Lipid Test (or not)?

[T2#Me]

I went to my surgery to give blood in advance of my next Diabetes Clinic on Tuesday.

The nurse told me she was only instructed by her computer to take blood for the HBA1C test, but not for the cholesterol, etc. test like last time. Apparently my previous lipids test was so good I was now on six month testing, maybe annual?

Personally, I would prefer to have quarterly lipids tests, to check progress and keep motivated, I'm planning to bring this up at the Diabetes Clinic ... good luck to me.

She asked me if I used a meter for monitoring my BSL, which surprised me somewhat, but seemed a positive attitude (she didn't offer to give me one, though )

Incidentally, just for info, I asked if they ever did insulin level testing, she look dumbfounded and told me she had never seen that done in this surgery.

Also, she gave me a pneumonia immunisation injection, which apparently they offer to diabetics above 65 years old. First I'd heard of that one, but I accepted it gladly.

Incidentally, still waiting for the foot test they promised me at the last Clinic three months ago. I had to ring and ask about it, at which point they sent me a self referral form, which I had to complete and send to the local hospital ... still waiting.

My surgery certainly is a parson's egg when it comes to diabetes ... they seem to have really good systems in place, but are somewhat lackadaisical in communicating them to patients. At the same time, they are really kind and helpful, which makes me feel rotten for criticising them.

Probably I'm being over critical, but that's just how it feels from my position at the moment.

I'm wondering what arguments I can use to convince them in the Diabetes Clinic that quarterly lipid tests are not unreasonable in my position ie working hard to reverse my young diabetes (HBA1C 48) with diet and exercise (which surely benefits them too in the long run?), but not wanting nasty surprises with six month or annual lipid testing.

Does this seem fair in other people's experience, or am I just being an entitled snowflake? My opinion shifts by the hour ...

 

[Mr_Pot]

I went to my surgery to give blood in advance of my next Diabetes Clinic on Tuesday.

The nurse told me she was only instructed by her computer to take blood for the HBA1C test, but not for the cholesterol, etc. test like last time. Apparently my previous lipids test was so good I was now on six month testing, maybe annual?

Personally, I would prefer to have quarterly lipids tests, to check progress and keep motivated, I'm planning to bring this up at the Diabetes Clinic ... good luck to me.

She asked me if I used a meter for monitoring my BSL, which surprised me somewhat, but seemed a positive attitude (she didn't offer to give me one, though )

Incidentally, just for info, I asked if they ever did insulin level testing, she look dumbfounded and told me she had never seen that done in this surgery.

Also, she gave me a pneumonia immunisation injection, which apparently they offer to diabetics above 65 years old. First I'd heard of that one, but I accepted it gladly.

Incidentally, still waiting for the foot test they promised me at the last Clinic three months ago. I had to ring and ask about it, at which point they sent me a self referral form, which I had to complete and send to the local hospital ... still waiting.

My surgery certainly is a parson's egg when it comes to diabetes ... they seem to have really good systems in place, but are somewhat lackadaisical in communicating them to patients. At the same time, they are really kind and helpful, which makes me feel rotten for criticising them.

Probably I'm being over critical, but that's just how it feels from my position at the moment.

I'm wondering what arguments I can use to convince them in the Diabetes Clinic that quarterly lipid tests are not unreasonable in my position ie working hard to reverse my young diabetes (HBA1C 48) with diet and exercise (which surely benefits them too in the long run?), but not wanting nasty surprises with six month or annual lipid testing.

Does this seem fair in other people's experience, or am I just being an entitled snowflake? My opinion shifts by the hour ...

I have 6 monthly blood tests with all the results including cholesterol, they only say it should be fasting annually, but I fast at every test to make the lipid levels valid. I have never had a HbA1c test on its own. They only normally do 3 month tests until your BG is under control.

