2's who have to rely on GP/DN. My consultant has asked me to explore with the GP why I am prescribed statins cos she doesn't think I need them

Perhaps you should do a bit of research yourself, and make sure you have a full breakdown of your cholesterol blood tests - HDL/LDL/Triglycerides. Statins are very much over prescribed by GPs, mostly unnecessary. There are hundreds of threads on the forum about this with lots of links and videos if you do a search.