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Confused after visit to GP

Discussion in 'Ask A Question' started by Gary1205, Sep 14, 2015.

  1. Gary1205

    Gary1205 Type 2 · Well-Known Member

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    Went to see my GP this morning, supposedly the diabetic specialist within the practice following an incident yesterday.

    Seven months ago diagnosed with type 2 and changed my ways completely cutting out snacks eating a balanced diet getting more exercise and have lost a lot of weight since diagnosis and at three month after a drop from 98 to 47 Hba1c metformin reduce from two to one a day. Also cholesterol level much reduce down to 2.6 from 5 something, with a view to coming off both meds when next test is due if I maintain or better the results(next blood test next Monday)

    Basically since last Thursday had very bad diarrhoea, Metformin not previously given me any issues bit did not have any other symptoms Thursday through Saturday. Still had diarrhoea Sunday morning, BG normal for me 5.3 on getting up. Began to feel worse during day. Had normal light lunch, but mid afternoon cam over all sweaty and felt sick. Indeed went to go to the bathroom and on my way there my legs just gave way and I fell to the floor. Did not pass out and made it to the bathroom where I was sick. Went to bed straight away did not eat any further during the rest of the day but came over hot twice more and was sick both times and continued to have diarrhoea, last visit to the bathroom in respect of both 9.45 pm last night. A good nights sleep followed and feel much better this morning, once again 5.3. Weighed myself as usual on a Monday now lost 4stone 1 lb and BMI 4 lbs inside healthy weight after 29 weeks.
    However as I drive 30 miles to work thought I had better visit GP because of the incident where my legs just gave way and also perhaps check on the diarrhoea situation, which I think is probably a bug albeit had it three days without being sick or having a temperature.

    I was alarmed when he told me I could have actually had a hypo when my legs gave way, as I has been led to believe T2s on Metformin could not have them and said this but he replied that is nonsense and I can. In all that went on with the fall and being sick and feeling hot I must confess I did not test myself at that point so have no way of knowing what my BG was especially as I felt like I had a bug. Will learn from it and test should it happen again.
    Also whilst he was pleased with me I got the feeling he did not think anyone could change there ways that much and lose the steady 2lbs a week like I have even though I told him I had maintained the previous weight for about 4 years, and so he has added a thyroid test to the list for the blood test next week as he says he is concerned about my weight loss, even though I took in with me a printout of my record I keep showing it a steady fall and told him all the lifestyle changes I have made and maintained since diagnosis.

    Sorry a lot of info here, but can type 2s have hypos like he says and also could the metformin suddenly start having an effect on my motions having been fine on it for six months up to now(he said this may be the cause and can suddenly affect you that way, but I think I had a bug as seem fine today)?

    Beginning to regret going to see him now.
     
  2. ButtterflyLady

    ButtterflyLady Type 2 · Well-Known Member

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    I think you were right to go see him, I would have done so myself and I would have recommended it if you hadn't gone to see him.

    IMHO I think the most likely cause of your symptoms is an acute illness like a viral infection or food poisoning. It would be extremely rare for metformin to cause those symptoms after months of use, especially as your dose was lowered. It would also be incredibly rare for a T2 to have a hypo on a low dose (or any dose) of metformin and no other diabetes meds. But if it happens again I agree with testing to find out.

    It's not unusual for HCPs to not believe us when we show them our amazing results from low carbing. Their loss. There's no harm in getting your thyroid checked and I think he is just being careful, which is good.

    It doesn't sound like he is incompetent and giving dangerous advice, but I'd keep an eye on him, lol. Always take what they say with a grain of salt and check here if you are unsure. Also read up on medications before starting new ones as often GPs don't say enough about possible side effects that we need to be aware of.

    Well done on your weight loss and BG reduction, you are doing great. Sorry you were so sick and I hope that doesn't happen again.
     
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  3. Daibell

    Daibell LADA · Master

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    I agree that a bug is probably the cause of your upset and not the Metformin. It is fairly unusual for T2s to go hypo just on Metformin but not unkown if you have been without food for many hours and this can affect anyone. Normally the liver dumps glycogen to compensate but we all vary.
     
