1st review with nurse...feel a bit :(

[Lea76]

Hiya

Im newly diagnosed and had my first three month bloods done in July. I had an appointment with the doctor for something else and asked for my results. She was very impressed and said they had gone from 7.8 to 5.4 and if I stay like this I could reverse diabetes and come of the metformin. I was amazed, felt so proud. However, a few days later I had a letter from the diabetic nurse saying she wanted to see me for a review, she obviously didn't realise I already knew my results.

Anyhow the appointment was Friday and its left me feeling a bit deflated to say the least. She said it was a good improvement but its impossible to reverse diabetes and no matter what it will get worse. She also said I will never be able to come off metformin as they offer too many health benefits.

Is this true? And why does the doctor day one thing and the nurse another??

Lea


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[CollieBoy]

Hiya

Im newly diagnosed and had my first three month bloods done in July. I had an appointment with the doctor for something else and asked for my results. She was very impressed and said they had gone from 7.8 to 5.4 and if I stay like this I could reverse diabetes and come of the metformin. I was amazed, felt so proud. However, a few days later I had a letter from the diabetic nurse saying she wanted to see me for a review, she obviously didn't realise I already knew my results.

Anyhow the appointment was Friday and its left me feeling a bit deflated to say the least. She said it was a good improvement but its impossible to reverse diabetes and no matter what it will get worse. She also said I will never be able to come off metformin as they offer too many health benefits.

Is this true? And why does the doctor day one thing and the nurse another??

Lea

Lea, Comgratulations on the progress :thumbup: :thumbup:
I don't think you can really reverse diabetes, just become really well controlled! (unless It's been caught really early before any pancratiic function has been lost!) You may be able to come off Metformin although there may be benefits to staying on it.
The idea that "it WILL get worse" is an assumption based on historical treatment records an d if you keep good control, you MAY not get any deteriotion or complications!!
As to why the doctor and nurse are saying different conflicting things is that there is a lot of misinformation and ignorance re diabetes amonst HCPs
ps, nurse will probably not be a diabetic nurse just a practice nurse who deals with the diabetics!

 

[Lea76]

Thanks for the reply. It was the diabetic nurse I saw. I can't understand why the information is so conflicting. She's made me feel like no matter what I do it won't be good enough as it will get worse. I was put on metformin straight away and not even given a choice in taking them I was hoping to come off them and she's told me ill be on them for life! Not what you want to hear when your only 37! I know it could be worse and I should be lucky but I just feel fed up!


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[Daibell]

Hi. Although you can't reverse diabetes as such if you are lucky and have T2 thru insulin resistance then you may be able to have a normal life again when any excess weight and bad diet are improved. As Fergus Crawford said there is an enormous range of competence within the NHS on diabetes so you will often received different and conflicting advice. One reason many diabetics progress downwards is that the NHS recommends the worse possible diet for T2s i.e. the so-called normal healthy diet based on the absurd Eat-Well Plate when diabetics are carbohydrate intolerant. You don't have to stay on Met for life. It's your choice which meds you do or don't take. Met is good for those who are insulin resistant and as a drug it has few sins. If you can get back to a normal weight and low-carb diet then there is no strong reason to stay on Met although most of us do

 

[Unbeliever]

I think you are looking at this in the wrong way _not your fault its just that a lot of nurses don't seem to be able to explain things very well.
Your Dr is right -you have done very well. You have achieved something really important you have reduced your HBA1C and many will envy you.You should be proud and happy.

Metformin should not be seen as a punishment for bad behaviour or a sign that you are not doing well enough.

Many take metformin for the cardiovascular protection it is supposed to give - it makes only a small difference to HBA1C.
Its as Daibell says -you can't reverse it but you can reduce the effects -and metformin will not harm you and may help with this..
if you keep on producing such good results no one will argue if you decide to drop meds.
The official line is that diabetes will ineveitably progress but more and more people seemt o be proving that this is not the case.
ometimes it is unfortuanately but if diagnosed before it has had time to do much damage it should not trouble you too much providing you are careful wih your diet .
It is very important too not to worry too much about waht might appear to be conflicting satements from nurses and doctors .
They are approaching it from different angles. The Nurse is often thinking of her targets and the pracical side of things whereas if you speak to a Dr as you did when the focus of your visit was not diabees hey will give you the overall opicture .
I know its confusing but it has happened to us all at some time.

Not taking you off metformin is one thing. This was probably never theur aim/ Its when they start wanting to put you on other drugs you need to be more oncerned . This is when it means that the curren reatmen isn't working.
Congraulations on your excellent result.

