Special Diabetic Clinics rather than GP surgeries

[gazebo]

Having read many blogs about the various differences in the help offered by GP surgeries I wonder if there is any mileage in specialist clinics where the staff would be up to date with all current thinking on how to deal with diabetes. If you have a foot problem you go to the podiatrist, a tooth problem to the dentist so why not a diabetic clinic. Like many of your readers I find my GP nurse and doctor offer no actual advice on lifestyle changes and just push pills. I have tried statins and suffered muscle problems so no longer take them, similary I tried Metformin but could not handle the sickness and depression. I now do not take anything for my Type 2 diabetes. My BMI is 22 and I go to the gym 4 times a week and eat healthily, recently started on lo-carb at the suggestion of one of your readers. My fasting BS is now 5.4 and is within 2 of this 2 hours after eating a meal. I know next time I see either the nurse or the GP they are going to try and push me onto pills again, the result is I try not to go to the surgery.
Having this forum is a god send, I find all my questions answered here and would prefer not to have to go to the surgery at all, unfortunately that is not an option.
I have spoken to friends who have other health issues and they all same the same, the GP is writting out a scrip before you even sit down, no wonder the NHS is running out of money.

 

[ally1]

i,m happy with going to my diabetic nurse at the surgery as my local hospital is a two bus, nearly two hour journey away

 

[CarbsRok]

There are specialist clinics the commissioning groups and previously the PCT's thought it was such a fantastic money saving idea to have as much care as possible at a GP practice because in their eyes it saves money. Short term may be but long term no due to likelihood of complications from lack of care and knowledge from the practice nurse and GP. Very short sighted really as the rate we are going there will not be any endocrinologists specialising in diabetes as no need so no point in paying them.

 

[Bluetit1802]

I get excellent service and treatment by my nurse. (Never seen a doctor about my diabetes, not even on diagnosis). Having said that, she does churn out the usual NHS dietary advice, but in all other respects I am cared for very well. I would hate the drive to the nearest hospital to attend a clinic, and the associated difficulties with parking. I'm happy as I am.

 

[Richard F]

I use the GP. More convenient. We did have an excellent really switched on Nurse, the new one is good but not as well informed.

This is fine for the day to day stuff. However they will refer you to a clinic as and when required

 

[anna29]

My own GP diabetes clinic is just a stroll down the road .
At the end of our street - so its a no brainer which I choose
and prefer .

As the nearest hospital is 7 miles away .
Waiting time is far longer there also .
Plus getting a car park space is a problem alone especially
at visiting times in the wards .

At my GP diabetic clinic the wait is never longer than 10 minutes of time .
No need to drive - just a 3 minute stroll down road .
Excellent DSN there too .

 

[graj0]

Having read many blogs about the various differences in the help offered by GP surgeries I wonder if there is any mileage in specialist clinics where the staff would be up to date with all current thinking on how to deal with diabetes. If you have a foot problem you go to the podiatrist, a tooth problem to the dentist so why not a diabetic clinic. Like many of your readers I find my GP nurse and doctor offer no actual advice on lifestyle changes and just push pills. I have tried statins and suffered muscle problems so no longer take them, similary I tried Metformin but could not handle the sickness and depression. I now do not take anything for my Type 2 diabetes. My BMI is 22 and I go to the gym 4 times a week and eat healthily, recently started on lo-carb at the suggestion of one of your readers. My fasting BS is now 5.4 and is within 2 of this 2 hours after eating a meal. I know next time I see either the nurse or the GP they are going to try and push me onto pills again, the result is I try not to go to the surgery.
Having this forum is a god send, I find all my questions answered here and would prefer not to have to go to the surgery at all, unfortunately that is not an option.
I have spoken to friends who have other health issues and they all same the same, the GP is writting out a scrip before you even sit down, no wonder the NHS is running out of money.