 

[Bluetit1802]

When my nurse told me I was due to move from 6 monthly to annual blood tests I pulled a face (I'm good at that), and said I wanted to keep an eye on my cholesterol and lipids, liver & kidneys, although not bothered about the HbA1c as I self monitor. She explained she could easily do this for me, but unless something wrong with the tests, there would be no follow up review with her after the 6 monthly blood test. It would just be annual and I would have to either ring for the results or look on-line. This was a perfect solution as I saw no need for 6 monthly reviews with the nurse and I see all my results on-line. This was 2 or 3 years ago now. I have been called in 6 monthly for the blood tests (which do include an HbA1c) and just see the nurse annually.

You could try this - not seeing the nurse saves the surgery a lot of time and expense. The blood tests themselves cost very little.

As for foot checks, my nurse does those annually and I am called annually for the retinal eye screening.

 

[Member496333]

It still dumbfounds me that there are no insulin tests commonly performed by GPs. Even more amazing is that no one even seems to understand the significance of insulin dysfunction. If fasting insulin was tested in regular health checkups, most cases of type 2 diabetes could be predicted years or even decades prior to onset and diagnosis. The incredulity is up there near the top of the ‘Absurdity Top 10’ list along with “eat more carbs” and “ don’t monitor your own glucose”.

A conspiracy theorist would think it’s all about selling grains and pharmaceuticals...

 

[Boo1979]

It still dumbfounds me that there are no insulin tests commonly performed by GPs. Even more amazing is that no one even seems to understand the significance of insulin dysfunction. If fasting insulin was tested in regular health checkups, most cases of type 2 diabetes could be predicted years or even decades prior to onset and diagnosis. The incredulity is up there near the top of the ‘Absurdity Top 10’ list along with “eat more carbs” and “ don’t monitor your own glucose”.

A conspiracy theorist would think it’s all about selling grains and pharmaceuticals...

They are not done by endocrinologists either

 

[NicoleC1971]

I don't think there exists a reliable and practical insulin test. Even if NHS clinicians had it on their standard check list for diabetics (they do not).
RE lipid panels, I assume the OP is worried about getting an elevated LDL ? It may be worth looking into the validity of that concern in the context of a low carb diet and assuming no other risk factors (family history, hblood pressure, weight, smoking status).
I get the'full monty' done whenever I get bloods drawn but I think that is because I am Type 1. My recent experience at a CCG diabetes meeting (of which more in anothoer post) really highlighted the reluctance of GPs to order addiitional tests or give test strips to those deemed low risk diabetics.
So lipids can change quite rapidly but the things I'd personally keep an eye on is your triglycerdies/hdl ratio which is reputed to be a better indicator of CV risk but is improved by diet rather than medication.

 

[bulkbiker]

I don't think there exists a reliable and practical insulin test.

I've had 3 done so far with medichecks.. also I believe that a c-peptide may be even better at diagnosing over or under production of insulin. Or so I have been informed by other members on the forum.. That will be my new years treat to myself. Just need to invent an excuse to get some blood drawn for something else..

 

[DCUKMod]

It still dumbfounds me that there are no insulin tests commonly performed by GPs. Even more amazing is that no one even seems to understand the significance of insulin dysfunction. If fasting insulin was tested in regular health checkups, most cases of type 2 diabetes could be predicted years or even decades prior to onset and diagnosis. The incredulity is up there near the top of the ‘Absurdity Top 10’ list along with “eat more carbs” and “ don’t monitor your own glucose”.

A conspiracy theorist would think it’s all about selling grains and pharmaceuticals...

I had a discussion about this a cople of months ago, with a researcher, whose projects and research tend to revolve around metabolic disorders and diabetes.

I asked if he (his team) tested cirrculatin insulin with rresearch subjects. His response was to explain that the currently usual (although not usually done) insulin testing (Have I lost you yet?) is expensive. By comparison to most of the tets we have, it is significantly more.

There is some work going on where "they" arre looking at various mechanisms for this, so hopefully things will change over time.