 

[sparkyrich]

The "got it for life" mantra is what they've been told for years. Recently there's been some research at Newcastle university suggesting otherwise - try doing a search on here, there's loads of threads.
As for the metformin, unless they're tying you down and force feeding it to you, once the doc says you're bloods are good, take the prescription with a smile and use it to line the cats litter tray


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[Westie2]

Please if you decide you do not want to continue with the Metformin at any time. Please tell your GP, they would rather you were honest with them than just pick up a script occasionally, when it will look as non compliance, rather than a considered decision you have made.
Be honest, ultimately it is your choice, you can always go back and have that discussion with your gp.


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[Mongoose39uk]

Please read around and don't just accept what the low cal group on here will tell you is the only way. For many, me included the eat well works.

As for no cure/reversal I will go with what Prof Taylor and other medical researchers say and not a bunch of well meaning amateurs.


http://www.ncl.ac.uk/magres/research/diabetes/reversal.htm

http://www.ncl.ac.uk/magres/research/diabetes/BantingDiabeticMed.pdf

It may not be a "cure" but may lead to being symptom free for some.

Your results are excellent, congratulations.

 

[Mongoose39uk]

Please if you decide you do not want to continue with the Metformin at any time. Please tell your GP, they would rather you were honest with them than just pick up a script occasionally, when it will look as non compliance, rather than a considered decision you have made.
Be honest, ultimately it is your choice, you can always go back and have that discussion with your gp.


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I agree talk to your GP

 

[Hazehkm]

In my opinion, and I work with doctors, if you are unhappy with what the diabetic nurse says, insist on seeing the doctor for a second opinion and take control of your own situation. Ultimately the doctor is the one who is responsible for your care and the doctor has the last word on what SHOULD be done, so if you're not happy with the diabetic nurse - see the doctor and have them override the nurse's decision.

Say to the doctor "based on my research and our last discussion, given my blood results, I would very much like to try managing my condition through diet only. Please can you explain if there is any medical reason why I can't do this? At least for a trial period?". That way you're in the driving seat - you're saying "okay, let's try it my way, if it doesn't work, I'm responsible enough to accept I may need medication to help - but don't write me off without trying".

I've not been on medication yet, but I insisted from the word go that I wanted to try to manage my condition through diet only FIRST - for at least 3 months - and then review it. They went with it and I'm FAIRLY confident it's working - but only the final blood result will tell. However, if I'm not convinced by the DN's view/decision, I'll be seeing my doctor - no question.

Good luck and don't get too down - YOU are in charge of your body - no one else!

 

[Mayfly]

Is it possible your nurse thinks you will stop being disciplined if she tells you you're doing well and not to worry? I know I started to meander a bit with the consequence I am now having to get back on track. Just a thought.

Otherwise, you've done brilliantly, keep in mind that every day you are in the low BG levels, you are preserving your future health, whether that's with Metformin or not. I can't see that I will ever come off the stuff, I would like to stop the Byetta, but I would only do that under medical supervision. I did stop the statins by myself, but only because the side effects were getting so bad. However, I was open and honest with my doctor and although he tried to produce evidence to show that I was wrong, it was still not convincing.

I can't argue the effects of Byetta though, even though I'm annoyed my doctor says it's that which lowered my BG's, not the low carbing.

I would argue for a low carb diet, however, I will admit that there are Type 2 out there who insist that their lives are healthier for the 5 a day, high carb diet as recommended - what can I say?

Well done, never feel that your efforts are wasted.

 

[Mongoose39uk]

Is it possible your nurse thinks you will stop being disciplined if she tells you you're doing well and not to worry? I know I started to meander a bit with the consequence I am now having to get back on track. Just a thought.

Otherwise, you've done brilliantly, keep in mind that every day you are in the low BG levels, you are preserving your future health, whether that's with Metformin or not. I can't see that I will ever come off the stuff, I would like to stop the Byetta, but I would only do that under medical supervision. I did stop the statins by myself, but only because the side effects were getting so bad. However, I was open and honest with my doctor and although he tried to produce evidence to show that I was wrong, it was still not convincing.

I can't argue the effects of Byetta though, even though I'm annoyed my doctor says it's that which lowered my BG's, not the low carbing.

I would argue for a low carb diet, however, I will admit that there are Type 2 out there who insist that their lives are healthier for the 5 a day, high carb diet as recommended - what can I say?

Read the plate properly and you may have a shock and find it isn't that high carb.

Well done, never feel that your efforts are wasted.

 

[DiabeticDan]

Hey Lea,

Congratulations on your HBA1C. It's an incredible score and something you should be proud of. My experience of my own diabetes is to always expect the unexpected. I began with doctors telling me that I was a certain Type One. 7 years later this is still being discussed and argued between various docs and nurses I've seen over the course of this time. Diabetes is such a complex condition to have and in the short time I have had it; the treatments and the attitudes have changed countless times.