Sadly, with a system that can't afford test strips for most type IIs, specialist clinics will be a non starter. Having said that, wouldn't it be easier to make the existing GPs and nurses more up to date with current thinking and what diabetic people are actually doing to successfully control their condition. My GP and nurse who will have done the Warwick thing may not be clued up but are impressed with my results and although skeptical at first are very open minded. Unfortunately they will not sway from NICE guidelines, that would rock the boat too much. I've even sat in the waiting room with a lady who was type II and insulin dependent hardly believing that my approach, being so contrary to what she's been told, achieves such good results.
I think that when you say to a doctor that you have changed your diet to have less carbs and as a result you don't have to take so much medication and your BG and HbA1c results are so good, the whole issue of carbs is a no brainer. Well should be, unless the doctor isn't listening.

 

[Daibell]

Sadly, with a system that can't afford test strips for most type IIs, specialist clinics will be a non starter. Having said that, wouldn't it be easier to make the existing GPs and nurses more up to date with current thinking and what diabetic people are actually doing to successfully control their condition. My GP and nurse who will have done the Warwick thing may not be clued up but are impressed with my results and although skeptical at first are very open minded. Unfortunately they will not sway from NICE guidelines, that would rock the boat too much. I've even sat in the waiting room with a lady who was type II and insulin dependent hardly believing that my approach, being so contrary to what she's been told, achieves such good results.
I think that when you say to a doctor that you have changed your diet to have less carbs and as a result you don't have to take so much medication and your BG and HbA1c results are so good, the whole issue of carbs is a no brainer. Well should be, unless the doctor isn't listening.

My diabetes GP had done 'the Warwick thing' not that long ago and wasn't aware of late onset T1 and told me to have a 'normal healthy diet' when I was starving myself to keep the blood sugar down and stick thin. She also said insulin was a last resort. Goodness knows what these people are taught at Warwick but it appears to have little to do with the reality of diabetes. I don't think the problem lies so much with NICE but the trainers out there.

 

[Daphne917]

I have now got a good DN who, despite telling me I don't need to test, understands low carbing - even suggested I give up bread, pasta, rice and mashed potato which before i saw her I was either eating in moderation (bread) rarely (mashed spud and rice) or not at all (pasta).

 

[PurpleOwl]

I go to my GP and my Diabetic Clinic for my treatment. I am lucky that my clinic is only 20 minutes away by bus.
I do find, however, that I get better care at the clinic then I do from my GP...

 

[gazebo]

Several people have menioned The Warwick Program so I googled it to find out what it is. According to the course content it does deal with patients with diabetes quite thoroughly however I could not find any mention of prevention or reversal to help prevent the effects of getting diabetes.
I still feel that the NHS is way behind the times in helping patients with advice on prevention and reversing diabetes and prefer to follow the NICE guidelines which just advocate dishing out pills. Last time I saw my DN she did confirm that part of the doctors wage includes an element for all patients which they put on drugs recommended by NICE. I do not think this is in the best interest of all patients although it is obvious that some people are happy with their GP & DN, I just wish a better standard could be acheived across the board.

 

[VinnyJames]

One answer would be to have at least 1 GP with a specialist interest in Diabetes.
I've been trying to find one for over a year to no avail.

It does seem if you are well controlled the NHS isn't interested. I do get eye and foot checks annually which I am both grateful and guilty about.

I don't think I need them basically. I believe research is going on to reduce check ups to every two years for well controlled diabetics.

I still have questions surrounding beta cells in the pancreas but it's hard to get answers. It could be that nobody knows the answers I guess...

 

[Bluetit1802]

One answer would be to have at least 1 GP with a specialist interest in Diabetes.
I've been trying to find one for over a year to no avail.

It does seem if you are well controlled the NHS isn't interested. I do get eye and foot checks annually which I am both grateful and guilty about.

I don't think I need them basically. I believe research is going on to reduce check ups to every two years for well controlled diabetics.

