Why the Patient and Doctor Have Different Interests

DavidGrahamJones

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I hear you! I should probably follow your advice.

I laugh at myself with the amount of electronics I take on holiday. We actually take an extension lead so that we only need one adapter and can plug several chargers in at the same, the one we have now even has two USB ports so we don't actuall need the charger for some items like the phones.

Is this through the NHS or private? (If you don't mind saying.)

No worries, my Nutritional Therapist is private and I pay her. My health has improved a lot since I started to take her advice. Still work in progress but I've learned several things about what's happening or not in my body.
 

Grateful

Well-Known Member
Messages
1,398
Type of diabetes
Type 2
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Diet only
I laugh at myself with the amount of electronics I take on holiday. We actually take an extension lead so that we only need one adapter and can plug several chargers in at the same, the one we have now even has two USB ports so we don't actuall need the charger for some items like the phones.

I'm at the other end of the spectrum. I have been using computers for nearly 40 years, rather longer than some, because in a former life I was a journalist at a major news agency (and later got into computers as a hobby, owning the very first "laptop," a Radio Shack Model 100, in about 1983). Nowadays though I only use the computer on my desktop. I don't even own a smartphone and take no devices on holiday except for a "dumb phone." I worry that it will soon be impossible to buy a replacement "dumb phone" when this one croaks.
 
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donnellysdogs

Master
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13,233
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Pump
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People that can't listen to other people's opinions.
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Going back to B12 issue.. although I am not a T2 but I do have someB12 experience.

I got diagnosed with B12 and folate deficiency in 2007. Given injections...

They were stopped by a GP in Wales in 2010. We paid for me to go and have infusions privately for a while.

Then I just thought let them drop, we're coing back to England so not worth bothering about.

My levels didnt drop, they went higher and higher and higher up to 1598. My diabetic consultant said "you dont look like you have lymph cancer".... as I was looking really well and fit.

2015 I was diagnosed with breast cancer. 6 months after that high reading.

After the 1st op it dropped to 450 for a few tests.. then slowly edged up slightly.

In end of April this year I had 2nd op to make me flat a supposed healthy breast removal. It wasnt healthy..

After this removal B12 was tested again and it was down to 200. Folate way below target.

My GP said she wouldnt worry unless it dropped to 100!! My memory and concentration and fatigue really knocked me. Same as back in 2007.

However, my diet does not have very much B12 in it so I am now supplementing to see if it is caused by my nutrition intake. I am due for more tests in December so I am going to be interested in results. I do feel less syotoms so I am hoping it has raised.

It is just a note really to say that GPs and consuktants arent really aware of how patients can be affected by high or low B12.... and significantly though how many factors have to be considered.
 
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prancer53

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209
Type of diabetes
Type 1
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Insulin
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Professionals who know little about diabetes who generalise!!
As a relatively recently diagnosed T2, I have been puzzled by the apparent disconnect (in some cases) between the patient's and the doctor's approach.

In summary, the doctors may be over-emphasizing the drug approach and under-emphasizing the dietary/exercise/lifestyle approach even though it can help a lot of T2s and even allow some of us to do without any meds at all.

So what may be going on? Bear with me for a minute:

(1) Uncontrolled diabetes is a serious disease with nasty complications. For a doctor to fail to do everything necessary to treat diabetes patients, and thus allow complications to develop, would be hard to understand -- even if that was just a handful of patients out of several hundred. If that means drugs could be over-prescribed in some cases, it is still to the "overall good" of the patient cohort viewed as a whole.

(2) The non-drug approaches to diabetes are entirely reliant on "self treatment." It's all very well for a doctor to give dietary/exercise/lifestyle advice but how many people will follow it? Also, how many will be totally truthful with their doctor when reporting what they have been doing? Plus, once again, it only takes a small percentage of failure to show the doctor in a pretty bad light.

(3) I am quite surprised at how vague the state of diagnostic knowledge seems to be. We all know the broad outline. When looking at T2, the issue can involve insulin resistance and eventually the exhaustion of the pancreas, such that it doesn't produce enough insulin. There are all sorts of tests for glucose tolerance or whatever, but almost no detailed "individual diagnosis." So for instance, I know that I am a Type 2 but have no precise knowledge of the state of health of my pancreas. I know that it must be working reasonably well because the diet/exercise regimen is working great. I have no *precise* idea how strong the insulin resistance is, nor (precisely) how healthy the pancreas is. These are obvious limits to modern medicine: and they are a powerful incentive for doctors to lump all diabetics into one basket when making treatment decisions.

I have no professional medical knowledge and I may be completely off-base in my analysis above. It's just my "two cents" as they say here in America.
You've got it in one---was recently having a very similar conversation to that in your post
 
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snametab

Member
Messages
18
Type of diabetes
Prediabetes
Treatment type
Diet only
I applaud you on your comments within your blog. You hit it right on the head.

I am a person who is not taking medication, and am doing dietary, keto eating plan, along with walking min 8 klm a day approx. 9,000 steps, or min 5 klm a day 7,000 steps, plus other general exercise on top. Carbs 20/50 a day and not had potatotes, bread, pasta or rice for 12 months! and I am in total control WITHOUT MEDICATION and lost 18 kilos in between. Feeling great energized and never felt better in my entire life aged 68 and still surfing every day!

The bewilderment to this, I have not received any support from my Doctor, I changed him for this after 30 years care he has provided me, to a new doctor, who to my wonderment even more, did not support the efforts I explained, to a degree he did not even look at my two A1C the latter which I reduced by 23% in four months NO MEDICATION.

