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

Fenn

Well-Known Member
Messages
1,405
Type of diabetes
Type 1.5
Treatment type
Insulin
Congratulations!

Well maybe the stupid among us (Me) do badly because I can't read or understand studies, if I'm lucky I understand about half of what the doctor says, have never taken an exam in my life or finished school, never read a book and spend more time correcting my typos and adding punctuation on here than looking after my diabetes lol I do however take it seriously, Just seriously with a grin.
 

Dollylolly

Well-Known Member
Messages
190
Type of diabetes
Prediabetes
Treatment type
Other
Dislikes
The docs thinking drugs cure all
There is also who doesn’t take care of themselves the most, the medical profession mainly doctors as they know best and make themselves worse, well that’s my theory not better.

most diabetic meds all carry side effect and should be told not whitewashed like some are sadly. For me I like to be told not a letter 2 weeks later which scared the **** out of me. Dapagliflozin I’m on for now but not for much longer.

So we have to do a balancing act of high sugars vs the meds but some don’t reduce it enough and then they increase it causing more side effects, or adding another drug to counter act the other. A minefield for sure for some.
 
  • Like
Reactions: Ceebee2

SuNuman

Well-Known Member
Messages
514
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Being diabetic lol.
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.
100% agree. X
 
  • Like
Reactions: EllieM

lovinglife

Moderator
Staff Member
Messages
4,537
Type of diabetes
Type 2
Treatment type
Diet only
You don’t have to be educated to be knowledgeable
 
M

Member496333

Guest
Mixed messages there to be honest. Prefers lifestyle over pharmaceuticals but wants to put Metformin in the water supply :shifty:

Anyway, great work so keep it up.
 

MrsA2

Expert
Messages
5,574
Type of diabetes
Type 2
Treatment type
Diet only
Timely post @Ronancastled .
I'm still trying to work out whether to keep complaining to my gp surgery to get my t2 diagnosis registered (they say I never had it. I say put it into remission because of quick and effective action. I just want regular checks).
I sometimes dream of even getting an appointment with a lowly dn, let alone a consultant.
 

danziger

Well-Known Member
Messages
166
Type of diabetes
Type 2
Treatment type
Diet only
Might not be the main takeaway but we’re going to need a LOT more public toilets if that Metformin idea is ever actioned! ;)
 

coby

Well-Known Member
Messages
1,083
Type of diabetes
Type 2
Treatment type
Diet only
Dislikes
Social mixing most sport, Soaps!
Firstly one of these :joyful:
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
Wow, what an amazing day you've had! Would SO loved to have been a fly on the wall :D
 

Buster_

Well-Known Member
Messages
60
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Mixed messages there to be honest. Prefers lifestyle over pharmaceuticals but wants to put Metformin in the water supply :shifty:

He didn't say he preferred lifestyle over pharmaceuticals, he said lifestyle changes were more effective than drugs, which we all know to be true: none of the drugs commonly in use will put a type 2 into remission but weight loss and a low carb diet very well might. He's simply acknowledging that not everyone understands or is willing to adopt and maintain the necessary dietary changes, thereby making drugs the only control option for that (probably very large) group.

I think people are getting unnecessarily offended over the A-levels thing too. Some people seem to have incorrectly interpreted his comment as "You thicko's without exams are too stupid to look after yourselves", but again, that's not what he said. He's a highly trained scientist and he shared a clinical observation, reporting that of the patients he encounters, those with a lower level of education tend to take their condition far less seriously than graduates. Why get offended at this fact?
 

lucylocket61

Expert
Messages
6,435
Type of diabetes
Type 2
Treatment type
Diet only
He's simply acknowledging that not everyone understands or is willing to adopt and maintain the necessary dietary changes, thereby making drugs the only control option for that (probably very large) group.
There are many who are, due to complex medical needs, unable to make sufficient dietary changes. And some for whom dietary changes are insufficient to control their diabetes
Why get offended at this
It's not a fact, it an opinion unscientifically formed.
 
