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Another unsatisfying appointment

S

SOTR

Well-Known Member
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81
I had another unstisfying appointment with my GP practice today. I had asked for an appointment with a GP specialising in diabetes.
They used to have one. So new to me GP anyway.

First off I asked for more regular HbA1c tests - perhaps every month. Oh no she says - HbA1c measures average blood glucose over the past three months, so we don;t see the point in doing them more than every three months.
Er...ahem... moving averages?\
She asked about my having a checkup every year - with the filament foot test. I replied this is basically useless - one time the nurse told me off for having an omelette for breakfast and told me to eat porridge. I know porridge spikes my blood sugar.

I asked about the restricted calorie diet, and I dont think she really understood.

Next I aksed about being put on a weight loss drug - and mentioned NICE guidelines. I dont see why people should get these drugs for cosmetic reasons, yet a diabetic is refused.
The reason to refuse? We put you into a weight loss clinic first to see how you get on with that. I said this would be useless to me, but accepted.
So six to eight weeks maybe trekking to some health centre, to be lectured on eating 'complex carbs' and porriidge.
 
@SOTR , I just want to make a comment on the 3 month HbA1c tests. Your GP is right. 3 months is roughly the life span of red blood cells. It's measuring the amount of glucose that's sticking to those red blood cells. Also the results are often skewed towards the last month of the test. It is the same here in Canada, HbA1c tests are conducted every 3 months, if required. No sooner.
 
you can ask to go on the dexcom or freestyle libre CGM. That usually gives you an average and is very much in line with HBA1C.
Perhaps look into keto or low carb diets. I am trying the intermittent fasting. I have my main meal at 4pm. At 19:40 I will have a snack then fast right through till 4pm. Not for everyone but there's a lot of options out there.

I think your GP is right trying to manage your weight at a clinic first.
 
I have to request testing to get one a year. I then have to ask about the checks - eye testing is once every 2 years.
My GP offered no advice at all - that was 2016, just prescribed tablets, no follow up, nurses are approving of the low carb diet, but very quietly.
I had half a century of bad advice and ridicule about my weight and how to eat - I did try the shakes and low calorie regime last year but stopped it when I was tested and my HbA1c was higher than for the last 5 tests.
 
Melgar said:
@SOTR , I just want to make a comment on the 3 month HbA1c tests. Your GP is right. 3 months is roughly the life span of red blood cells. It's measuring the amount of glucose that's sticking to those red blood cells. Also the results are often skewed towards the last month of the test. It is the same here in Canada, HbA1c tests are conducted every 3 months, if required. No sooner.
Click to expand...
If that's true, wouldn't it support the argument of the OP for monthly tests...?
 
Monthly HbA1c would be pointless, she's right on that part, but I get why you want closer tracking. Some people use continuous glucose monitors (CGMs) for exactly that reason, since you can see the spikes in real time instead of waiting 3 months
 
Hi
Type 1 of 50 years here.
The absolute game changer for me around 8 years ago was the CGM.
You can monitor the effect of insulin, food and exercise on your body which is key to successful control.
My last hba1c was 39 or 5.7 and my up to date CGM estimate is 38 or 5.6.

Happy times and places

Tony
 
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