Oh you need to change gp practice asap. I loose patience with mine because they keep giving me inferior generic meds to save money. But overall its an excellent practice with excellent facilites.
Teatment since NHS Reforms Began
- Thread starter SWFC John
- Start Date
Re: Treatment since NHS Reforms Began
For What It's Worth:
I'm all for self-management. What are the tools we need for good self-management?
1) Information. There should be diabetes "classes" available, without charge, so the newly-diagnosed can get basic information. It's also helpful if there's a follow-up (intermediate? advanced?) class to provide more details, updates, answer questions that arise, etc. There used to be such a class - I don't know if there still is - but I know that our local one was cut from 12 sessions to 10 session to (last I heard) 6 sessions. This was laid to NHS cuts.
2) Diagnostics. That means HbA1c (at least twice per year, and quarterly is an even better way of tracking) and meters. It doesn't do any good to issue meters and not provide adequate supplies (sticks / jab cartridges). Equally, it doesn't do any good to tell people to buy their own. If I had the money to provide my own, I'd do so - and I'd have the latest type that could record the information directly into my computer. I'd have a spare in case one breaks. I'd make sure I always had plenty of supplies on hand, because I could purchase them at will. Since an HbA1c averages blood glucose for the previous 3 months, it doesn't tell you beans about the other nine months of the past year.
What it boils down to is - if they want us to self-manage, then they must provide the tools we need when we can't afford to buy them. And if they want to manage our care for us, then they have an ethical responsibility for due diligence with sufficient HbA1cs, test kits, diet counseling, fitness classes...
IMHO
[This is a long-winded way of saying - John, regardless who is in your local surgery, they should be paying attention. No matter what previous personnel did or didn't do, the current nurse is falling down on the job. I'd make an appointment with the GP and discuss these concerns. It may not get you anywhere, but at least you will know the surgery is aware of the situation and your experiences.]
For What It's Worth:
I'm all for self-management. What are the tools we need for good self-management?
1) Information. There should be diabetes "classes" available, without charge, so the newly-diagnosed can get basic information. It's also helpful if there's a follow-up (intermediate? advanced?) class to provide more details, updates, answer questions that arise, etc. There used to be such a class - I don't know if there still is - but I know that our local one was cut from 12 sessions to 10 session to (last I heard) 6 sessions. This was laid to NHS cuts.
2) Diagnostics. That means HbA1c (at least twice per year, and quarterly is an even better way of tracking) and meters. It doesn't do any good to issue meters and not provide adequate supplies (sticks / jab cartridges). Equally, it doesn't do any good to tell people to buy their own. If I had the money to provide my own, I'd do so - and I'd have the latest type that could record the information directly into my computer. I'd have a spare in case one breaks. I'd make sure I always had plenty of supplies on hand, because I could purchase them at will. Since an HbA1c averages blood glucose for the previous 3 months, it doesn't tell you beans about the other nine months of the past year.
What it boils down to is - if they want us to self-manage, then they must provide the tools we need when we can't afford to buy them. And if they want to manage our care for us, then they have an ethical responsibility for due diligence with sufficient HbA1cs, test kits, diet counseling, fitness classes...
IMHO
[This is a long-winded way of saying - John, regardless who is in your local surgery, they should be paying attention. No matter what previous personnel did or didn't do, the current nurse is falling down on the job. I'd make an appointment with the GP and discuss these concerns. It may not get you anywhere, but at least you will know the surgery is aware of the situation and your experiences.]
Thanks for all the replies.
I found out a right gem today that came out when handing my prescription in.
On a Friday my surgery has a diabetic nurse!
You would have thought they would have made all the diabetics that attend the surgery aware of this really lol
I'm really hoping she will be a bit more helpful
I found out a right gem today that came out when handing my prescription in.
On a Friday my surgery has a diabetic nurse!
You would have thought they would have made all the diabetics that attend the surgery aware of this really lol
I'm really hoping she will be a bit more helpful
KaseyCoff said:
I have booked an appointment for my next hba1c and much to my dismay it turns out the nurse i have been seeing is the nurse that specialises in diabetes
SWFC John said:
Got my latest results today and it is back down to 6.1%, i am over the moon
FWIW my nurse also seems to have had a change of heart which is great, she knows who i am and what's what when i see her now, she also listens as well now so that's a much nicer relationship.
SWFC John said:SWFC John said:
Got my latest results today and it is back down to 6.1%, i am over the moon
FWIW my nurse also seems to have had a change of heart which is great, she knows who i am and what's what when i see her now, she also listens as well now so that's a much nicer relationship.
5.9% now, im well chuffed
Sid Bonkers
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Well done John, keep up the good work :clap:
Regarding your "Practice" nurse it is almost unheard of for any GP surgery to have a Specialist Diabetes Nurse (SDN) in their employ, most employ a nurse or two/three/four etc depending on the size of the practice and they are responsible for looking after the various clinics at any practice. I see a respiratory nurse and the diabetes nurse, guess who they are? Yes the same person, the tittle Respiratory Nurse and Diabetes Nurse just referees to different clinics. It is simply the job of the surgery nurses to carry out the regular tests and checks required under the government requirements so the surgery can get the QOF (Quality and Outcomes Framework) cash for ticking boxes on government forms. Some of course will be better than others but very few will be fully qualified SDN's.
