NewTD2
Well-Known Member
- Messages
- 1,563
- Type of diabetes
- Treatment type
- Tablets (oral)
Dr Bailey,
Can I please private message you?
Dirty to hear about your broken leg.
I hope you recover very soon!
Andrew
Sure, no problem. I’m currently laid up having broken my leg falling off my bike (No, exercise IS good for diabetes, at least if done sensibly!). So, for the next 3 weeks or so I have time on my hands though posting here is something I wouldn’t normally have time to do. The disintegrating NHS is wholly another subject all together. I’d like to think that most of us DO care but it’s not easy when you’re fighting fires every day of every week. I hope that you get the care that you deserve.
An HbA1c of 46 is excellent if you are Type 2. So good in fact that if you had never had one done before you would not be diagnosed with diabetes although you would be classified as being at high risk of developing diabetes (42-47 to be precise). A word of warning for those with type 1 (and indeed some with Type 2, especially those on insulin.) 46 is too low and almost certainly means you are having too many hypos. The mantra of “lower is better” is not always true. For Type 1 (with perhaps the exception of pregnancy, where really tight control IS important), mid fifties or so is probably about optimal. Hypos are NOT trivial and can cause lasting damage to the brain.I think HbA1c of 46 is very good. What do others think?
No problem. You can find me on Facebook and use messenger if you make it clear who you are (but once I’m back at work the replies might dry up!)Dr Bailey,
Can I please private message you?
Dirty to hear about your broken leg.
I hope you recover very soon!
Andrew
An HbA1c of 46 is excellent if you are Type 2. So good in fact that if you had never had one done before you would not be diagnosed with diabetes although you would be classified as being at high risk of developing diabetes (42-47 to be precise). A word of warning for those with type 1 (and indeed some with Type 2, especially those on insulin.) 46 is too low and almost certainly means you are having too many hypos. The mantra of “lower is better” is not always true. For Type 1 (with perhaps the exception of pregnancy, where really tight control IS important), mid fifties or so is probably about optimal. Hypos are NOT trivial and can cause lasting damage to the brain.
No GP Practice should refuse any patient on the grounds they have a long term condition. Some of us DO care and passionately so. I may not always agree with my patients but I will always try to answer their questions and explain, particularly if I disagree. Unfortunately medicine is not a business where the customer is always right, but then again, neither are the doctors!I hope this won't come off as a stupid question, but here's the situation. I don't have a GP in London (I'm not from the UK originally and I never have had, I was indestructible of course.)
I want to absolutely minimise the contact I have with any sort of medical professional, no offence but they are not doing anything very useful and we don't really get on (what is it with diabetes specialists and refusing to answer questions).
Anyway currently the only way I have of getting repeat prescriptions for stuff is via the hospital, which can't really go on for ever, although of course now it does have to go on forever, so.
The problem is, will any GP see me as a bad risk, a pain in the neck, someone who will be sick forever and just soak up their time, not someone they want on their books, and so on. I am not used to being in this situation, I am used to happily ticking the "no pre-existing conditions" box whenever it comes up, and I feel very awkward just walking in and going "hello can I sign up please, I'm chronically unwell."
Unfortunately medicine is not a business where the customer is always right, but then again, neither are the doctors!
You should definitely register. Despite how it comes across on this site sometimes, the vast majority of GPs want to support you and make you well. Most of the time they only have a 10 minute slot with you, so will probably just ask how you are getting on and refer to the hospital for any further treatment. BUT - they can sort your prescriptions and, in the case of my local surgery, provide you with somewhere to offload sharps bins. Plus you are a bit more vulnerable to other stuff now so if you are registered then at least you can ring through if there is a problem - such as the flu that your homeland is offloading on us!I hope this won't come off as a stupid question, but here's the situation. I don't have a GP in London (I'm not from the UK originally and I never have had, I was indestructible of course.)
I want to absolutely minimise the contact I have with any sort of medical professional, no offence but they are not doing anything very useful and we don't really get on (what is it with diabetes specialists and refusing to answer questions).
Anyway currently the only way I have of getting repeat prescriptions for stuff is via the hospital, which can't really go on for ever, although of course now it does have to go on forever, so.
