An interesting discussion with a diabetes nurse.

[BRSBRI]

Evening everyone: had a chat with a new temporary diabetes nurse today at the practice as she wanted to book me in for a May once-over - and here's the upshot:

1. Last time I was there, my BP was all over the place and sat at 179/120. It's now settled and regularly returning 120/80 via the machine I bought. However, she wants to put me on Ramipril 2.5mg "as it won't do any harm".

2. Told me as an aside they never prescribe glyclazide now - not that I need it, but an interesting comment. And why she brought it up, who knows.

3. By ditching most carbs, I've lost over 20 kilos in weight taking me to normal BMI for my height (6 feet 0)...but she still was concerned about me ditching "too many carbs". Insists I see a dietician so I can be more fully informed. I won't repeat her views on this forum. Let's just say, best forgotten.

4. HbA1c came back at 47 rather than the 70+ from when this all started. She tells me, "Much more work to do as getting lazy will hurt you". Nicely put.

5. Also insists I go an a group zoom call for diabetes education. Anyone else had this?

So, a mixed bag really. The other DSN covering my super hero regular nurse, is more low-carb friendly, helpful and doesn't wince when you mention erectile dysfunction...

It just goes to show and prove it's all down to individual HCPs and their willingness not just to be box tickers. Hurry back my usual DSN! Puhlease

 

[bulkbiker]

Pretty par for the course I'm afraid...

Bet she didn't explain that every medication will have side effects so it could definitely do some harm..

Ah dear the good old stopping "too many carbs" because we needs lots of course except that we really "need" zero.

Great news on the drop in HbA1c well done you ...odd that she wasn't more surprised as I bet not many of her other customers have done similar things.

Zoom call might be useful if it's an Xpert health but apart from that I'd avoid as well as the dietician.. you'll get more pertinent info here.

 

[Andydragon]

My diabetic nurse today talked about dropping carbs being fine, and that you don’t need any; that she does intermittent fasting and I could look at that if I wanted. she said also she only eats a small amount of carbs prior to doing some intensive exercise to help for energy and that I could do that (small oatmeal and apple perhaps) but was a passing comment and not advice

she also said all my cholesterol was fine. Also as I said earlier, totally drug free immediately.

she also talked about eating Greek yoghurt and berries

she also said I should increase protein in order to maintain weight.

so... there are definitely good ones out there. I was actually a bit flabbergasted

 

[Mrs T 123]

Well done on reducing the HbA1c - you are heading in the right direction. If it is a Desmond course on Zoom I wouldn't bother - I attended one a few years back when newly diagnosed and I felt it was a waste of time - a lot better info on here but up to yourself to decide ...

 

[HSSS]

Evening everyone: had a chat with a new temporary diabetes nurse today at the practice as she wanted to book me in for a May once-over - and here's the upshot:

1. Last time I was there, my BP was all over the place and sat at 179/120. It's now settled and regularly returning 120/80 via the machine I bought. However, she wants to put me on Ramipril 2.5mg "as it won't do any harm".

2. Told me as an aside they never prescribe glyclazide now - not that I need it, but an interesting comment. And why she brought it up, who knows.

3. By ditching most carbs, I've lost over 20 kilos in weight taking me to normal BMI for my height (6 feet 0)...but she still was concerned about me ditching "too many carbs". Insists I see a dietician so I can be more fully informed. I won't repeat her views on this forum. Let's just say, best forgotten.

4. HbA1c came back at 47 rather than the 70+ from when this all started. She tells me, "Much more work to do as getting lazy will hurt you". Nicely put.

5. Also insists I go an a group zoom call for diabetes education. Anyone else had this?

So, a mixed bag really. The other DSN covering my super hero regular nurse, is more low-carb friendly, helpful and doesn't wince when you mention erectile dysfunction...

It just goes to show and prove it's all down to individual HCPs and their willingness not just to be box tickers. Hurry back my usual DSN! Puhlease

So you’ve ditched 20kg, taken your bp from near 180 down to 120, got your hb1ac down from over 70 to only just prediabetic 41. In other words got much much healthier.

And she wants to put you on bp meds that will take you low, accuses you of getting lazy and criticises your achievements by telling you to do the opposite of how you got here (low carb) and sending you for education that you obviously don’t need.

this is not only disappointing but bordering of malpractice. I’d be furious and making it known.