I asked mine a question about insulin and she admitted that she didnt know much about insulin. Not her fault as she clearly hadnt been trained to SDN standard.
I was under a hospital SDN when first diagnosed as I was put on insulin, she was very knowledgeable and worked within the hospitals Diabetes Unit and worked under the supervision of an Endocrinologist. These are very different nurses indeed from GP surgery nurses even those who specialise in diabetes.
So having seen both sides as it were I am lucky to have had the benefit of a SDN when first diagnosed, when I needed it most, although my care was transferred back to my GP after I stopped using insulin. Even when I was using insulin however my practice nurse still wanted to see me I assume because of the cash incentive for the GP if I was checked by them.
QOF Cash for GP's http://www.qof.ic.nhs.uk/
Regarding your "Practice" nurse it is almost unheard of for any GP surgery to have a Specialist Diabetes Nurse (SDN) in their employ, most employ a nurse or two/three/four etc depending on the size of the practice and they are responsible for looking after the various clinics at any practice. I see a respiratory nurse and the diabetes nurse, guess who they are? Yes the same person, the tittle Respiratory Nurse and Diabetes Nurse just referees to different clinics. It is simply the job of the surgery nurses to carry out the regular tests and checks required under the government requirements so the surgery can get the QOF (Quality and Outcomes Framework) cash for ticking boxes on government forms. Some of course will be better than others but very few will be fully qualified SDN's.
I asked mine a question about insulin and she admitted that she didnt know much about insulin. Not her fault as she clearly hadnt been trained to SDN standard.
I was under a hospital SDN when first diagnosed as I was put on insulin, she was very knowledgeable and worked within the hospitals Diabetes Unit and worked under the supervision of an Endocrinologist. These are very different nurses indeed from GP surgery nurses even those who specialise in diabetes.
So having seen both sides as it were I am lucky to have had the benefit of a SDN when first diagnosed, when I needed it most, although my care was transferred back to my GP after I stopped using insulin. Even when I was using insulin however my practice nurse still wanted to see me I assume because of the cash incentive for the GP if I was checked by them.
QOF Cash for GP's http://www.qof.ic.nhs.uk/
I have concluded this nurse is just a random lady wearing a nurses outfit.
Because my sugars went belly up i asked if it was ok to have my hba1c done every 3 months. Went in last week and explained i was in for my 3 monthly check. She said you don't need it but agreed to do it.
She tried to get blood from one arm and didn't manage it, nothing unusual about that but she just left my arm leaking blood and went straight in to my other arm, she got blood but was bending the needle upwards, i don't think for a minute that was intentional but for the first time in 6 years having my bloods done actually hurt. She removed the needle and just left me with blood coming out of and running down both arms :thumbdown:
She then said we will do a liver and kidney check, they have not been done for ages, March i replied as this is my annual review. She then said we will do your cholesterol as that's not been done in ages, 3 months ago i replied and it was at 3.3, i requested it doing as it was forgotten in my annual review. she then said we need to check your feet as that's not been done in years, 3 months ago i replied as the ultra sound was used on them, something i have never had done before, it wasn't needed as a strong pulse could be found but it was done as a demonstration.
Now i know people will read that and just see it as a big moan but and she is only doing her job, which i agree but how on earth can you not know what you have done only 3 months previous? It is incredibly frustrating when you are trying your best but the people that are watching your back dont even know what they playing at.
Anyway everything was fine and my hba1c had taken another slight drop to 5.8% and my cholesterol has fallen to 3. I have put a reminder in my phone to book my next bloods in 6 months, i would have preferred to have kept a 3 monthly regime but hey ho.
Its not just me BTW, i have yet to hear anyone say a nice thing about her as a nurse although she seems nice enough as a person.
Because my sugars went belly up i asked if it was ok to have my hba1c done every 3 months. Went in last week and explained i was in for my 3 monthly check. She said you don't need it but agreed to do it.
She tried to get blood from one arm and didn't manage it, nothing unusual about that but she just left my arm leaking blood and went straight in to my other arm, she got blood but was bending the needle upwards, i don't think for a minute that was intentional but for the first time in 6 years having my bloods done actually hurt. She removed the needle and just left me with blood coming out of and running down both arms :thumbdown:
She then said we will do a liver and kidney check, they have not been done for ages, March i replied as this is my annual review. She then said we will do your cholesterol as that's not been done in ages, 3 months ago i replied and it was at 3.3, i requested it doing as it was forgotten in my annual review. she then said we need to check your feet as that's not been done in years, 3 months ago i replied as the ultra sound was used on them, something i have never had done before, it wasn't needed as a strong pulse could be found but it was done as a demonstration.
Now i know people will read that and just see it as a big moan but and she is only doing her job, which i agree but how on earth can you not know what you have done only 3 months previous? It is incredibly frustrating when you are trying your best but the people that are watching your back dont even know what they playing at.