Metformin is a good drug to have because it gives you extra control on top of all the other things you will do in relation to diet and exercise. Extra control is good because it means you also have extra freedom. You want that extra slice of toast, or another biscuit or dare I say it some cake!!! Then you can and it's OK and with the help from the drug it will keep your sugars controlled (obviously alongside everything else!!).

In terms of the diabetes never getting better, that's totally person dependent. Some people can control their diabetes through exercise and diet, some can't. Some will need Metformin, some will need stronger tablets, some will need Victoza, and some will need insulin. It stands to reason that as you get older, your pancreas will get older too and less effective. You could become resistance over time to the medication.

I think Lea, you need to know that diabetes is simply an annoyance. Taking a tablet 2 or 3 or 4 times a day is an annoyance. Taking your blood sugars is an annoyance. But it's not everything. Chasing sugars can get you down and out of control. When changing your lifestyle, never blame it on the diabetes. It's because you want to grow old, see your children grow up and have their kids, and enjoy your life in as good a quality of life as you can for as long as you can.

If you have any other questions feel free to ask and good luck with whatever treatment YOU choose!!

Dan

 

[Lea76]

Wow I'm blown away with all the lovely responses

I think you are all right and I just need to take the metformin and stop seeing myself as a failure. I think I haven't quite accepted that I am a diabetic and it's for life! I keep thinking I've been misdiagnosed and maybe I should get that out of my head. Im really lucky that I can eat just about anything without my bloods going about 7 after eating! I'm following a lowish carb diet and cut my fruit intake right down I don't feel like I'm on a diet and I feel like I've just permanently changed my eating habits.

I also feel like the nurse doesn't have faith in me and I'm just another type 2. I feel quite ashamed about being type 2 and I think I need to accept it and get on with it. As really it's nothing to be ashamed off but some people are so judgmental.

Sorry if I've waffled, thanks again for the lovely replies x


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[Mayfly]

Is it possible your nurse thinks you will stop being disciplined if she tells you you're doing well and not to worry? I know I started to meander a bit with the consequence I am now having to get back on track. Just a thought.

Otherwise, you've done brilliantly, keep in mind that every day you are in the low BG levels, you are preserving your future health, whether that's with Metformin or not. I can't see that I will ever come off the stuff, I would like to stop the Byetta, but I would only do that under medical supervision. I did stop the statins by myself, but only because the side effects were getting so bad. However, I was open and honest with my doctor and although he tried to produce evidence to show that I was wrong, it was still not convincing.

I can't argue the effects of Byetta though, even though I'm annoyed my doctor says it's that which lowered my BG's, not the low carbing.

I would argue for a low carb diet, however, I will admit that there are Type 2 out there who insist that their lives are healthier for the 5 a day, high carb diet as recommended - what can I say?

Read the plate properly and you may have a shock and find it isn't that high carb.

Well done, never feel that your efforts are wasted.

Sorry, I fail to see what your point is? People were saying "Don't listen to the low carbers" and I am saying, "I agree with low carbing, however I also agree it's not for everyone". Why are you so antagonistic, or am I just supposed to read your signature and agree it's OK for you to be rude and get away with it?

 

[Mongoose39uk]

Excuse me where exactly was I rude?

All I did was point out that if people do read the NHS guidelines properly and look at portion sizes overall they find that it is not a high carb diet.


A forums a place for discussion not just blind acceptance

 

[Mongoose39uk]

Also no one said don't listen to the low carbers.

They said low carb is not the only way read around and make your own mind up so get of my case.

 

[izzzi]

I recently made my 3 monthly visit to my diabetic nurse.
She was very understanding and seemed different to previous diabetic nurses, I commented on her positive attitude towards my type 2 diabetes etc;
She nicely explained that many diabetic nurses are quite old fashioned and not properly trained in the knowledge of the various types of diabetes and the different kinds of treatments etc;.
Then she told me that she was type 1 diabetic. Then the penny dropped why got treated so well.
Roy

 

[Martina79]

You were not seeing professional. the nurse should not speak in that manner-being pesimistic , disrespect your wishes and foce you to be on medication. did she expalin you any further? look on videos with Dr Gabriel where diabetics even with type 1 are putted of insulin in few days because of vegetarian food. you need to change nurse.

 

[catherinecherub]

You were not seeing professional. the nurse should not speak in that manner-being pesimistic , disrespect your wishes and foce you to be on medication. did she expalin you any further? look on videos with Dr Gabriel where diabetics even with type 1 are putted of insulin in few days because of vegetarian food. you need to change nurse.[/quote

We've talked out this particular "Dr" before. I wouldn't let him treat my goldfish if I had one.

viewtopic.php?f=10&t=16782

You might also like to read this,
"Read this intelligently because the next crank you read may be your last".

http://scienceblogs.com/denialism/2008/ ... ttpwwwnor/