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1st review today

sunlover

sunlover

Active Member
Messages
27
Location
Scotland
Type of diabetes
Type 1
Treatment type
Insulin
Dislikes
Feeling cold...which is hard as i live in Scotland!
Hi All

I have my 1st review today and a bit anxious as i can see it turning into an argument. I need advise please, I went on friday for the blood tests and seen a different nurse to my initial diagnosis, he looked through my notes asked what meds i was on (metformin) and said ah you must be type 2. Well thing is my initial nurse said she didnt know what type i was and to wait for the 3 month check to see how my levels are, can they tell from this, I dont want to be fobbed off as my levels havent settled. I had a high of 30.2 at the begining and got down to 11 with low carbing which i am now struggling with, this morning I was 29.4 but think this is stress with this appointment today as I dont feel i am being looked at properly.

I am prepared today to stand up for myself just need to go armed with infomation, can you please advise what I should be asking.

Thanks in advance
 
Ask for a blood test to determine what type you are may be the best option. And like you said your stressed and that will raise your levels try to relax. Good luck with your first review.
 
First off I am not a doctor so here are my opinions.

I think that you should really push for a firm diagnosis as to what type you are, I supect you are T2 but in need of some stronger
medication, but that is up to your doctor.

Without the diagnosis you cannot be treated in the appropriate manner, there are some very simple and cheap tests the doctor can do, so really push hard to get some more tests and a firm diagnosis.

Metformin is sometimes prescribed for other types of diabetes other than T2, so being prescribed it is not a proper diagnosis!

There should be no need to be confrontational to get what you want, simply explain what you have done to try to help and quote a few figures, tell them you want to be proactive in the management of your diabetes but that until you have a proper diagnosis you cannot make choices as to what form of management you would wish to consider to bring down your BGs to a good level.

Good Luck.

H
 
Thanks guys, I was just so annoyed that the nurse assumed I was type 2, I did have blood tests on friday so hope this will determine what type I am but then why didnt the first lot of tests do this, with my levels so high im just worried im not on the correct dose or been diagnosed correctly, i just dont know much about it. I wont be confrontational but i wont just walk away with unanswered questions like I did on Friday hopefully the tests will determine -and ill try to chill a bit, levels down to 20.4 now.

x
 
Hi All

just back from my 1st review and it didnt go well, I am sat here in tears so frustrated. The nurse said my 3 monthly bloods showed I had an average of 11-13 but last friday was 18 on testing, my weight has dropped by 6 kg since oct. They want to increase my metformin to 3 a day which id be happy with if not for the cramps when they tried that already, at this point the nurse clearly got the hump and said id need to see the doctor to discuss this which im happy to do, I asked before the increase my tabs can they confirm if I am type 1 or 2, same ans again there is no test to say this. I then mentioned what had been said on here it was a simple blood test, and she went off on one saying only hospitals do that and I shouldnt be taking too much from this type of website, she also didnt like the fact that ive been low carbing and said i will damage my kidneys and that Im messing around with food! She said I should have potatoes/rice with every meal even though i explained i spike after eating that sore of carbs to mid 20's. I honestly dont know where to go from here, I'm seeing doctor on 17th Dec to go through this again, she even asked if I thought I was type 1 - how would I know I rely on them for that information. I just want on the right medication without all this hassle - any advice pls? Do i change surgery I have only moved to the area so dont have any knowledge if this is common advice.
 
Well the nurse is wrong, a simple blood test can at least indicate whether you are T2 with certainty and T1 and maybe others with some
certainty.

Metformin is the standard first treatment after diet for T2, it is available in a slow release form and will help a lot with stomach problems.

To not be able to tell you what sort of diabetic you are is strange, and I wonder if the nurses reaction might have something to do with her feeling stressed in not knowing what to tell you.

I suppose it's all down to which doctor you see, I know I could make an appointment and ask for a test and if it is reasonable he would do one.

