Anyone else living in France?

[chinta]

Hi

I was diagnosed last week as being Type 2. It wasn't a huge surprise as I'm overweight, in my 50's and my dad and his sisters were all Type 2. Well it wasn't a huge surprise but I'm more shocked than I expected to be. I'm English but live in France. My view of the French health system vs NHS is that I am fortunate to be in France because I believe we get much better care. However, my doctor has told me absolutely NOTHING about my condition apart from prescribing metformin 850mg twice a day and "suggesting" that I lose some weight. And in order to do this all he has suggested in no sugar, jam, pastries etc. Very basic attitude to dieting I thought. I have to go back for a fasting blood sugar test in 3 months and he will decide if my meds need adjusting.

I have an appointment at a French version of a well woman clinic in 3 weeks time and shall ask them about support and information in case my doctor is just being lazy.

I have spoken with my sister-in-law in the UK who was diagnosed a couple of years ago and she has given me so much more information and through my own research I have found this site. I hope that some of you here will help if I have any (many) questions.

I would love to know if anyone else on this forum s living in France.

 

[phoenix]

I live in France but am T1, I see a specialist for all my diabetes related care and have good care. I've only seen my GP three times in fourteen years! I know though that T2 is normally dealt with by the GP.
It's not the same as in the UK though. It is up to me to be proactive in getting appointments and making sure that I have lab tests in good time
As a T2 you have a chronic condition called an ALD and all your diabetes related care should be reimbursed at 100%. When you go to the well woman appointment I should certainly ask about this .
It does take some time for the paperwork to be done. it won't make much difference for metformin but your top-up insurance won't be needed for any diabetes related specialist appointments as long as the specialist only charges normal rates.

Your doctor should at a minimum test your HbA1c every 3-6 months and there are other blood tests for cholesterol and blood and urine tests for kidney function .He should also look at your feet at least once a year. Very importantly you should be advised to go to an ophthalmologist for a retinopathy check. (but where I live there is a dearth of them so you have to make appointments 4-6 months in advance)You might be able to get an appointment to see a dietitian; I know several type 2s who have seen one in my local area. My local hospital also runs T2 courses but I think the provision does vary from area to area.

According to the Sophia site (see below) an ECG and perhaps a stress test are also normal. (I have one every 2 years and also a scan of my arteries)

There is a telemedicine scheme called Sophia which is available for all people with diabetes, though of course it does rely on talking on the phone; not always the easy option if your French isn't good.. Here is their website. https://www.ameli-sophia.fr/service-sophia/presentation-du-service-sophia.html There is also quite a lot of information on the site
Lastly, here is some of the official documentation regarding T2 and what the care should be. (in medico/legal French I'm afraid) http://www.has-sante.fr/portail/jcm...rcours-de-soins-diabete-de-type-2-de-l-adulte

 

[chinta]

Thanks very much. That's kind of reassuring to know that you've had to be proactive too. I spent the weekend reading as much as I could on the net and of course when I went to see the GP yesterday morning he didn't mention anything, apart from filling out the 100% forms which he did there and then and sent off for me. I didn't have to pay anything for the metformin because he put on the prescription that the forms were being processed. He did actually mention getting my eyes tested. We normally wait til we come to England to get that done because glasses are so much cheaper in the UK but I presume that if I just want the test done, as opposed to buying glasses I may as well get it done here now, especially with 100% reimbursement.

I'm not too sure what the HbA1c test is. Is that the fasting test? No mention of exercise or about my feet. Those things I got from my sister-in-law.

 

[patchworks101]

Hi

I was diagnosed last week as being Type 2. .....

I would love to know if anyone else on this forum s living in France.

Hi
I'm T1, near Poitiers, and think the service here is brilliant. I see the consultant 3 times a year but can phone him or write to him whenever I want and he's always very responsive and helpful.

As a T2 you have an ALD (affliction longue durée), as Phoenix says. However, go back to your GP as it is his responsibility to complete, online, a form for CPAM to declare you as ALD. About 2 weeks later you will receive a letter, from CPAM, confirming the ALD and 100% entitlement. You will then receive all medical treatment, and prescriptions, relating to your diabetes free of charge. This can include heart and eyesight examinations.