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  4. Gary1205

    Gary1205 Type 2 · Well-Known Member

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    Thank you both for your replies. My wife came up with an observation last night in that surely if it was a hypo would have needed to take something on to bring me out of it, only drank water and did not consume anything else until the following day.

    Shame isn't that some in the medical profession don't seem to believe that we can take this condition seriously and change our ways whether it be low carbing or in my case just having a balanced diet and getting more exercise than before. Sadly he also came out with the usual garbage that I should not be testing and relying only on the HbA1c result. Told him straight at this point I would continue as it is another factor in my management in so far as I have learnt what I can and can't eat and also what leeway I have to keep within guideline levels and it is clearly working for me.
     
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  5. andcol

    andcol I reversed my Type 2 · Well-Known Member
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    A very simple answer is yes a T2 on met can have hypos - I think this is precisely what happened to @Scandichic
     
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  6. andcol

    andcol I reversed my Type 2 · Well-Known Member
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    The answer to that is not necessarily. Your liver would have eventually delivered you some glucose. However, you would likely have another episode shortly afterwards (I think you did from your explanation) until your body eventually got itself back in balance. Metformin changes the level of AMP and ATP chemicals in your body so the liver finds it harder to release glucose and easier to convert it to glucogen for storage.
     
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  7. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Legend

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    The legs giving way and the collapse could also have been a sudden drop in blood pressure, which can happen during bowel issues as the body pumps blood furiously to the bowel areas to help out. I have fainted twice in the last 6 years (never previously), both times when my bowels were misbehaving with that awful pressure type pain/cramps you get at those times. Both times it was a sudden BP drop, meaning all the blood ran out of my head and down to my stomach.
     
  8. Robbity

    Robbity Type 2 · Expert

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    I remember @Scandichic posting about this happening to her, too. So whether or not it's what happened in Gary's case, it can and does happen.

    Robbity
     
  9. Gary1205

    Gary1205 Type 2 · Well-Known Member

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    Thanks Andrew Bluetit and Robbity for your replies. I guess another reason I felt it was a bug at the time was had previously experienced the sudden feeling of being hot and sweaty and then being sick when had a sickness and diarrhoea bug in the past. Also have in the shortime been diabetic especially when I went cold turkey on sugary things in the early days actually felt cold and shaky when my BG dropped, so assumed this would be my sign. Guess I have learnt a valuable lesson and will test when anything odd happens in future as clearly there is no way of knowing for sure otherwise.

    Still feeling a bit upset at the GP I guess as was hoping to come off all meds in the next two weeks and now there is a possibility might be starting something else. Also it was the way I think he worded things as I was left feeling the control I have taken to bring my weight and BGs down could not have been down to my efforts alone in his opinion and in particular the weight loss had to be down to something else, especially as I feel I have been so disciplined on the diet & exercise front since diagnosis. To me it would be a remarkable coincidence if I developed a thyroid problem at exactly the same time as I changed my lifestyle. I think it is fair to say he has taken the wind out of my sails with his attitude.
     
  10. Robbity

    Robbity Type 2 · Expert

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    Don't take any notice of his stupid criticism - how on earth are you supposed to know what's happening in the here and now of you have to wait 3, 6, or even 12 months before you find out how you're doing. As my grandma used to say "sometimes they're lacking the sense they were born with!" :D

    For me my testing tells me what's happening in real time, and it more helpfully tells me whether my levels are steady and fairly level or whether they're spiking - something the HbA1c won't do for you. Let him work from that figure and you just keep on testing if you feel you need to.

    Robbity

    PS Actually thinking back to when I was first diagnosed I occasionally had slight funny turns too, where I felt cold and a bit woozy and couldn't get words out, and actually felt that I needed to eat something (generally) a bit sugary, but it was before I had a meter; they may have been false hypos.
     
