my new gp - and foot update 5

[mk_steve]

Those who have followed my posts know I was diagnosed around mid december but since changed my gp cos my previous one seemed a tad incompetent when it came to my foot. Well, saw my new gp this morning (was going to be monday but I managed to bring it forward).

She did say she couldn't do anything about the foot because the hospital were still "treating" it as they want to do an x-ray and consider a bypass. She cannot interfere. I did say she could at least tell me there was nothing to worry about - but she didn't!

However, she added to my medication! I was prescribed only Metformin for the control of the diabetes by the first gp. My new gp said I should have also been presribed a couple others - generally standard issue - symvastatin to reduce cholesterol (my last reading that she had was 6.2. but the hospital measured it recently at 5.5 but my gp said it has to be less than 4).

I was also prescribed 75mg Aspirin - to help thin the blood.
Also prescribed ramipril - to protect the kidneys.

You gotta wonder why previous dr didn't prescribe these! Anyway - I am on them. My HbA1c recently measured (couple or 3 weeks ago) was 8.2 which she said is too high, gotta be below 7, but I pointed out this will include a significant period before I was diagnosed and started any medication.

The plan then is to take another blood test in two weeks looking for lower cholesterol and lower HbA1c.

So, I have decided to use this as a test; an experiment on the low carb concept. I am eating chicken, pork, cheese, eggs, ham, bacon etc. (with veges thrown in - sprouts, cauliflower, broccoli, celery, cucumber and the likes ). I will either see all indicators coming down in the right direction or up and get into lots of trouble with the doc around mid march.

watch this space ....

 

[Dennis]

Hi Steve,

I am not trying to knock your new GP but there are some things that perhaps you need to be aware of.

My new gp said I should have also been presribed a couple others - generally standard issue - symvastatin to reduce cholesterol (my last reading that she had was 6.2. but the hospital measured it recently at 5.5 but my gp said it has to be less than 4).

There is a government drive at present to get as many people as possible onto simvastatin and GPs are being paid a bonus for each new one they can sign up! However, in your case your overall cholesterol level is still a bit high so it shouldn't do you any harm. However, the need for it does depend not so much on what your total cholesterol is but what proportions of HDL, LDL and triglycerides it contains. High HDL is good, high LDL and trigs is bad. The simvastatin should reduce the LDL and trigs, but severe muscle cramps, particularly in the legs, are a common side effect.

I was also prescribed 75mg Aspirin - to help thin the blood.

There are very mixed messages about aspirin. It is often prescribed to help prevent heart disease and strokes in those patients deemed to be most at risk, which includes diabetes patients. However, recent research shows aspirin to be linked to an increased chance of bleeding in both the stomach and brain. In the latest study, published on bmj.com, researchers concluded that the benefits of giving low dose aspirin to prevent heart disease were offset by increased cases of serious bleeding. Some doctors swear by it, some won't touch it.

Also prescribed ramipril - to protect the kidneys.

Ramipril is an ACE inhibitor - its main function is to reduce blood pressure. Kidney protection is a secondary benefit.

An HBA1C measures your blood sugar over a 90 day period (13 weeks), so if your next one is scheduled for only 5 weeks after the first, it won't show a huge difference.

Like your choice of diet - a few weeks on a regime like this will do both your blood sugar and cholesterol levels a power of good.

 

[Voilet]

You've not got to wonder at all.

My doc did not prescribe Ramipril or Aspirin or Simvador (a statin) because my blood pressure has always been OK (Ramipril is an ACE inhibitor and Aspirin - both used to reduce the risk of heart attacks and strokes) and my cholesterol (the statin) was below 4. I was happy with that - but the Diabetic Consultant, who saw me only once, insists that everyone over 60 gets her belt and braces approach. My doc did not think that I needed these additions to a small dose of Metformin but agreed to fall in with the Consultant, perhaps anything for an easier life. For my part I swallow the pills but my blood pressure has remained the same and my cholesterol remains between 3 and 4 where it has always been.

Perhaps the first doc was not so daft after all.

 

[mk_steve]

Thanks. Interesting replies.

My blood pressure is fine; however recent urine test showed my kidneys were dumping proteins which was why she prescribed the ramiprill. She did say it lowered blood pressure too.

I too think the next blood test only 5 weeks after the last one may not show an appreciable difference, however it will cover a period closer to the date I started medication whereas the last one included about 4 or 5 weeks prior to the start of my medication when presumably my blood glucose was very high. The main reason for the blood test though is to check the effect of the simvastatin. Redoing the HbA1c is just an extra since I told her the last measurement was probably weighted high since it was covering a 4 to 5 week period before I was diagnosed. (I do feel I shouldn't have to tell them these things though.) She should really compare it with the HbA1c measured at the time I was diagnosed which covered 3 months prior diagnosis with the recent test and if it is lower (which it should be!) then all is moving in the right direction. She wanted to increase my Metformin but I felt we weren't being scientific about it and understanding the context of the recent blood test.

 

[hanadr]

Don't be too disappointed ifyour HbA1c isn't much different. It does work over 120days or so, but is weighted by the most recent weeks. That diet will help. Are you monitoring averages?