A vent about slack GPs

eddie1968 said:

I think GPs dish out the M&Ms (Metformin & more Metformin) is they are a generic and cheap tablet to dispense. I had terrible GI effects and they did not a lot for my HbA1c levels. Metformin is therefore cheap as chips to the NHS compared to other meds. Doctors should spend 2 minutes explaining on the extra toilet rolls you will need and what to do in event of an "accident" lol.

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Metformin is cheap, but that's not why it's the first line option for T2 meds. It's the only oral med for T2 that doesn't have the risk of serious side effects like cancer and heart attacks, and other things. It's not meant to do "a lot" for HbA1c levels - it has several benefits, including reducing the liver dump that drives up fasting BGs.

And yes, doctors should be a LOT clearer about the possible side effects... we see many stories about diarrhoea and stomach pain on the forum, but that is a self-selected sample. The majority of met users don't get those effects. It's appalling though that when I read the side effect stories on here, the doctor didn't warn the patient, and didn't say call me if you get bad side effects and I will look at the other options. People are sent off with no info. It's unethical and poor practice.

Celeriac said:

So few people seem to tolerate bog standard Metformin (pun intended) that I really don't see why GPs bother with it. Is it that much cheaper than SR ?

My GP and consultant are stellar but the nurses argh. Not just practice nurses but those in walk-in centre, hospital, clinics. Bossy, not as knowledgeable as they think they are, often downright abusive. It's never OK to restrain someone physically to get your point across, for example.

Even when I spoke to a nurse on 111 re: the cream recall, I got the tutting that I, as a diabetic had dared to eat it in the first place.

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Yes, ordinary metformin is much cheaper than SR. Most people will not need SR, so it makes sense to use it only if needed. Doctors need to start warning people though!

Celeriac said:

IMO GPs don't warn about the brown tsunami, because they feel patients will balk and say no to Metformin.

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And isn't that silly, because the patients who get the tsunami will soon say no to metformin anyway. And most people don't get those side effects, or they don't get them for long, or they are improved on SR. Doctors absolutely have to warn patients of common side effects before gaining informed consent to treat with meds. But many are slack. That's why I always ask, and double check by reading the info leaflet online too. Learned the hard way.