Are Doctors really up to speed with T2?

[Smallbrit]

I'm in Cardiff, but used to live in the US, and I have to say I got much more information and up to date advice ten years ago there than I've been given here, possibly because they were dealing with gestational diabetes - the diabetes nutritionist there taught me how to test with a meter, what glucose ranges to stay in, how to carb count; I even got shouted at when I ate a banana I was pregnant here in Wales last year and my GP and the midwife were indifferent rather than anti anything; they just told me to do what I was comfortable with when I asked.

All my treatment in Cardiff has involved regular visits to the diabetic nurse, with little in the way of constructive advice - I was told to exercise more and eat more healthily, although I wasn't specifically told what that meant. I got diagnosed with prediabetes after the usual first check up when I moved here three years ago. I had the usual referral to the nutrition course, which seemed to be aimed at people who needed to lose weight and was teaching about calories, and have the yearly retinal screening apoointments. I saw my GP only when he intervened last year when my HBA1C shot up from low 40s to 89 in a three month period, which I think it's safe to say is what happens when you eat biscuits continually to console yourself. Even then, he didn't really tell me that I wasn't at a prediabetes level anymore or that I should have a more radical approach with such high numbers. I figured that out from here

I'm going to say that my GP's surgery at least go with the hands-off approach and don't try to tell me anything contradictory to what I learnt in the US. I went down from 89 to 76 HBA1C after 3 months, by only adding exercise and eating a few less biscuits and my only advice from the GP was to keep doing what I was doing. Which is not really good enough, I think.

 

[Bogie]

We obviously have help and education a lot better here in Canada. While GPs know very little about Diabetes, the specialists we have do. I now go to a specialist care provider called LMC. www.LMC.ca They do have a helpful Diabetes Education section on their website. LMC is fairly new and I hope that they continue to grow and expand and that possibly their care model is adopted where you are. Wish you had similar in GB as they are a one-stop diabetes care centre.

 

[Polly1974]

Hi everyone. I live in West Wales and was finally diagnosed with type 2 back in January of 2017 with an HBa1c of 70. I was sent home with a low dose Metformin prescription and a leaflet showing me what to eat.
I must say I was a more than a little confused at this stage, as I already ate a well balanced diet and the leaflet they gave me only confirmed that. Having been told that I had likely been diabetic for a couple of years, I was already suffering with the added problems of neuropathy and retinopathy, and of course the usual suspects, such chronic fatigue, aches and pains, sleep disorders, etc; etc;
After complaining to my GP on several occasions about the metformin upsetting me, she referred me to the diabetic nurse for a chat. She then referred me to the 'specialist practitioner' at the surgery. A mild mannered man with virtually no people skills and even less interest in my personal issues. He reluctantly changed my meds to Gliclazide and sent me back to the nurse, who then issued me with a BG meter along with a very basic tutorial on how to use it. [basically, she hadn't got a clue either] "Only use it now and then" she said. "The strips are expensive and you'll end up like a pin cushion." I was also told that I would still have to see the other GP about my depression, and all she wanted to do was double my anti-mad pills. I thought that depression and diabetes were inextricably linked?
I managed quite well with the gliclazide for a few months, until I experienced several Hypo's in quick succession, at which point and with an HBa1c of 55, my GP told me to come off all meds, as I didn't need them any more.
Thanks Doc. That lasted all of 3 days, before I was in a terrible state and had to go back. He then prescribed a low dose Pioglitazone, which seemed ok for a while until my symptoms got worse over time and my HBa1c had risen to 60, and my depression was unbearable. It was clear that he had under prescribed the dosage. At this point [ I ] suggested that we double the dose and that [ I ] start monitoring myself more regularly.
Since then I have been testing myself up to 6 times a day, and now I have a good set of results to start working on. I managed to blag some more pills and upped my dosage as my BG was still over 10 average. This is not working either and now I'm stuck. I do not trust the practise, yet I still need their help. I hear of many diabetics who have a designated specialist, who monitors new patients closely and works with them until they find their feet and can cope on their own.
I feel let down by my Doctors surgery. Are they all like this in Wales??

Where in west wales are you?