I still have questions surrounding beta cells in the pancreas but it's hard to get answers. It could be that nobody knows the answers I guess...

My Practice website lists all the doctors with profiles and specialities. There are 2 that specialise in diabetes, neither of whom is my personal GP, but we can elect to see whichever doctor we chose when we make an appointment. This is good to know, despite the fact I have never seen a doctor with regard to my diabetes, even on diagnosis, as the nurses deal with us Type 2's, but at least if I have any questions or problems I know which doctor I can see, and all local.

 

[Missy Cat]

Hi all

Just reading the previous posts. I was only diagnosed in October and immediately referred by my GP to my local NHS diabetes centre. I still remain under their care, the DSN and consultant, and they will not discharge me back to the GP services yet.

I cannot state enough how brilliant they have all been, especially my DSN. She sees me regularly and phones me once a week to get my glucose results. She also coordinates all the other specialists and pulls everything together.

I suspect like most things it's a postcode lottery and its a shame we don't all have access to the same excellent service we all deserve.

 

[malky39]

There is special clinics with nurses and consultants with expertise in diabetes there the diabetes clinics at hospitals. This is where I go for all of my diabetes care. I trust my nurses more than I would my GP with my condition the nurses know me and the problems specific to me. In the 10 years since diagnosis I have never used my GP for my diabetes care. They do try and get me to go to them, which I think is purely because I am on there books and they have to look like they are doing something, but I never go and never will unless out of some stroke of luck a GP in my surgery arrives who is a specialist in diabetes even then I would probably still go to the hospital. Its also quicker to get an appointment with the nurse as my surgery you need to wait a week, which is a long time to wait.

 

[gazebo]

There is special clinics with nurses and consultants with expertise in diabetes there the diabetes clinics at hospitals. This is where I go for all of my diabetes care. I trust my nurses more than I would my GP with my condition the nurses know me and the problems specific to me. In the 10 years since diagnosis I have never used my GP for my diabetes care. They do try and get me to go to them, which I think is purely because I am on there books and they have to look like they are doing something, but I never go and never will unless out of some stroke of luck a GP in my surgery arrives who is a specialist in diabetes even then I would probably still go to the hospital. Its also quicker to get an appointment with the nurse as my surgery you need to wait a week, which is a long time to wait.

I had not realised attending a hospital clinic was an option, I will look into it in my area. Thanks for that tip.

 

[poohtiggy]

I am lucky that my GP specialises in diabetese he also agrees with my testing (though I self fund) my DN is also very good and I can usually get an appointment if needed. As I said I am very lucky

 

[VinnyJames]

Hi all

Just reading the previous posts. I was only diagnosed in October and immediately referred by my GP to my local NHS diabetes centre. I still remain under their care, the DSN and consultant, and they will not discharge me back to the GP services yet.

I cannot state enough how brilliant they have all been, especially my DSN. She sees me regularly and phones me once a week to get my glucose results. She also coordinates all the other specialists and pulls everything together.

I suspect like most things it's a postcode lottery and its a shame we don't all have access to the same excellent service we all deserve.

@MissyCat What was your blood glucose levels at diagnosis?

 

[Missy Cat]

My readings were varied. The first time my friend tested them I was 22.7mmol and hours later 21.2mmol they never went below 15mmol and that was only when fasting. Most of the time in the early 20s. To be honest at the time of the diagnosis I was hardly eating, I had no appetite at all.

My GP did say my case was complex as I had previously had an enlarged pancreas and some other odd presenting symptoms. They were unsure of T1 or T2. My consultant has now said its pancreatic diabetes which I believe is termed T3c???

Still having lots of other tests though for some other symptoms.

 

[malky39]

I had not realised attending a hospital clinic was an option, I will look into it in my area. Thanks for that tip.

You sure can, both hospitals I have attended had clinics the first was the best as every week day they had a time slot where you could just turn up and wait to be seen no appointment needed