As you state, NOT EVERYONE will follow this routine, it takes self motivation to the highest degree, and determination to prove to the Medical Industry and Diabetes world they are wrong in chronic irreversible disease, and personally not a doctor but feel, they are going down the wrong avenue in treating the symptom SUGARS, instead of focusing targeting CAUSE INSULIN RESISTENCE. Sugars are a symptom of the CAUSE. This is a concerning factor no one seems to want to admit, take on board and even consider, this is the case, and reviews on how to treat in different way should be considered.

Not knowing how "precise" the general situation of ones condition is as you say, plus with added frightening concern, the cut off numbers our situation is based upon ultimately, are all ARBITRARY CUT OFFS, there is no medical evidence or clinical support to back up this decided number, even the so called Experts USA and other, state, and acknowledge they are just that
Arbitrary at whim and random, in good faith as presumed, to capture the disease earlier, but in do so, its not so black and white, as ONE NUMBER DOES NOT FIT ALL SIZES. Diabetes should be viewed with pragmatic approach BASED ON INDIVIDUAL circumstances, situation, and will power and flex the so called arbitrary cut off numbers as to be given label diabetes is life changing and effects one mentally and daily life from travel insurance, dentist, employment, and other.

How Precise is the cut offs that's the question, they are lowered at whim, from 140mg/dl then to 110mg/dl then finally 100mg/dl On all changes, what happened, thousands of normal people, overnight, suddenly became pre diabetic, not an official diagnosis by the way to my understanding?, or diabetic, finally resulting in big business of sales of medications for these people who were not taking medications before, monitors, strips it goes on that a person who is labelled as pre or diabetic become the best customer of Diabetes world for ever. that's concerning!

The world shares this disease, yet its admitted again, all have different cut offs they may be small, but they differ, here in Spain as A1C cut off is 6.6% I am on this border cut off number, yet in New Zealand as their cut off A1C without classic symptoms my case, is 6.7%. Its a case where you are diagnosed at the time is good luck or bad luck. I am in spain, labelled as diabetic, if I jump on plane back to Australia or New Zealand, I am PRE DIABETIC, caution only situation, exercise, and diet change,reviewed in 12 months approach, how pragmatic is that, its how it should be until the world comes up with a 100% full proof medical and clinical cut off number, that the entire world strictly follows this criteria number and follow the same format of diagnosing.

Obviously, I don't view myself as Diabetic I respect spain they are not wrong, but that does not mean they are right either, New Zealand criterias cut off A1C is not wrong either, but if I have a choice I put myself a label of Pre Diabetes, as I cannot do more than I am doing now, I have reduced high normal sugars down to normal 88mg/dl fasting, 92mg/dl 2 hr after eat 97mg/dl random, and only check my fingers every three months, and they are consistently stable, with only a difference of 1 or two numbers higher or lower either side. Yet the diabetic world say A1C is the gold and the best, not finger testing.

A1C have flows in precise situations lab errors, lab differences of testing, 0.5% or more one way or the other, and the format they check as I understand, is candy sugar sticking to red blood cells over 3 months, again, not everyones blood cells are the same, a diabetic I believe cells live 81 days, a non diabetic 141 days, if I am not mistaken? if this proves the case, the sugar will have stayed LONGER on the non diabetic, but that does not mean they have more sugar, yet the test result no doubt will show a High, so its a false situation that A1C assume that everyones red blood cells live the same lifespan that the format of testing is based upon Once upon a time, the Who stated on their website, they felt A1C were not recommended as a reliable marker for diagnosing, they have not changed this and allow same, Australia, do not have A1C covered as the main form to diagnose, it is viewed, as a help tool along with finger testing.

There are some serious situations areas surrounding Diabetes overall that I feel clearly need adjusting, and reviewing and especially as you state, IN MY OPINION, THERE HAS TO BE CUT OFF LEVELS OF COURSE, AS GUIDES, but it also has to have pragmatic approach by the system, the doctors, to view the persons INDIVIDUAL situation, and not one size or number fits all is the serious problem here.

if one is sitting on a cut off number and diagnosed diabetic even though they have reduced their numbers, exercising, no carbs, and continued control of sugars, such circumstances have to be taken on board that the cut offs are arbitrary, first of all and the person could be below this number as well. and this is not taking place this has to change, as over medicating can take place wrongful diagnosis spain Diabetic, another country Pre Diabetic, is appalling, and also affects the mental state, of any other good health of the person, that may deteriorate re anxiety and worry unnecessarily.

The Doctors, have to be more supportive to the person as individual and I feel is incumbent on them to be pragmatic, use common sense, and show flexibility within reason when numbers to not greatly exceeed the border cut off arbitrary

I again applaud your comments viewing, a great blog.

Mallorca
 
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Lainie71

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1,921
Type of diabetes
Type 2
Treatment type
Diet only
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The term "big boned" lol repeatedly told this growing up!
Hi. I'm afraid the degree of in-depth testing we are given for diabetes is mainly limited by cost to the NHS and ignorance by some GPs of the existence of these tests. You can have some of these done privately as I did for c-peptide and GAD. There is a tendency to lump us into one of two categories i.e. T1 or T2 often by guesswork and you may need to follow up yourself with private tests.
Yes just as my GP told me there was no way of knowing what type of diabetic I was - I am beginning to wonder myself what type I am :grumpy: