Teatment since NHS Reforms Began

[SWFC John]

First off hello everyone, my name is John and i was diagnosed with type 2 on my 39th birthday in 2007.

Since being diagnosed i always received a wonderful level of care with 3 monthly HBA1C tests and a nurse that was caring, helpful and massively supportive. Under her wing i picked myself up (although we all know fear is a great motivator) and got my act together, i started playing competitive football, swimming 1km, walking 20 odd miles every week and of course being a good boy and eating better. I did struggle to lose weight but managed to shift a couple of stone, the world felt great and my HBA1C was always around 5.5.

However just short of 2 years ago she was told her job was in doubt and she left. Since then the level of care i get is very poor. The new nurse never knows what you have gone to see her for, she never reads my notes and is really unsupportive and unwilling to listen to my concerns. She said i only needed a HBA1C every 12 months and refused to let me have a self test kit, which i know is not relative to a HBA1C but at least it would let me see where my sugar was at.

Anyway to cut a long story short i started cheating badly and not really giving a monkey uncle any more, if they didn't care why should i.

Which brings me to last Monday when i went for my latest HBA1C. On arriving she asked me if i was there to get my flu jab :roll: to which i said no my blood results. She said oh dear, there is a problem (after consulting a conversion disc thingy), your HBA1C has shot up to 7.9, i am doubling your metformin, ok see you in 12 months. She didnt explain how bad this was or anything, i left the surgery very upset and i don't mind telling you a near 45 year old man had a good weep once he had walked the short distance home.

Now forgive me if i am wrong but was i out of order to expect some more information from her? For a start ill be back in march as that is my anniversary but seeing as i have been given a kick up the jaxy and i am being a good boy i am off back for another test in 2 months when i can work some of them dam jelly beans out of my system :crazy:

Like i said i know i have been an idiot, i have eaten what i want and i have put the couple of stone back on but when i was getting 3 monthly tests you could see little jumps that made you thing i had better be good for a bit.

I have bought myself a new test kit simply because of the doubling of the metformin, i want to see myself what's going on and so far everything seems in order with results a few hours after eating anything from 4.7 to 5.8 so far, so i can see myself i am not "racing".

Any tips or things i should be asking on my next visit i would greatly appreciate.

 

[Jaxx01]

I'm only newly diagnosed and yet to have a follow up but I definitely agree with you that you should have been given more information!

I was diagnosed two months ago tomorrow and there's been no mention of going back just been told they check BP, weight, hba1c etc once a year!!! Great!! So I've taken it upon myself to grab a meter and test myself..

I am totally shocked after reading that it's pretty standard practice really to he left in the lurch!!!

 

[SWFC John]

Complacency on my part has been as much a downfall as the poor health care I have been receiving I guess but moving from 3 monthly testing and the removal of a prescription self test kit certainly stopped me from being on my toes. Fingers crossed I'm back on the wagon now.

 

[SWFC John]

Jaxx in a month go back and ask for a hba1c because falling numbers don't half give you a boost

 

[Sid Bonkers]

Hi John and welcome to the forum.

A few things jumped out at me reading your recent story, firstly your use of the phase "fear is a great motivator" or there abouts which is exactly what I say whenever I describe my diagnosis and subsequent efforts to control it , it is a very true statement and it certainly was true in my case, never lose that thought, you dont have to live with it hanging over your head like an axe, but just remember how you felt on diagnosis and more recently when you had your last Ac1 result, and use it to spur you on to take good care of yourself.

Your more recent control between "4.7 to 5.8" postprandial seems excellent so I'm sure that if you carry on doing what every it is you are doing that your next Ac1 will show a big improvement.

I think you know exactly what it is you need to do regardless of the level or frequency of your diabetes clinic meetings, at the end of the day our control is in our own hands, it is we who have to deal with our own control on a day to day basis and diabetes is for life and no diabetes nurse however good or bad is going to be there with us watching what we eat and how we exercise.

It sounds as though you have made your mind up that this is not going to beat you and that is the right way to address it, you will find loads of good advice here and lots of diabetics who will offer you any support you feel you may need from time to time.

Keep up the good work :thumbup:

 

[Squire Fulwood]

Anyway to cut a long story short i started cheating badly and not really giving a monkey uncle any more, if they didn't care why should i.

Sounds just a tad petulant to me. Bottom lip sticking out and complaining that you won't be good unless they bring your nice nursie back.

Having read many posts on here it seems that many people have to put up with indifference from the NHS but a lot of people have taken responsibility for their own fate. People are buying meters when the good old NHS won't. People are changing their diet and challenging a spread sheet instead of a nurse. You can get by you know.

I believe I have the best diabetes nurse on the planet, she has a Bsc in diabetes care but I only see her once every six months the rest of the time it is down to me. She probably doesn't remember my name unless it's on her computer screen.

My signature explains my attitude to life the universe and everything.

 

[SWFC John]

I am very sorry you thought my post has echoes of petulance in it, this is probably down to my style of writing, of course i didn't just go sugar mad, i was cheating by my own standards, you might be a perfect patient but some of us lapse when there are no reminders just how serious diabetes can be, like i said earlier "Complacency on my part has been as much a downfall as the poor health care I have been receiving".

However you are not fully aware of the circumstances regarding the new nurse, I have yet to meet anyone that uses the surgery and be happy with the service she provides regardless of their condition. You mention looking at the computer screen to get your name, our nurse doesn't even do that, on each occasion i have visited i have had to tell her what is wrong with me and what medication i am on and before you retort with a snide remark this is across all of her patients i have spoken to, not just me.

Your beautifully composed "Bottom lip sticking out and complaining that you won't be good unless they bring your nice nursie back" comment is without foundation given you do not know me or the support i received from her in matters such as the death of my father etc. The new nurse just wants you out of the door ASAP. I don't want a loving relationship with her but it isn't unreasonable to expect help on any issue should i require it.

I thought i was joining this forum for a little mutual support, i didn't realise i was going to be flamed within 24 hours, that's a record even for me i think, pat yourself on the back and have a Mars Bar, congratulations. :mrgreen:

 

[AliC]

...

Now forgive me if i am wrong but was i out of order to expect some more information from her?

...

Out of order? Absolutely not. If anything is out of order, it's this lack of support and appropriate diagnosis (Disclaimer: I'm not qualified to diagnose or assess a diagnosis!)

Something that springs to mind is that if your measurements have increased where they were ok before, you could directly attribute it to the change in your lifestyle - your "cheating badly" ;-)

So why address the symptoms by increasing a dosage but not addressing or even seeking to understand the cause? What's to stop the cycle repeating? (Although it sounds like you're back on track!) The problem here is the lack of, or removal, of support, and we all need that, some of us in different ways.

Glad it sounds like you're getting back on track!

I've just started self-testing myself, and I plan to show my records at my next diabetic review (in fact that will also be my first diabetic review! Which I am due for). I get the feeling my GP practice is good at supporting diabetics.

 

[IanD]

What they don't tell us is that it is OUR condition & we need to take responsibility for our health.

Their responsibility is to give as much info as they have & direct us to where we can find further help. That menas giving a printout of our blood tests, so that we can increasingly understand & take specific action. Over the years we will then have a written record of progress one way or the other.

I fear that the professional attitude of some is to record HbA1c annually & increase the medication. They do not realise properly that a radical change of diet to low carb will be effective to reduce blood glucose - if we don't eat it, it can't overload our pancreas.

The truth is that with knowledge, a blood testing meter, & an determination to get good control we CAN substantially control our diabetes at a level where we can live without fear of complications. But don't rely on adequate support from the Dr & nurse. Ask here, & you will get advice from others who have taken control.

 

[SWFC John]

All i can say is this site has given me more help via articles and other peoples posts that the NHS has ever given me.

The last 12 months have been pretty rubbish to be honest with you, loved ones have died and loved ones have been through cancer scares and to top it all off my mum ended up in hospital with a blood clot on each lung. I know the person responsible for me, is me and i am now hoping i have back as my priority.

 

[Daibell]

Hi. With an HBa1c of 7.9 your nurse should have made a 6 monthly next appointment with HBa1c until your sugars were under better control. 7.9 isn't too good and she should have explained this. Hopefully the right lowi'sh carb diet and exercise should bring it back down. Don't expect miracles with Metformin even at max 2000mg dose but it's good to have it anyway.

 

[X-entricity]

Squire Fulwoods comments were out of order. The emotional roller coaster of life affects people differently and you were obviously feeling down. The NHS is not a priviledge. We actually pay for it and have a right to expect good service from it. I am lucky, I have a great doctor and team but I can understand your frustration with yours.
Keep trying, I have found that self monitoring keeps my moral up and increases my determination to beat this dreaded pest.