  • Like
Reactions: KidDougi and KK123

Ronancastled

Well-Known Member
Messages
1,236
Type of diabetes
Type 2
Treatment type
Diet only
YES! You must ... I was riveted !

Right, missus is watching Dr. Pimple Popper so now is as good a time as anyway.
Firstly, I'd like to apologise about his comment on the educated vs those who didn't achieve a high academic level.
One of the first questions he asked me was "what was my profession", I informed him I was a design engineer so he knew he was talking to someone academic. I think this was further enforced by me quoting all the main studies, knowing relevant metrics & units.

Anyway, onto the good stuff.

I described visceral fat as being described as chewing gum in pathology reports on cadavers.
He asked me if I liked foie gras, which I don't, he said "that's duck fatty liver created by force feeding them grains & that's what your liver is coated in".

I quoted my early Kellogg's Shreddies test where I hit 13.3 at the 1 hour, "That's diabetes" he loudly declared leaning forward" . . . then I told him I repeated the test 4 months later & only reached a 7 & he burst out laughing, think he was happily surprised.

I asked him if he believed in Taylors theory on beta cell dedifferentiation & recovery being dependant on restoring original cell function. He was non-committal, said it was a plausible hypothesis but may just be the effect of the remaining cells working harder. I thought about asking about Dr. Longo's FMD but decided to leave it.

I asked him about IF & while he didn't declare himself a fan he was in favour of whatever kept the weight off. Said he was frustrated by private clients who he sees every 3 months who may have only lost a kilo & are delighted with themselves. This Endo was a huge fan of bariatric surgery or weight loss pharmaceuticals. Encouraged me to take Ozempic it to further my weight loss, said it suppresses all appetite cravings. Although he was impressed by Taylors 15kg weight loss in his best responders he claimed bariatric surgery can produce double that & most importantly maintain it for longer remission. On the subject of weight loss I dissed Slimming World & their high carb foods but he defended it on the ground that he's seen results.

On the subject of Ozempic he said there's a game changer injectable in Phase III trials that surpasses it's results. Should be on the market in 2022.

I covered his low belief in long term remission in my first post but there were a few incidentals I left out. He said I was always predisposed to develop T2, it was my lifestyle choices that hastened it to my age of 47 at diagnosis. He did say he has seen bariatric surgery patients delay it into their 70s but did say it would return regardless of weight loss. In other cheery news he told me that as my wife had GD on our 3rd child she would also get T2 & because both of us had it then our children were 80% likely to get it.

On the subject of CGMs he was a big fan though did believe that the Dexcom was far more accurate than the Libre. His problem with the Libre was the lows read too low & the highs read too high. He wasn't aware of the 2019 study I mentioned where 153 non-diabetics wore a Dexcom to establish normal non-diabetic glucose levels, he asked me to email him on the links.

On the subject of Desmond, Xpert & other dietary courses advising the food pyramid/Eatwell plate/wholegrain carbs he glanced it off saying people should tailor their own balanced plan. I did tell him that was a rubbish answer & he laughed. I pushed the idea that all newly diagnosed T2s should be a CGM to show them the effect of carbs but said not all patients would even put it on. His experience was that most patients think that tablet allows them to eat their previous diet, even finding a T2 who regularly pricked their finger was an oddity.

I did quiz him on a full Kraft 4 hour OGTT with insulin but he said even his private clinic don't run them. He did give me the name of a private company which I've since forgot but said they were expensive & needed to be interpreted correctly.

On my FBG being low 4s & my average glucose on the CGM being 4.6 he was very impressed, more impressed when I told him some days were upward of 200gs of carbs. He did pick up however that I spike up to 8 sometimes, especially on breakfast or lunch, said it looked more dramatic on the graph cause it came from such a low baseline. I did ask him if I could be doing any microvascular damage & he shook his head stating that at my levels damage was impossible.

