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Advice from diabetes nurse

S

scousefly

Member
Messages
16
Type of diabetes
Type 2
Treatment type
Tablets (oral)
I am increasingly frustrated by the ‘advice’ from my doctors diabetes nurse. I am type 2 on metformin extended release she says I test far to often and I will get sore fingers. I test 2-5 times a day depending on activities and what I intend to eat. I use my BS level to determine how much or little I eat and tbh it works for me. The advice from her is always contradictory to what I do and I find my yearly review annoying. I don’t have a sore finger and I’m following the advice I originally got when diagnosed from the hospital. Who or what is correct?????
 

You are obviously. You have your diabetes she doesn't.

Test if you think it helps (it certainly did for me).

Not sure I'd agree with restricting the amount you eat but I'd certainly look at the effects of what I had eaten on my blood sugars by testing and remove foods that caused excessive spikes.
 
You have to trust someone to receive advice from them so if the advice doesn't fit your knowledge and your experience of your own disease then it is time to be honest with this person. Listen to their response and then see if you feel it is worth your while going.
I go because I need to get certain tests done and get access to my treatments. What is in it for you?
 
Us T2s are usually still given advice not to test at all!
However testing is the only way to know how your body responds to the food you have just eaten before you totally forget what you ate.

Since you are trying to control your diabetes through you way of eating (please NOT a 'diet'), your meter is your best advisor.
This is because although all Type 2 diabetics have an intolerance to carbohydrates, the type of carbs and the quantity of carbs we can tolerate reasonably well varies from person to person. Some can eat some oats, some can eat an apple, some can eat a raw carrot - I can't because they spike my blood glucose too high. If it was not for me testing before and after meals until I knew this, I would've had no way of finding it out.

If you are only on Metformin (and not Insulin) then Low Carb High(er) Fat is a good option for you. It is a 'way of eating' not a diet, since the objective is to have as few meals per day with few enough carbs keep a good BG level while never going hungry.

So eat good satisfying meals with lots of protein and plenty of fat so you can last until the next meal without either snacking or suffering ravening hunger.
I'm living proof that Low Carb is a way to control Blood Sugar and to lose weight without calorie restriction or feeling deprived. As are many of Dr David Unwin's patients in the UK, Virta Health's patients in the USA and thousands of users of this site's Low Carb Program.

Never ignore you health care professionals, but weigh the evidence for yourself and trust your meter.
 
TBH the only positive I have taken is my cholesterol is down from 5.3 to 3.8 but she pushed for statins. I refused the first couple of times then relented. I find I’m having to be more firm and maybe obnoxious to the point of actually saying it works for me, her response was ‘ I’ve got 17 years experience’. That maybe so dear but it’s not necessarily good advice/experience your imparting.
 
You control your diabetes in your own way, and it works. If that works, and what she's suggesting obviously wouldn't, well....

I had two nurses, one in the practice and one at the hospital. One supported testing because she saw I was dialling down my HbA1c with a mad speed, the other didn't agree on it. I don't see the one who didn't support it because she was an idiot. I don't see the other one because with my blood sugars, I don't need to any more. I just get my GP to fill in the forms for the tests and that's it.

Do whatever works for you and just use the appointments to pick up your latest test results.
Jo
 
Well, I'm a type 1 and all the current nurse at the GP surgery does for me is raise my blood pressure. She still wants me to take statins (which destroyed my short-term memory in 2004), she wants to avoid all sugars at all costs ( which doesn't work for me because I am sensitive to insulin and exercise, so without some extra fast-acting carbs at times, my sugar levels plummet). After an argument, she then takes my blood pressure, which is up of course, because of our disagreements. I then refuse to have my tablets to control bloid pressure altered and on my way out make an appointment to see my GP. He takes my BP a week later and of course it is fine.

You are free to make your own decisions, whatever that nurse says. I have been doing blood tests for about 40 yrs and my fingers are just fine. I've had the same lecture about damaging my fingers and just laughed out loud. I couldn't help it.
 

I’d say ignore. Are you self funding? If so, definitely ignore. I have learnt so much my testing. We are all different and what works for one, won’t work for another. Carry on an you will learn what with for you. They usually say not to test for financial reasons.
 
Now that I have my routine down, I only test when eat or do something that’s not normal for me. I do the occasional fasting prick just to make sure the maintenance plan is on track.... but, I’m the most boring person in the world when it comes to diet, I pretty much eat the same everyday. I’m brainwashing myself, I eat for a purpose, not for pleasure lol
 
Do what you find works for you.
Does she have a single days experience of living with T2? If not, it's worth noting that 17 yrs of experience of parroting out advice often does not equal the experience of someone who has found what works for them. It's an individual condition, not a one size fits all one. She may mean well, but sometimes you just need to say that doesn't work in my experience, here's what does. If someone is very pushy, you can either push back or just let it go in one ear and out there other. Depends on the situation though I guess.

Personally, I have found my own path.... and it's not something that standard testing advice recommends and I've ignored all dietary advice that has been given. It maybe given with good intentions, but it's completely inappropriate for me. When you get to know your condition and how best to manage it and your knowledge develops along the way, you become the expert of you. There is much you can teach them. Whether they listen or not.... who knows.
 
The latest diabetes nurse at my surgery gave up giving me dietary advice when, the last time she tried, I asked politely how many of the practise's other patients with type 2 diabetes have kept their A1c at the level I have for as long as I have. She admitted that not one other patient has. Then I asked how many of then are low carbing - again she said none. Then she had a 'light bulb' moment and started asking sensible questions which I was more than happy to answer.

Also your nurse needs a gentle reminder that her job is to support patients not to be antagonistic and if she doesn't take that on board then complain to the practice manager.
 
I was told I would get sore fingers as well - didn’t stop me testing though!
 
I've been testing for six and a half years now and never get sore fingers, but I do occasionally have a rare "Ouch!" moment if my lancet gets a bit blunt or I've accidentlly dialled it too deep. And, I started off having to overcome my original needle phobia...

If I'd never started testing I wouldn't have learned how both food and other issues can all affect my diabetes, and as a result what I can do to keep my levels generally low and stable. As a bonus, I've come of metformin and some other long term non diabetic medication as a result of this good management. Both my GP and my DN are happy with how I control my diabetes, but GP told me he's unable to fund my test strips due to our practice's financial restrictions.

Regardng statins: I was obediently and ignorantly taking them for years before I became diabetic and as far as I'm concerned now, all they ever did for me was to help me on my way to eventually becoming T2. Finally stopping them definitely improved my glucose levels.
 
I told my DN a couple of days ago that I am LCHF she didn't bat an eyelid I also told her I finger prick test daily but am now self funding a Libre again nothing but support for what I am doing. She's great has been treating diabetes for years and is very knowledgeable.

My GP on the other hand not so keen.
 
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