 

[Doubting_Diabetic]

I am probably mentioning information that has already been mentioned here but it is good to revisit. This sight, Diet Doctor.com, and Dr. Jason Fung are tremendous resources. Great advice, great recipes, and valuable information. There are a lot of resources out there. I can prove the viability of low carb-high fat. 4 years ago I was diagnosed with T2. Put on metformin and a multitude of different drugs. On 29Dec2014 I had a stroke related to a tumor in my heart. After another stroke and a heart surgery to remove the mixoma, the nurses put me on insulin because it was easier for them to control the diabetes, they said. Once I had my head about me I told my Dr. that I was not doing insulin and that I would defeat diabetes. By that time I was on 700UI of insulin a week plus I now weighed 358 pounds (US). In the course of 3 months I was not taking any corrective insulin. My daughter was scheduled to get married 1000 miles away and I told the Dr. that I would be insulin free before I went there. He about had a heart attack. "You will kill yourself" he said. 6 weeks later I went to my appointment with him and told him I was no longer taking insulin, my BG was 73 average (US) and he did an A1C and I was at 5.4 (US). I walked my daughter down the aisle without my walker, and survived the ordeal. It is now 3 years later, eating very low carb Keto diet. I have lost 170 pounds, my average BG is 73-83, and my A1C is 5.2. I will never go back to eating the old way again. I know that eating 5-7 grams of carbs per day is not achievable by most people but what do I have to lose? OH, yes, my eyesight, my limbs, my liver, my kidneys and ultimately my life. These are very good reasons not to eat the prescribed diet that many professionals tell you to eat because that is what the dogma says. Forget the food guides, eat what your body and glucose meter tell you is best. Good luck with the low carb-high fat lifestyle because that is what it is, not a diet but a LIFE style.

 

[bulkbiker]

I am probably mentioning information that has already been mentioned here but it is good to revisit. This sight, Diet Doctor.com, and Dr. Jason Fung are tremendous resources. Great advice, great recipes, and valuable information. There are a lot of resources out there. I can prove the viability of low carb-high fat. 4 years ago I was diagnosed with T2. Put on metformin and a multitude of different drugs. On 29Dec2014 I had a stroke related to a tumor in my heart. After another stroke and a heart surgery to remove the mixoma, the nurses put me on insulin because it was easier for them to control the diabetes, they said. Once I had my head about me I told my Dr. that I was not doing insulin and that I would defeat diabetes. By that time I was on 700UI of insulin a week plus I now weighed 358 pounds (US). In the course of 3 months I was not taking any corrective insulin. My daughter was scheduled to get married 1000 miles away and I told the Dr. that I would be insulin free before I went there. He about had a heart attack. "You will kill yourself" he said. 6 weeks later I went to my appointment with him and told him I was no longer taking insulin, my BG was 73 average (US) and he did an A1C and I was at 5.4 (US). I walked my daughter down the aisle without my walker, and survived the ordeal. It is now 3 years later, eating very low carb Keto diet. I have lost 170 pounds, my average BG is 73-83, and my A1C is 5.2. I will never go back to eating the old way again. I know that eating 5-7 grams of carbs per day is not achievable by most people but what do I have to lose? OH, yes, my eyesight, my limbs, my liver, my kidneys and ultimately my life. These are very good reasons not to eat the prescribed diet that many professionals tell you to eat because that is what the dogma says. Forget the food guides, eat what your body and glucose meter tell you is best. Good luck with the low carb-high fat lifestyle because that is what it is, not a diet but a LIFE style.

Welcome to the forum fellow ketoer..

 

[stephen3]

I don’t know if they are all like that where you live but I do know that my GP is quite useless with type 2. He wanted to put me on insulin last year when my hba1c was too high. I refused and asked for a second opinion as I instinctively felt that there was something wrong with his diagnosis.

I was referred to the specialist at my local hospital who stated that my medication was too strong and should be reduced. In fact I had been over-prescribed gliclazide and was having overnight hypos which resulted in massive rebound glucose readings.

This continued sporadically for a year until I managed to get out of the GP’s clutches and began seeing a diabetes specialist nurse who reduced the gliclazide to zero.
The latest wheeze that the surgery has embarked upon is to “standardise” test strips and meters to “ensure” that everyone has the best equipment. This means that my all-singing and dancing Bluetooth meter is to be replaced with a big standard device that, surprise, surprise, uses the cheapest test strips on the market.

When I challenged this retrograde “improvement” on the grounds that I could use my meter to email readings, averages, log book and notes to the DSN and asked how it could be better to be forced to switch to a more basic device, I got a phone call rescinding the move.

The moral is: doctor doesn’t always know best!

 

[masonap]

My reply is going to be different from those above because I was first diagnosed in the UK in about 2000, I think my GP was quite good and we had a good Diabetes Nurse that I saw twice a year. I was prescribed metformin.
Then I moved to Germany in 2013 and my 'House Dr' or 'Family Dr' was very good, blood tests Qtrly but my BG readings were rising so in 2015 I was sent to a Diabetic Specialist. What a complete difference in experience!!!! Now I have someone who knew what they were talking about, a true 'expert', and now I have confidence in my specialist. I was then prescribed insulin as my BG HbA1c readings were over 9. In the same clinic I also met with the dietitian, and I also learned about the 'Low Carb' diet that we are supposed to follow (bad advice previously from the NHS with high carb low fat!). My meds (tablets and insulin) have since halved, my BG readings are almost always good and my HbA1c is now perfect.
Keep at it, use these forums for advice, and I wish you all the best.

 

[sarahmorter2]

I also used to live in WW, Hi

I am not a T2Diabetic, but my husband is. He has followed low carb since Feb last year and I did this with him to support him and for ease of cooking meals. For me it has meant I have thrown my anti mad pills away that I've been off and on for 20 years. Low carb does much more in my opinion than lower your blood glucose levels. I feel significantly better for not eating pasta, potatoes, rice and of course steer away from all the processed stuff. Do try low carb, you'll see a difference pretty quickly if it works for you - less than 2 weeks. Good luck

 

[Sugarbaby123]

Hi! Another Welshwoman here, my T2D was picked up on routine annual check and the confirmed by Hb1Ac , thankfully only 50. I’m trying to reverse the diagnosis with Low carb eating and 5 weeks in it’s been a challenge. Especially over the Christmas period but the weight loss has been rapid and noticeable. I’ve also got under active thyroid problem and mild depression. Not confident to get rid of the happy pills yet, I’ll see how life goes. Found my surgery helpful but as a HCP myself I brushed up on recent research and LCHF eating seemed to make sense for my diet choice. Have tried all manner of weight loss plans in the past but this one is dead easy to do and is working so far. No idea how my blood glucose is doing- not testing- waiting til my next Hb1Ac in Feb. Don’t rely on your GP to spoon feed you advise - use the forum and look up Mike Moseley on low carbs. Best of luck xx

 

[janrat68]

i was dignoised last may it did come as a hell of shock to me cos i thought not another illness to add to the collection and since im vegan walk to miles a day plus with my dogs all weathers i thought that would be the last thing id get i already had my gp suergy and dn have been quite good with helping me a just to what i see they did put me on a one day course that i thought was a bit useless which gave the usual sphelel about what foods to aviod etc and not using meters im quite stubbon and i like to do my own research into things im not perefct now but thanks to this forum im now gaining confidence with be able to control my own syptoms and know what foods work and dont work for me

 

[Bertybean]

Yuh

 

[NewTD2]

My GP told me that my recent HBA1C result of 46 (6.4%) is “normal” and be happy with it.

When the HBA1C chart clearly says it’s NOT normal and it is infact within the pre-diabetic range.

Any sane doctor would encourage me to at least strive to aim for 38 and below to non-diabetic range.

Worrying to be honest that some GPS are useless!!!

 

[dbr10]

My GP told me that my recent HBA1C result of 46 (6.4%) is “normal” and be happy with it.

When the HBA1C chart clearly says it’s NOT normal and it is infact within the pre-diabetic range.

Any sane doctor would encourage me to at least strive to aim for 38 and below to non-diabetic range.

Worrying to be honest that some GPS are useless!!!

Totally agree. Speaking as a type 2, everything should be done to ensure bg levels are in the non diabetic range if at all possible through diet, medication and exercise. I have encountered the "that's okay" or "that's good enough for a diabetic" nonsense several times, when it clearly isn't.

 

[Sue192]

Totally agree. Speaking as a type 2, everything should be done to ensure bg levels are in the non diabetic range if at all possible through diet, medication and exercise. I have encountered the "that's okay" or "that's good enough for a diabetic" nonsense several times, when it clearly isn't.

Same here. Second set of tests put me down into pre-diabetic. "No further action needed". I will be phoning in March for the next set!

 

[Graemeruk]

Welcome to the forum fellow ketoer..