 

[BRSBRI]

So you’ve ditched 20kg, taken your bp from near 180 down to 120, got your hb1ac down from over 70 to only just prediabetic 41. In other words got much much healthier.

And she wants to put you on bp meds that will take you low, accuses you of getting lazy and criticises your achievements by telling you to do the opposite of how you got here (low carb) and sending you for education that you obviously don’t need.

this is not only disappointing but bordering of malpractice. I’d be furious and making it known.

Given all the support - super support I've had this was an interesting diversion into what many have to contend with on a regular basis. Got the impression I was irritating her with questions and the approach was almost "Do not question me"...



Thankfully, only there for 4 weeks and back to what I've become used to...phew...

 

[BRSBRI]

My diabetic nurse today talked about dropping carbs being fine, and that you don’t need any; that she does intermittent fasting and I could look at that if I wanted. she said also she only eats a small amount of carbs prior to doing some intensive exercise to help for energy and that I could do that (small oatmeal and apple perhaps) but was a passing comment and not advice

she also said all my cholesterol was fine. Also as I said earlier, totally drug free immediately.

she also talked about eating Greek yoghurt and berries

she also said I should increase protein in order to maintain weight.

so... there are definitely good ones out there. I was actually a bit flabbergasted

Great news - and well done you!

 

[NicoleC1971]

Temporary dsn must be suffering with cognitive dissonance - she 'knows' that dropping carbs is bad but you have lost 20 kg? She knows that the only way to treat hypertension is with meds but you've done so by dropping carbs and losing weight... I assume her comment about 'getting lazy' reflects her underlying belief that you've starved yourself and are bound to slip up so that in May she cam bombard you with pharmaceuticals....
You've done well and have the results to show for it. How about sharing your story via the supportive nurse as I am sure it would inspire others.

 

[Ushthetaff]

The S in DSN does stand for specialist aye ? Don’t get me started , a few courses does not a specialist make , my experience of so called specialist is not good to say the least in fact a neighbour of mine who is type 1 was told not to take his quick acting insulin while his Dsn worked out his long acting insulin dose , for five days , I wouldn’t have had her in charge of a kettle in the staff room . Grr sorry for the rant , what do I know not been on the course I guess only been diabetic for 40 years

 

[BRSBRI]

The S in DSN does stand for specialist aye ? Don’t get me started , a few courses does not a specialist make , my experience of so called specialist is not good to say the least in fact a neighbour of mine who is type 1 was told not to take his quick acting insulin while his Dsn worked out his long acting insulin dose , for five days , I wouldn’t have had her in charge of a kettle in the staff room . Grr sorry for the rant , what do I know not been on the course I guess only been diabetic for 40 years

Well said there. Only a few months in to this journey, I can already see there's a huge disparity in care and knowledge with HCPs...and the lazy box ticking rigmarole seems deeply ingrained in a few...

I'm glad in some respects I've seen the other side of the tracks so to speak having been spoiled rotten by my regular team...

 

[BRSBRI]

Temporary dsn must be suffering with cognitive dissonance - she 'knows' that dropping carbs is bad but you have lost 20 kg? She knows that the only way to treat hypertension is with meds but you've done so by dropping carbs and losing weight... I assume her comment about 'getting lazy' reflects her underlying belief that you've starved yourself and are bound to slip up so that in May she cam bombard you with pharmaceuticals....
You've done well and have the results to show for it. How about sharing your story via the supportive nurse as I am sure it would inspire others.

That's a great idea re sharing.

 

[Resurgam]

My diabetic nurse today talked about dropping carbs being fine, and that you don’t need any; that she does intermittent fasting and I could look at that if I wanted. she said also she only eats a small amount of carbs prior to doing some intensive exercise to help for energy and that I could do that (small oatmeal and apple perhaps) but was a passing comment and not advice

If porridge and an apple is a small amount of carbs - I'm a bit boggled there...

 

[Andydragon]

If porridge and an apple is a small amount of carbs - I'm a bit boggled there...

It was an example, as you do know, some of us can tolerate carbs better than others. Whilst the advice may not apply to all, carbs giving energy prior to exercise was the discussion

we can all debate whether there are different options

 

[Tophat1900]

@BRSBRI - you're a winner, congrats on the outstanding results. Carry on, I see no need to change anything except DSN's