 

[Boo1979]

I had a discussion about this a cople of months ago, with a researcher, whose projects and research tend to revolve around metabolic disorders and diabetes.

I asked if he (his team) tested cirrculatin insulin with rresearch subjects. His response was to explain that the currently usual (although not usually done) insulin testing (Have I lost you yet?) is expensive. By comparison to most of the tets we have, it is significantly more.

There is some work going on where "they" arre looking at various mechanisms for this, so hopefully things will change over time.

The cost of the test was also the reason my consultant gave for declining to do a C peptide test, while ordering GAD, Islet antibody and thyroid profile tests instead

 

[miahara]

I get HbA1c tests about every 3 months and an annual full lipids tests plus kidney function etc.
I've just had GAD and c-Peptide tests, though it took a bit of pushing to pursuade my GP to order them - she'd never done it before. But I've been losing weight (skinny diabetic to start with) and HbA1C has been rising for 6 months and I was querying if I might be T1 or LADA. Took a month to get results as tests are sent from here in Scotland to a lab in Devon but both results were negative, so no insulin needed yet.
I count myself forunate in that my GP - a lovely lass is very much open to discussion and learning about diabetes. In one of our early chats when I mentioned LCHF diet and she saw the results on my HbA1c tests, she commented - "We're learning together."

 

[archersuz]

Also, she gave me a pneumonia immunisation injection, which apparently they offer to diabetics above 65 years old. First I'd heard of that one, but I accepted it gladly.

I had the pheumonia jab on Thursday and I still can't raise my arm as the muscle is so painful and stiff! Good job it's a once in a lifetime jab.

 

[Mr_Pot]

I had the pheumonia jab on Thursday and I still can't raise my arm as the muscle is so painful and stiff! Good job it's a once in a lifetime jab.

Did you have the flu Jab at the same time? My nurse told me they now space them by 2 weeks to reduce the incidence of arm ache.

 

[Bluetit1802]

Also, she gave me a pneumonia immunisation injection, which apparently they offer to diabetics above 65 years old. First I'd heard of that one, but I accepted it gladly.

Everyone over 65 is offered the pneumonia jab, not just diabetics. I had mine before I was diagnosed. My non-diabetic husband had his when he was 65.

 

[T2#Me]

Everyone over 65 is offered the pneumonia jab, not just diabetics. I had mine before I was diagnosed. My non-diabetic husband had his when he was 65.

Good to know, thanks ... sadly my surgery appears not to know this eg my wife for example was never offered this jab, and neither was I until I was 73 (and, as the nurse said, diabetic) ... they are a bit behind the door, seemingly

 

[Bluetit1802]

Good to know, thanks ... sadly my surgery appears not to know this eg my wife for example was never offered this jab, and neither was I until I was 73 (and, as the nurse said, diabetic) ... they are a bit behind the door, seemingly

This is not up to individual surgeries. It is an NHS thing, and available at all surgeries. There should be posters up on your surgery walls.
https://www.nhs.uk/conditions/vaccinations/when-is-pneumococcal-vaccine-needed/

 

[legolgel]

It still dumbfounds me that there are no insulin tests commonly performed by GPs. Even more amazing is that no one even seems to understand the significance of insulin dysfunction. If fasting insulin was tested in regular health checkups, most cases of type 2 diabetes could be predicted years or even decades prior to onset and diagnosis. The incredulity is up there near the top of the ‘Absurdity Top 10’ list along with “eat more carbs” and “ don’t monitor your own glucose”.

A conspiracy theorist would think it’s all about selling grains and pharmaceuticals...

It is true, my sister had some markers but they told her they couldn't do the test until she was really sure she got Diabetes.... Is it really unethical

 

[archersuz]

Did you have the flu Jab at the same time? My nurse told me they now space them by 2 weeks to reduce the incidence of arm ache.

No, I had the flu jab at least a month ago.