Couldn't agree more . Had Type diabetes for 12 years mainly on Metformin in later years but researched like crazy, gradually increased exercise even more , tried to lose weight and getting BG within range and struggling for the first many years as still being advised on eating carbs. Since switching to the keto in just 1 week sugar was normal and HBA1c fast retreating to normal levels over the next three months, 10 kgs weight loss in 4 weeks, blemishes old scars bumps and lumps disappeared, sleeping like a baby , aches and pains reducing and altogether feel 100% different . It is tough to cut out the carbs for the first 3 weeks until the habit starts to break but now Im only really testing to make sure im not close to having a Hypo! which are more likely for the moment . Did you notice an increase in hypos on Keto as your sugar got under control and did they settle down. Did you go straight in to fasting or wait a while as HBA1C reduced? What do you eat before say a couple of hours of strenuous aerobic exercise, say hiking , running cycling any carbs at all ?. Any hypos near the end of strenuous excursive?? .

 

[bulkbiker]

Did you notice an increase in hypos on Keto as your sugar got under control and did they settle down. Did you go straight in to fasting or wait a while as HBA1C reduced? What do you eat before say a couple of hours of strenuous aerobic exercise, say hiking , running cycling any carbs at all ?. Any hypos near the end of strenuous excursive?? .

I only took metformin for 3 weeks and since stopping that have never taken any medication so have never had a hypo. Bloods get down to mid 3's when fasting and felt a bit odd the first time but no problems after that.
I exercise rarely and eat carbs even more rarely (bit of swimming aside). I started intermittent fasting (no breakfsat) almost after the day of diagnosis. And hardly ever eat it any more just a coffee with cream or tea with lactofree milk. Then sometimes lunch and always dinner. I have done a few extended fasts to get through weight loss plateaus but haven't done one for a while. Maybe it's time as weigh loss has halted after eight stone down.

 

[Solaire]

My husband was diagnosed 10 years ago, type 2, through a general urine sample for something else. He got a phone call to go to one of the walk ins straight away. Went, saw the doc and was told his glucose reading was 26 (mmol) he was in good health, very slim and was a bit surprised as he had no idea ...however his grandmother and mother had both been diabetic ...straight into metformin and diet checked and that was fine ..over the next few years he was getting sooo thin and I went with him to see our doc and told her “look at him, these tablets are killing him” ....I had also discovered that metformin was used in obesity she was very interested and dropped the amount of metformin and gave him glictizide ...after couple of weeks we noticed his eyes were becoming very bloodshot and a couple days later very bad, all over the whites. He went to the eye Hospital near us where the doc said it was the glictizide and stop immediately ..that worked ...doc then gave him glimipiride 3 times a day with metformin twice a day ....he regained the weight he had lost and more energy thank goodness ...our doctor is excellent. He always has higher levels that normal because he is on lifetime steroids (long story) and they keep the levels up so she is happy if his readings don’t go above 10 ..that is ok for him ..but we also have nursing practitioners who unfortunately are rubbish ..he now doesn’t follow their advise after explaining to his doc what the nurses, and the diabetic nurse wanted him to do and she said don’t listen to them ....sorry for long story ...but here in UK we often find that those of us who have diabetes, or care for one, end up educating ourselves and know more than the professionals ...

 

[Solaire]

I have also found that a lot of folk who have no experience of diabetes think you have to be fat to have type 2 ! My husband is the same weight and build as when I first met him in the Army over 50 years ago ...he has always been lean ...as was his mum who was also diabetic ...even one of the diabetic nurses asked if he had been on a weight loss diet just as well he has remained skinny all his life as he has a bad spinal problem which makes it difficult for him to walk any distance and is in permanent pain ....he also had a heart attack 3 years ago and the specialist at the Hospital remarked how well he was apart from that ......and all the joint problems .......but he is coming up to 74 so does really well .....he does not do the internet at all which is why I am here ....we live and learn with the conditions we have ...and do end up often knowing more than our doctors who are after all just general practitioners ...in the past 10 years we have learned soo much about diabetes as we did also for our son who has epilepsy, and his children who are both autistic ..we need to know .......happy healthy 2018 to you all ...

 

[dbr10]

Same here. Second set of tests put me down into pre-diabetic. "No further action needed". I will be phoning in March for the next set!

Clearly further action IS needed to stop progression. This is the fault with NHS treatment being based on waiting until the patient gets worse, then give them more pills.