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  11. ButtterflyLady

    ButtterflyLady Type 2 · Well-Known Member

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    Don't let him get to you. He is just feeling threatened and he is trying to stay "in control", after all he is the "expert" and all good things should be down to what he does and not anyone else! (sarcasm)

    If your levels are good, there's no need to start taking another med, and you still may be able to come off the meds eventually, after letting him know of course. If you continue to feel like he is pushing you around, find a new doctor because they are not all like that.

    I think everyone here would agree that your positive results are down to your hard work.
     
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  12. Gary1205

    Gary1205 Type 2 · Well-Known Member

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    Thanks Robbity, I did stand up to him and say I would be continuing to test as I currently do because it is working for me. As they say if it ain't broke don't fix it. Agree with you totally waiting for the HbA1c test is too late.

    Thanks for your kind and supportive comments CatLady. I do know deep down that it has been down to my efforts in change of diet and lifestyle, but sadly as I say it really was his approach as if he did not believe anyone could be so focused as I have been that knocked me for six. The DN described me last time as the practice's star patient following my then weight loss of almost two stone and the reduction from 98 to 47 in three months for my HbA1c. So maybe other diabetics in the practice i use do not take as focused approach as I have and perhaps that may explain his reaction as he is maybe unused to seeing someone take their condition so seriously. My late father was a T1 had kidney failure, a leg amputated and other diabetes complications and was taken from us too early at the age of 58, so have seen first hand what can go wrong if I do not look after myself now, so that is probably why I am very focused and did say all this to him as well.

    Any how, thanks to all for your continued support, next blood test this coming Monday so hope to be able to report more good news on the HbA1c and cholesterol front next week.

    Best wishes
    Gary
     
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  13. Scandichic

    Scandichic Type 2 · Well-Known Member

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    I also hypoed on Metformin. I was on too many. Asked doc to reduce. He refused. My hubbie called NHS line and a paramedic appeared. He tested my bs and I had hypoed. Hospital told me to stop taking it. Doc refused to reduce meds. Very good chemist and he reduced meds. When I have had a cold or upset stomach I have gone too high as my body fought the infection. Then crashed and hypoed. New doc now who is very good. Take care and well done with the weight!
     
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  14. Gary1205

    Gary1205 Type 2 · Well-Known Member

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    Thanks Scandichic, beginning to look as though I probably did hypo. Shame we seem to be led to believe T2s on metformin can't hypo.
    I did go back to the surgery today as Monday's GP had really upset me with his attitude that there must be something wrong with me because of my weight loss, he had made me feel that it was not down to my efforts the way he worded things and felt quite discouraged. Was feeling down and this was I believe having an impact on my BG 4.8 last night 6.3 this morning. Maybe I have been lucky but can count on the thumbs of two hands previously how many times I have gone up overnight and never by that amount so thought it might be stress and also as I was not happy with explanation about the need for a thyroid test went and saw another GP in the practice today. Ironically the same one I saw in February when I went along because of the symptoms I was displaying and had my fears confirmed. First time I had seen him since and he instantly noticed the difference in my appearance and when I explained about my lifestyle changes was very complimentary and made me feel much better. He also gave me some very different reasons than Mondays GP about the need for a thyroid test and said he thought the weight loss was totally down to my lifestyle changes, so feel more comfortable about that and the test now. He also thought Sunday's incident was possibly a hypo and explained what he thought had probably gone on. He was so different from the supposed Diabetic specialist GP and really took time to explain things and also made me feel things have been down to my efforts, unlike the other one who with probably some ill chosen words left me feeling things were down to another condition rather than any effort from me.
    But the best news of all is when I explained about my testing and how it works for me in my management, unlike Mondays GP who told me to rely solely on the HbA1c result, this one thought it was a really good idea especially when I gave examples of how it has worked for me, and he has given me a repeat prescription for test strips and lances. I am so glad I went back and feel much happier now. Everything is also okay now with my number twos.
     
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    #14 Gary1205, Sep 17, 2015 at 9:55 PM
    Last edited by a moderator: Sep 18, 2015
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