The problem is, will any GP see me as a bad risk, a pain in the neck, someone who will be sick forever and just soak up their time, not someone they want on their books, and so on. I am not used to being in this situation, I am used to happily ticking the "no pre-existing conditions" box whenever it comes up, and I feel very awkward just walking in and going "hello can I sign up please, I'm chronically unwell." Especially given the news that the NHS is basically dying moment by moment. It's not very easy.
Are they going to want to run a whole barrage of tests and stuff? I'm not really up for that, I have enough bits of metal stuck in me.
Not true for everyone. It would be nice if proffesionals would see case to case. I have the proof of my Libre that I'm not going hypo all the time, and when I do I usually don't go below 3,6. (still normal for healthy people and only counted as hypo to avoid dangerous hypo's. I do treat as hypo though when below 3,9). Despite this proof my DN still doesn't like it that my hba1c is under 40. I do like it, especially as taking the right amount of insulin is much easier when I'm not too high. As long as I can keep it low without nasty hypo's and without too much hassle I'll do that. At least with the Libre she has to believe me when I say I'm staying in the safe zone, no idea what would have happened without it.46 is too low and almost certainly means you are having too many hypos.
46 is good when your t2 diabetic the perfect is 49 I’m coming down from 69 to 61My GP told me that my A1c of 46% is “normal”, which clearly isn’t!!!
She hasn’t got a clue about diabetes so I changed GP/surgery straightaway!
My note of caution about hypos is based on statistics: Those patients with T1 diabetes with very low HbA1c levels are at higher risk of permanent disability and death than those with slightly higher readings. Having said that there are 2 obvious points. Firstly, you are a person, not a statistic (as I think Abraham Lincoln said: “there are lies, damned lies and statistics “!). Secondly statistics do of course lag some time behind the here and now and we may have to revise our views with the arrival of Libre and other continuous glucose monitors. My dream is that we will have an artificial pancreas one day that is as good as the real thing; that’s where the future lies until the elusive cure is found . Personally I would kill for an HbA1c like yours if I was confident I was not getting any significant hypos. I know it is not really for this thread, but you are a great example of why CCGs are so short sighted by refusing to allow Libre and the like on NHS prescription. Carry on as you are and you will never end up with sight, kidney or vascular problems (which are hugely expensive to deal with) because of your diabetes, but being cash strapped as they are they cannot see the longer picture. I think that you make an excellent point, but still need to beware the dreaded hypos!Not true for everyone. It would be nice if proffesionals would see case to case. I have the proof of my Libre that I'm not going hypo all the time, and when I do I usually don't go below 3,6. (still normal for healthy people and only counted as hypo to avoid dangerous hypo's. I do treat as hypo though when below 3,9). Despite this proof my DN still doesn't like it that my hba1c is under 40. I do like it, especially as taking the right amount of insulin is much easier when I'm not too high. As long as I can keep it low without nasty hypo's and without too much hassle I'll do that. At least with the Libre she has to believe me when I say I'm staying in the safe zone, no idea what would have happened without it.
(type lada or type2, diagnosed a bit over a year ago, on moderate carbs and tresiba + fiasp. And a lucky ******* that my diabetes is relatively easy to control. At least for now)
And sorry for derailing this thread.
@NewTD2 I'm a bit confused as to whether you're type 1 or 2 but if type 1 and in London (judging by Barnet) you can go to any of the London hospitals. Just call up them up, interview them on key points that matter to you and ask how to self refer. I live in the Barnet CCG but get seen at one of the inner London teaching hospitals and have been with them for a long time. GPs don't have enough experience to provide this type of care and let's not get started on some of the DSNs.....
An HbA1c of 46 is excellent if you are Type 2.
It's the sort of reading doctors and DN say is okay but isn't.I'm sorry but I heartily disagree with that statement. 46 is well into the pre diabetes category so to tell someone with Type 2 that is excellent is hardly going to encourage them to get it lower.
My note of caution about hypos is based on statistics: Those patients with T1 diabetes with very low HbA1c levels are at higher risk of permanent disability and death than those with slightly higher readings.
We use cookies and similar technologies for the following purposes:
Do you accept cookies and these technologies?
We use cookies and similar technologies for the following purposes:
Do you accept cookies and these technologies?