The test I would have thought they will arrange is a G.A.D. (Glutamic Acid Decarboxylase Autoantibodies test) and maybe a c-peptide test to see how much insulin your body is making.

11 - 13% I am guessing is your HbA1c result again I guess that is is an approxiamtion of the now standard mmol/mol measurement
(11% = 97 and 13% = 119 mmol/mol), it would normally be shown as a definate value not a range so it might be two different results?

The good news is that whilst those readings are not good they are not bad enough to get worried about in the short term.

So think positive, you now know that the NHS diet is to high in carbs for most of us, that you don't get on with the nurse, (and back in the early days I had a couple of "discussions" about diet, and many of us have, now I just nod and smile!) and that when you get to see the doctor he will, without doubt, have some interesting notes on the computer. If you want you can ask to see those notes, I have and he was quite happy to let me see them.

You could ask the doctor (when he arranges for the blood tests, as I am sure he will) why the nurse said what she did.

So keep plodding on, you will get there in the end, we all do!

In the meantime, keep an eye on the carbs, keep losing weight (6kg is a whole STONE well done), and try a bit of gentle excercise, walking for 10 or 20 minutes is a good start.

H

EDIT With a quote from http://www.patient.co.uk/doctor/Glucose ... -Tests.htm

"There are a variety of definitions and diagnostic criteria for concepts such as impaired fasting glucose (IFG), impaired glucose tolerance (IGT), the metabolic syndrome and 'prediabetes'. The most important concern for primary care practitioners is that they can identify those patients with frank type 1 or type 2 diabetes, and be able to advise and monitor patients with indicators of impaired glucose metabolism who are at risk of developing type 2 diabetes"

The red font is my doing
 
Thanks Hallii

I have copied the tests you mentioned and I will ask the doc on the 17th, the range she mentioned was one test, she said 6 weeks ago it was 13-15 and is the Hba1c test I am on average bg 16 in the morning and mid 20's during the day, just hope its sorted soon.
I think for my next bloods ill get the results from the doc and not have a wasted appointment as was today, thanks for all your advice.
 
Hi,

You say you are losing weight, do you need to lose weight? If you are not really overweight and have settled into low-carbing you should not really keep losing weight real quickly. With figures like yours it may be worthwhile asking for strips to test for keytones.

I was initially diagnosed as a type 2, ended up on maximum doses of Met, Gliclazide and Januvia but still my levels rose. I went from an HbA1c of about 5.7 in 2011 to fasting levels of 14+ this summer. Eventually, after my Doctor telling me my levels were still acceptable and my figures wouldn't keep going up and stay up, another doctor referred me to a hospital Consultant.
By the time I got there my Hba1c was about 86 (in new money) and when they tested my keytones I was +4. The Consultant said I should have been diagnosed type 1 from the start and agreed to do a GAD test. This came back very positive thus confirming type 1.

I am 47 and although not skinny have never been drastically overweight to any extent. I went from 9.5 stones earlier this year to 7.5 stones by August with fat and muscles disappearing. The Consultant said she would have expected to see me admitted as an emergency within the next week if I didn't start on insulin there and then.

Please fight for your rights to get the facts established.....it is your body not there's.
Regards
Angie
 
Hi. I agree with the last comment. If you have lost weight without trying and are not now overweight and if you are still quite young then a lot points to being a late onset T1 (LADA). As Halli says, there are two tests that can be done i..e GAD and c-peptide and the GP can arrange these. The tests are quite reliable and are the standard way of defing a late onset T1 from T2. You must keep the carbs lowish'ish in line with the meter. If you are T1 then you do need to watch out for ketones in the presence of high blood sugar. Whatever your diagnosis your GP must ensure that your HBa1c comes into range; that is effectively your right as a diabetic under NICE guidelines. As you have gathered your nurse is talking nonsense which is not unusual, sadly. I hope your GP is better informed. BTW taking Metformin for T1 or T2 will reduce your sugars a bit and won't do any harm as it's a good, safe drug so don't worry on that score
 
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