There are spectacle providers in France that operate similar to the likes of Specsavers with their pricing plans. However, normally your 100% covers the rates that CPAM state are applicable and will NOT be the cost of your specs from most opticians. Make sure you check what the reimbursement (100% rate) will be before ordering any spec's.

The HBa1c test will test your long-term glycemic levels and is normally done every 3 months. It does not have to be a fasting test but is normally arranged for first thing in the morning.

There are as many diabetics in France as there are in the UK so you are not alone. Why not contact your endocnologie unit at the hospital. They wil have details of all sorts of courses etc that you can go on.

All the best

BB

 

[BUTCH BRADDON]

Thanks very much. That's kind of reassuring to know that you've had to be proactive too. I spent the weekend reading as much as I could on the net and of course when I went to see the GP yesterday morning he didn't mention anything, apart from filling out the 100% forms which he did there and then and sent off for me. I didn't have to pay anything for the metformin because he put on the prescription that the forms were being processed. He did actually mention getting my eyes tested. We normally wait til we come to England to get that done because glasses are so much cheaper in the UK but I presume that if I just want the test done, as opposed to buying glasses I may as well get it done here now, especially with 100% reimbursement.

I'm not too sure what the HbA1c test is. Is that the fasting test? No mention of exercise or about my feet. Those things I got from my sister-in-law.

I live in the Lot et Garonne. I am type 1 and was diagnosed before moving to France. I have to see my GP (Medcine traitant) every 3 months. HbAic and morning glucose tests are done routinely every 3 months and kidney function about twice per year. Yearly eye checks and scans on carotid and lower limbs every 2-3 years. I also get a call from Sophia every 3 months as mentioned above. All in all I am very satisfied with the level of care. Note HbA1C is a measure of your glucose level over a long duration and tells your GP generally how you are managing.

 

[chinta]

Thanks for all the replies. The GP has already done the forms and sent them to CPAM for me. At least now I know what I can expect. II couldn't believe that the service wouldn't be as good as the UK. My family's experience of the French health service over the last 12 years has been excellent.

 

[SunnyExpat]

No matter where in the world, I order my glasses online. Single prescription glasses, in decent frames, for about a tenner.

 

[fredericmarcel]

Bonjour Chinta, I live near Paris and I am French (I married an English woman and my three daughters are French and English). Being diagnostized with diabetes last July came as a shock to me and I was sent a week in hospital to start treatment to get my blood sugar and triglycerides down. They gave me the standard official education about diabetes management.
I decided I would be 100% proactive and started researching for ways to manage my diabetes on Amazon;com; i discovered there where books speaking about curing or reversing your diabetes. I started exploring in forums and in a process that was like a search for gold, I finally decided Dr Richard Bernstein's book
http://www.amazon.com/Dr-Bernsteins...4&sr=1-1-spell&keywords=dir+richard+bernstein was the most trustworthy guide.
After three months of following his low carb diet, I have stopped all my meds and insulin. My FBG is 4.9 (0.89 in France, 89 in the USA).
My AC1 is 5.5% You can learn about AC1 here http://www.phlaunt.com/diabetes/ (this is an excellent reference site for proactive people).
After a few bad experiences in hospital, I decided to avoid the "service public" and go to a private centre de soins in Paris.
I suggest you take full responsibility for managing your diabetes and find professionals who trust you and help you succeed in your endeavour. My medecin traitant really helps me and is amazed by the way I have managed my diabetes. According to the official definition of diabetes, I am no more diabetic. Of course, if I eat carbs, I will become diabetic straight away. But if I follow the low carb diet, I think I can stay safe.
Dr Bernstein's solution is quite radical. The diet is close to Dr Atkins diet. Here is an excellent book that you might like
thttp://www.amazon.co.uk/Atkins-Diabetes-Revolution-Robert-M-D-ebook/dp/B000FC2QEG/ref=sr_1_1?ie=UTF8&qid=1447829744&sr=8-1&keywords=Atkins+Diabetes+Revolution%3A+The+Groundbreaking+Approach+to+Preventing+and+Controlling+Type+2+Diabetes
A last piece of advice : if you decide to manage your diabetes in a proactive and happy way, do not talk about it with doctors before you feel completely confident that they will not freak out because you are being autonomous.
I hope this helps and I wish you a happy journey in the management of your diabetes and well-being.
Do not hesitate to ask any question. We are here to help one another and without this forum and this one http://www.diabetesforums.com/forum/forum/4-type-2-diabetes/, I could never have gone through the obstacles that I had to overcome.
Best wishes.
Frederic

 

[fredericmarcel]

SunnyExpat, can you give us a link to the sites which you recommend for buying glasses online?