Anyway everything was fine and my hba1c had taken another slight drop to 5.8% and my cholesterol has fallen to 3. I have put a reminder in my phone to book my next bloods in 6 months, i would have preferred to have kept a 3 monthly regime but hey ho.
Its not just me BTW, i have yet to hear anyone say a nice thing about her as a nurse although she seems nice enough as a person.
lucylocket61
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I no longer have annual checks, or any checks. Since coming on this and other forums, getting educated and self testing, my HbA1c has dropped to normal levels. So my last visit to the DSN last December resulted in me being pronounced cured, and discharged from her care as no longer diabetic
paul-1976
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lucylocket61 said:
Although we know the NHS can't differentiate between well controlled and cured..I have a great HbA1c level although if I started eating junk and ditched the insulin I'd be back to square 1.
stuffedolive
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lucylocket61 said:
Cured? on the basis of Hba1c tests - I think not. I'd get back there and demand a fasting glucose tolerance test as that is the only measure of how your body is handling a given glucose load. If you can't pass that (without any form of medication) then you're still diabetic.
Go to it Lucylocket61!
lucylocket61
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thats right paul-1976.
I had a little test of eating a piece of cake and yep - right up in the teens again.
So as long as I stick to the plan, I am OK. But it concerns me that other people may not know this, and leave the surgery "cured" and then not get tested again until they come back to the doctor in a year or so with related complications due to thinking they are no longer diabetic
PS Hello again :wave:
I had a little test of eating a piece of cake and yep - right up in the teens again.
So as long as I stick to the plan, I am OK. But it concerns me that other people may not know this, and leave the surgery "cured" and then not get tested again until they come back to the doctor in a year or so with related complications due to thinking they are no longer diabetic
PS Hello again :wave:
lucylocket61
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stuffedolive
I have never had a fasting glucose tolerance test ever. It was deemed by the DSN as unnecessary for my diagnosis.
I asked DSN at my last appointment if I can at least have an annual HbA1c test, but was told that type 2 is very slow in progressing, so if it returns it will be picked up at one of my health checks the doctor does at the surgery routinely. I only ever had an annual HbA1c anyway.
I dont know how frequent these body MOT-type checks are for the over 50's.
I have never had a fasting glucose tolerance test ever. It was deemed by the DSN as unnecessary for my diagnosis.
I asked DSN at my last appointment if I can at least have an annual HbA1c test, but was told that type 2 is very slow in progressing, so if it returns it will be picked up at one of my health checks the doctor does at the surgery routinely. I only ever had an annual HbA1c anyway.
I dont know how frequent these body MOT-type checks are for the over 50's.
julifriend
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lucylocket61 said:
I'm 56 next week and have never had a MOT type check from my GP, though I had a letter a few months ago offering something similar. Every time I tried to book they had no free appointments. Maybe I need to have another go.
I was sent a letter offering me a MOT from Highland Health Board, when I phoned to make an appointment I told them I was diabetic and was told that I was Not suitable for the scheme. Maybe they were worried I'd mess up their figures. :grin:
Sent from the Diabetes Forum App
Sent from the Diabetes Forum App
stuffedolive
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Lucylocket61
I was diagnosed 9 years ago , aged 48, on the basis of 2 fasting glucose tests (FGTT) - I had been having sporadic FGTTs over the previous 4 years as I was deemed to be pre-diabetic. Since that time my Hba1c has never been above 6.6% (49) and did go down to 5.9% (41) and is now 6.4% (46)and I have been given annual (more or less) Hba1c tests, which seem to go up and down depending on my weight. Since the start of 2013 they put me on 4monthly Hba1c tests because my Hba1c had crept upto 6.5% (49).
When mine went down to 41 (6 yrs ago) the locum tried to declare me cured but she consulted a senior partner (diabetic expert) who said 'no, once diabetic, always diabetic - keep up the annual testing'.
Your signature says you have a Hba1c of 5.7% which, although not 'diabetic', isn't exactly low so I would have expected that they should be continuing with annual Hba1cs at the very least.
Anyhow, you know what you need to do to keep your Hba1c low so just keep up the good diet and as much exercise as you can manage, then hopefully you'll keep that low figure for a long time yet.
Good luck
I was diagnosed 9 years ago , aged 48, on the basis of 2 fasting glucose tests (FGTT) - I had been having sporadic FGTTs over the previous 4 years as I was deemed to be pre-diabetic. Since that time my Hba1c has never been above 6.6% (49) and did go down to 5.9% (41) and is now 6.4% (46)and I have been given annual (more or less) Hba1c tests, which seem to go up and down depending on my weight. Since the start of 2013 they put me on 4monthly Hba1c tests because my Hba1c had crept upto 6.5% (49).
When mine went down to 41 (6 yrs ago) the locum tried to declare me cured but she consulted a senior partner (diabetic expert) who said 'no, once diabetic, always diabetic - keep up the annual testing'.
Your signature says you have a Hba1c of 5.7% which, although not 'diabetic', isn't exactly low so I would have expected that they should be continuing with annual Hba1cs at the very least.
Anyhow, you know what you need to do to keep your Hba1c low so just keep up the good diet and as much exercise as you can manage, then hopefully you'll keep that low figure for a long time yet.
Good luck