As you can see we had a report & he repeated to me that I was an outlier, the type he's lucky to see once every 3 months. As we departed I joked that I appreciated his honesty & would attend his private clinic in the future if I needed but hoped I never see him again unless to bring him for a pint of carby Guinness.

So that was it, only had 30 mins so I think I did well to remember 90% of it. I remember seeing posters going blank when they had their consults & I had notes prepared, luckily on the day it flowed because of what I schooled up on thanks to this forum.
 

MrsA2

Expert
Messages
5,574
Type of diabetes
Type 2
Treatment type
Diet only
Thanks for sharing those 30 minutes with us. Very interesting
 

KidDougi

Well-Known Member
Messages
56
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.

Back then, there was plenty of reason why people would leave school without A levels. Reasons which had little to do with intellect or cognitive ability.
I’m sure most here can work out the reasons for themselves!!
 
  • Like
Reactions: KK123

zand

Master
Messages
10,784
Type of diabetes
Type 2
Treatment type
Diet only
If people with A levels were better at looking after their health then no uni student would ever smoke, take illegal drugs or get drunk. My son shared a house with some medical students...

I would think that perhaps those without qualifications are maybe more likely to respect their doctors too much and follow the advice given to the letter thinking it is the best way. Perhaps that's why someone would only lose a kilo in 3 months. They are qualified medical practitioners after all, you wouldn't expect them to be giving bad advice to a newly diagnosed diabetic would you?

At diagnosis I already knew the advice my doctor and DN gave me was wrong. It was the same advice that had led me to T2 in the first place.

Edit: @Ronancastled weren't you lucky that you had to wait 2 years for the appointment?! You did far better without the endo's 'help '.
 
Last edited:
  • Like
Reactions: KidDougi

Buster_

Well-Known Member
Messages
60
Type of diabetes
Type 2
Treatment type
Tablets (oral)
It's not a fact, it an opinion unscientifically formed.

There are very many published, peer reviewed studies which show a definitive link between higher educational attainment and healthier lifestyles, longer lifespan and reduced incidence of sickness. This is not opinion, it is well establish fact, proven scientifically.

This endocrinologist stated that his clinical observations concurred with this mountain of evidence.
 

Mr_Pot

Well-Known Member
Messages
4,573
Type of diabetes
Type 2
Treatment type
Diet only
There are very many published, peer reviewed studies which show a definitive link between higher educational attainment and healthier lifestyles, longer lifespan and reduced incidence of sickness. This is not opinion, it is well establish fact, proven scientifically.

This endocrinologist stated that his clinical observations concurred with this mountain of evidence.
There's definitely a link between educational achievement and salary. Which leads to better housing, expensive food, regular holidays and private medicine.
 
  • Like
Reactions: KidDougi

KK123

Well-Known Member
Messages
3,967
Type of diabetes
Type 1
Treatment type
Insulin
The comments about 'A levels' versus 'no/little education' make me smile. Do people really think that just because someone may not have stayed on at school to do A levels or get a degree that they are somehow inferior educationally, because they don't have a certificate? What is actually being talked about is intelligence and the ability and will to understand the subject matter, people either can do that or struggle to do that regardless of schooling or poverty or any other factor. Absolutely s*d all to do with whether you managed to answer questions on a subject and pass a written exam at the age of 18. I have worked across all so called 'classes' and believe me when I say many of those with a higher education are not what you would call intelligent and many of those without a higher education most definitely are, it is about the person whichever end of the social spectrum you happen to sit at. Of course access to higher education and its lifelong benefits (as someone above said) might influence health as money often does but it's a shame when people confuse that with an individual's personal intelligence. Some people really do have this superior attitude, 'What do you do?, oh.......' and then that's it, you are treated in a manner pertaining to your educational/employment status as perceived by them. That Consultant should be in a different job in my opinion. Oh well, rant over.
 
Last edited:
  • Like
Reactions: KidDougi