 

[SunnyExpat]

SunnyExpat, can you give us a link to the sites which you recommend for buying glasses online?

http://www.goggles4u.co.uk shipping to Paris £9.95, an American company, but with an eu dispatch when I last used them, so I didn't need to sort out any customs/import duty.

Have you ever given the Newcastle Diet a shot, many doctors here are fairly well clued up on it now, and it seems to work well.

 

[fredericmarcel]

Thank you SunnyExpat, I will order new glasses on that site.
I gather from your name that you live in the South of France.Périgord, Provence, Côte d'Azur.
I will study the Newcastle Diet out of interest. But I am so happy with the ketogenic diet that I would only considering another diet if if I could not keep my blood sugar in the normal zone.
In three months, I have not felt hungry once. Just a little nostalgy when I finish my meal at the idea that I could indulge more...and go back to I was before, thank you but no thank you

 

[chinta]

Thanks again to everyone, especially Frederic, you've given me lots to read and think about!! I currently live in Manche and as I said, my own doctor has given me no information at all apart from prescribing Metformine. I still have my appointment in December for the health check that was offered to us as a couple because my husband is approaching 60 and sometime next year we are moving to Bayeux and will obviously have to change GP. So at least I will get the benefit of the views of 3 different doctors!!!

 

[fredericmarcel]

I love Bayeux. So many happy memories of the Cathedral!
If you adopt the type of management recommended by either Dr Bernstein's or Atkins' book and get support on a forum by people who have a long experience of low carb or ketogenic diet (they are one and the same), you will not need to depend on your doctor and you might even reduce or go without meds. The diet is extremely different from the usual English or French diet. And one added benefit is the weight loss (I have lost 10 pounds in three months though that was not an important goal for me : just collateral benefit).
But diabetes is a very serious condition and I wanted to be empowered and not dependant on doctors. Plus, having read these books (and others because once you start, you really want to become well informed), I knew that the official doctrine for diabetes and diets is outdated and dangerous. I think it will be modified since it is the cause for a worlwide epidemy of obesity and diabetes.
So, I wish you good luck with your doctors in Manche and Calvados; but do not forget you are the boss. And that is as it should be.

 

[SunnyExpat]

Thank you SunnyExpat, I will order new glasses on that site.
I gather from your name that you live in the South of France.Périgord, Provence, Côte d'Azur.
I will study the Newcastle Diet out of interest. But I am so happy with the ketogenic diet that I would only considering another diet if if I could not keep my blood sugar in the normal zone.
In three months, I have not felt hungry once. Just a little nostalgy when I finish my meal at the idea that I could indulge more...and go back to I was before, thank you but no thank you

The American '.com' version of the site has a good range as well.

I'm not entirely sure I could live in France and not eat the bread and pastries though.
That seems to be the beauty of the Newcastle diet, you can reset yourself, and as you say (although I can't imagine anyone ever would), if you don't gorge to excess, a few sensible choices occasionally don't seem to skyrocket your BG anymore.
Maybe worth a try for nostalgia's sake?

 

[fredericmarcel]

I could not imagine not eating the french way. But here I am after three months of low carb diet : I have never enjoyed my food as I do today. And I am so full of energy (and lean like I was when I was twenty).
I eat cheese, meat, eggs, vegetables, almonds. So, I do not intend to try anything else for the moment.
And I have plenty of scientific books and websites and forums when I feel I am quite rooted. And I don't even think that my way is the best way. It just seems to work for me.

A good introduction to low carb for chinta http://www.dietdoctor.com/lchf
You certainly can consider the Newcastle diet as well as the low carb diet. They both are serious. Anyway, it will take you a while to change your lifestyle if this is the way you decide to go.