 

[Daibell]

Hi. I have learned over the 9 years I've had T2 that you just have to take control and not rely on the NHS to monitor your condition. You may be one of the very lucky ones with an excellent local practice but mine is like most i.e. mediocre. At the end of the day GPs aren't employed by the NHS, merely contracted to it, and their priority may not be the same as yours. My advice to anyone newly diagnosed is go to the NICE diabetes website and download all the relevant documents. They are excellent and recently updated. This is the 'official' guidance based on actual experts not your local GP/nurse who may not be such an expert. Budget to have a meter and strips. Don't complain when the NHS won't pay for them as it's a small price to pay for the control it gives you. Gradually adjust your diet to what makes your sugars in the right range. Ignore branded/faddish diets; just understand the science and select foods that work for you and your sugars. Understand that the supermarkets are part of a food industry determined to overload us with junk food so read the labels. Your HBa1c Is an important measure so be prepared to know where it should be and what medications in addition to diet and exercise might be required and discuss these with the GP/nurse. Many years ago I suggested to my diabetes GP that he add Gliclazide to my Metformin and he said 'that's a good idea' and added it! Over the years you do get used to the diet and medication and for many of us the condition is progressive but at least we are not alone out there. Have a good 2013.

 

[hanadr]

Over the 10 years or so since I was diagnosed, they've been trying to convince me that once a year full blood testing is enough. I don't agree, so I ask my nurse[ who is actually a practice nurse with an interest in diabetes, not a full DSN¬!] to arrange an interim test for every 6 months.
If your nurse isn't interested, ask to speak to the practice mqanager and find out if there is anothe nurse who is actually interested and see her/him. Sometimes you need to be assertive.
Hana

 

[SWFC John]

Hi. With an HBa1c of 7.9 your nurse should have made a 6 monthly next appointment with HBa1c until your sugars were under better control. 7.9 isn't too good and she should have explained this. Hopefully the right lowi'sh carb diet and exercise should bring it back down. Don't expect miracles with Metformin even at max 2000mg dose but it's good to have it anyway.

The nurse just sort of freaked out and doubled my dose with no questions regarding my diet or physical activity.

I did a finger prick test yesterday 4 hours after a fairly carby dinner and it was 5mmol/l so i am happy with that.

 

[SWFC John]

What a strange word for the profanity filter to block when it is inevitable it is going to be used given the nature of the site LOL

 

[Jimbob2392]

I have been amazed at the blood sugars that have worried you all and the behaviour of your practice nurse!
In my case a diabetic nurse wrote to me when I complained about the withdrawal of testing strips for type 2 diabetics and said type 2 cannot have a low blood sugar or hypo! I was on metformin and glicticide at the time. My answer was a change of doctor and nurse who really understood type 2 and the effects of glicticide the result of this change is my peace of mind that I am being looked after by people who know their jobs! Just a quick point I decided to use long acting insulin instead of glicticide(bad side effects) blood sugars can be high and at night etc H1 check is just below 7 my exercise regime etc keeps me fit and if I drop below 5.5 get the shakes etc so find where your body is happy and enjoy yourself! Oh yes my wife is type1 and has been for 35 years her nephew since he was 7 and they and their doctors are more than pleased with aH1 of 7.9

 

[jamby41]

I feel sorry for some posters on this forum such as squire fulwood very rude and arrogant springs to mind. Most posters are very helpful I've had a few. When your new to something as serious as diabetes it is frightening and confusing. You try to hang on to people you trust like your nurse. I was diagnosed in August and I'm only just now understanding blood glucose readings and HB a1c because a member of this forum realised I had got stuff wrong and helped me to understand. If you have to show off and be rude then get lost and leave it to forum members who care ti help

 

[CherryKerry]

I have a very good diabetes nurse and I find it a comfort knowing that if I have any issues at all with my control then all I have to do is ring the clinic and they will help. If I hadn't of received the support I did from my nurse then I highly doubt id have the control I do now. I completely understand what you say about nurses being different because I have found that the ones who don't see me each time have no record of how my control has been. I ask to see the same nurse every time and it's really helped. Also the clinic are more than happy to arrange for me to see the same nurse each time.
I hope you are able to change nurses and eventually find one who is supportive and helps you get back on track for good!

 

[DylansDad]

I have no idea what my hba1c readings are - I had a 6 monthly non fasting blood test in December, when I rang to check if the results were back, the following conversation transpired:

Me: Are my hba1c test results back?
Receptionist: yes, they're normal
Me: What do you mean normal ?
Receptionist: It says here that the levels are raised, but that's normal as you've got diabetes
Me: Can I make an appointment to see my practice nurse ?
Receptionist: - It says here - no further action required - why do you want to see the nurse ?
Me: I want to discuss my results, can you tell me what my hba1c levels are
Receptionist: Sorry, I'm not medically trained to read them out - it just says, no further action required. :?

This conversation then went round in circles for a couple of minutes however I finally managed to get an appointment on 7th Jan at 07:30 :shock:

DD