 

[SunnyExpat]

I could not imagine not eating the french way. But here I am after three months of low carb diet : I have never enjoyed my food as I do today. And I am so full of energy (and lean like I was when I was twenty).
I eat cheese, meat, eggs, vegetables, almonds. So, I do not intend to try anything else for the moment.
And I have plenty of scientific books and websites and forums when I feel I am quite rooted. And I don't even think that my way is the best way. It just seems to work for me.

A good introduction to low carb for chinta http://www.dietdoctor.com/lchf
You certainly can consider the Newcastle diet as well as the low carb diet. They both are serious. Anyway, it will take you a while to change your lifestyle if this is the way you decide to go.

Surely you ate the French way until diagnosis?

But for @chinta way easier to try the Newcastle Diet, and then see what effect a small amount of carbs has.
If it was still in england, much easier to give them up.

 

[fredericmarcel]

Surely you ate the French way until diagnosis?

But for @chinta way easier to try the Newcastle Diet, and then see what effect a small amount of carbs has.
If it was still in england, much easier to give them up.

There are many French ways. I ate quite simply. I loved crudites and it was difficult for me to do without my beloved carottes rapees and tomates. And fruit. Not to forget the great breads France is blessed with. But there you are;: diabetes has been such a shock that I had to fight back. And since I feel quite happy to do without meds or insulin without feeling deprived,(for the moment), I do not regret the old days. I have eaten enough sugar, Poilane bread and fruit for three lifetimes
What is important for people newly diagnostized is to have the inforformation and the support group they need to start taking control of diabetes. It is much more important, in my opinion, than such and such solution, wouldn't you agree?

 

[SunnyExpat]

There are many French ways. I ate quite simply. I loved crudites and it was difficult for me to do without my beloved carottes rapees and tomates. And fruit. Not to forget the great breads France is blessed with. But there you are;: diabetes has been such a shock that I had to fight back. And since I feel quite happy to do without meds or insulin without feeling deprived,(for the moment), I do not regret the old days. I have eaten enough sugar, Poilane bread and fruit for three lifetimes
What is important for people newly diagnostized is to have the inforformation and the support group they need to start taking control of diabetes. It is much more important, in my opinion, than such and such solution, wouldn't you agree?

I agree entirely, there are many ways to beat diabetes, it's important to know all the options, and benefits from the methods that can be tried.
It's good to discuss every available option.
Particularly for those of us that are not fortunate to be dealing with our home healthcare, as some things are not immediately clear in different countries.
There must be many french advocates of LCHF, equally I'm sure there may be a french version of the 'Newcastle Diet' which I'm hopeful you can advise us on?
I'm always impressed by the French ability to converse in english so fluently, my foreign language skills are nowhere near as good, but then again, I can normally manage present tense.

 

[chinta]

I think the most disappointing thing for me is that I was looking forward to going to Bayeux at Christmas to buy some lovely goodies from the beautiful chocolate shops and patisseries. Fresh cherries steeped in cherry brandy and dipped in dark chocolate, or candied pineapple covered in white chocolate, or of course, chocolate truffles are now obviously definitely out of the diet. I have to say though, giving up French bread is not a sacrifice to me. I really find it quite bland, boring and doughy. Croissants however, that's another matter. We also eat a lot of pasta, jacket potatoes and white rice, which I am obviously going to have to now cut down on, or do I need to cut them out completely?

 

[SunnyExpat]

I think the most disappointing thing for me is that I was looking forward to going to Bayeux at Christmas to buy some lovely goodies from the beautiful chocolate shops and patisseries. Fresh cherries steeped in cherry brandy and dipped in dark chocolate, or candied pineapple covered in white chocolate, or of course, chocolate truffles are now obviously definitely out of the diet. I have to say though, giving up French bread is not a sacrifice to me. I really find it quite bland, boring and doughy. Croissants however, that's another matter. We also eat a lot of pasta, jacket potatoes and white rice, which I am obviously going to have to now cut down on, or do I need to cut them out completely?

It's always good to reduce carbs, but the specific answer to your question depends on how you decide to tackle diabetes, and how your body reacts. A meter is the only way to be sure.