Definate diagnosis

[akelarules]

Hi

I was given the definative - "you are diabetic" on Firday - noone available to see me until Monday, so I toddled along to my appointment armed with a list of questions.

Nurse told me not to be taking blood tests daily to quot hewr "£you'll drive yourself mad with worry eveytime you test" - surely I should test. Our PCT doesn't provide test strips or lancets only for insulin dependants.

She took blood for HbA1c test and said she's call, won't need medication unless its over 7% (PCT guidelines) fasting bloods wre 7.6 before glucose and 12.6 after glucose

I am to make sure I eat porridge every day!? Cut down my banana intake (I eat 3 a day on reccomendation to control high blood pressure)

She tells me can eat red meat (this is 2 months after the doctor told me to cut out red meat because my "bad" cholestrol had gone up again even though I'm on statins)

I am now totally confused and not sure what I should say to her when we meet later today to go through my blood results.

Karen

 

[tubolard]

Hi Karen,

Anything to do with the boy scouts organisation?

As far as diet is concerned, there isn't a one-size fits all diet for people with diabetes, and this is where testing becomes important. To establish a diet that works for you, you need to be able to self test.

NICE guidelines suggest that self monitoring of blood glucose be discussed with you, any PCT that denies you test strips are breaking the guidelines established by both NICE and the National Diabetes Support Team.

Offer self-monitoring of plasma glucose to a person newly diagnosed with Type 2 diabetes only as an integral part of his or her self-management education. Discuss its purpose and agree how it should be interpreted and acted upon.

R23 Self-monitoring of plasma glucose should be available:
to those on insulin treatment
to those on oral glucose lowering medications to provide information on hypoglycaemia
to assess changes in glucose control resulting from medications and lifestyle changes
to monitor changes during intercurrent illness
to ensure safety during activities, including driving.

R24 Assess at least annually and in a structured way:
self-monitoring skills
the quality and appropriate frequency of testing
the use made of the results obtained
the impact on quality of life
the continued benefit
the equipment used.

R25 If self-monitoring is appropriate but blood glucose monitoring is unacceptable to the individual, discuss the use of urine glucose monitoring.

If you are a newly diagnosed type 2 on diet only then I think R23 is particularly appropriate for you.

The NHS constitution states

You have the right to make choices about your NHS care and to information to support these
choices. The options available to you will develop over time and depend on your individual needs. Details are set out in the Handbook to the NHS Constitution.

The above isn't a pledge, so the NHS and your practice do not need to aspire to meet this aim, they have to meet it.

GMC guidelines contain the following:

Work in partnership with patients

• Listen to patients and respond to their concerns and preferences
• Give patients the information they want or need in a way they can understand
• Respect patients' right to reach decisions with you about their treatment and care
• Support patients in caring for themselves to improve and maintain their health

There doesn't appear to be much working in partnership going on between your practice and you.

CatherineCherub posted an excellent article in the Where to buy test strips? thread about access to strips for type 2s.

Returning to diet, the British Dietetics Association recommend a low GI diet which does involve reducing carbohydrate intake to a certain degree and others on this forum follow a more restricted carbohydrate diet. You'll find the low carb diet discussed in more detail in the Low Carb forum, I've tried to explain in general terms the low GI diet in this post.

Have a look in the food forum Recipes thread for some recipe ideas.

Hope this helps

 

[viv1969]

Sorry about your diagnosis, but this is the perfect place to get you on the right track, especially if your care team are a bit, shall we say, misguided?

The first thing I would do is try to talk to my Dr to discuss the diagnosis and the treatment. I would not be satisfied to initially be getting everything from the nurse. State your case for wanting to test your bloods regularly….Tell them you want to take control of your levels aggressively and the only way you can do that is to get to know the foods that affect your BG numbers. Tell them you’re not doing it to worry yourself – in fact quite the opposite. To NOT test would worry you more. I was never able to get a monitor on prescription, but they are cheap to buy. It’s the strips that are expensive, and it’s important you make every attempt to get them on prescription. If not, you can buy them from chemists, but they ARE expensive.

Personally I am only now getting to grips with the diet aspect of diabetes. I followed the “Eat plenty of carbs” instructions from my nurse for a along time, and couldn’t get my BG readings out of double figures. A few weeks ago I drastically reduced my carb intake and voila! My numbers are now between 5.5 – 7 before meals and 8 – 9 2 hours later. Still not ideal, but a HUGE improvement on the 12’s and 14’s I was getting. For this I can only advise you to scour these forums and read….read all you can and experiment with foods. Pasta, bread potatoes etc are not your friends…lol

I’m sure folks more knowledgable will be along shortly with far better advice.
, as I am a relative newb too.

Good luck!

 

[akelarules]

Hi Guys

Thanks for the support, its good to finally have a firm reason why I've been feeling like "death warmed up" for the past year!!

Tubolard - yes I am in Scout association - Cub Leader at 1st Sutton Ely how did you know?

Off to see the DOCTOR later (nurse not available!) so hopefully can get some real advise!

K

 

[tubolard]

Being a former cub scout, Akela, gave it away just a little bit Fond memories of being a youngster stood in a circle with my mates promising Akela that we would do our best - and then being mischievious little tykes for rest of the evening :lol:

Good luck with the GP and whatever you do, don't take no for an answer.

Regards, Tubs.

 

[akelarules]

Hi Tubolard

Guess the name gives the game away!

Going to make a nuisance of myself today - they're going to have their hands full with me!

K

 

[akelarules]

Hi Guys

Got my HbA1c results back, they are 6.7% and nursey says they OK and carry on diet only for next 3 months then get them done again!

Is this ok or should I still see Doctor and check things out further with her?

K

 

[sugarless sue]

If you can control it with a good reduced carb diet then that is OK .You may not need medication for a good while .

 

[akelarules]

Hi Sue

thanks for that, its really reassuring (I see you're diet only) My dad is insulin dependent and juct keeps telling me to get the Doctor to put me straight onto medication.

Can you give me some really good ideas for lo-carbing please, for instance the nurse said check your sugar contents - how much should I be looking for, I know with my fats its anything less than 4% does it work the same with sugar?

K

 

[sugarless sue]

Do you mean packaging? If you are checking packages look at the total carb content not just the sugars.If it is more than 10gm per 100gm of carb give it a miss!!

 

[Dennis]

Hi Akela,

It's good that they have given you an opportunity to see if you can get those blood sugar levels down by diet alone. This is what doctors are supposed to recommend, although they are supposed to recommend a reduction in carbs and an increase in daily exercise as well.

As Tubs said previously there are several options open to you so, if you haven't already done so, have a look at his link for low GI and also at the various sections on low carb diets. Your HBA1C is not tremendously high so you don't necessarily need a crash low-carb diet. I would suggest just start with a small reduction in the amount of carbs that you eat each day. For example try cutting out a third of your daily intake of the worst offenders for raising blood sugar, bread, pasta, rice, cereals and potatoes. Sustitute with foods that are higher in protein and lower in carbs. But keep testing so that you can see what effect your diet changes are having. Then you can always tweak this up or down as appropriate.

 

[hanadr]

Hi Karen
If they won't give you a meter and test strips, can you fund them yourself? Meters are cheap, it's the strips that cost. I gett mine on ebay. ( taking all the usual precautions)
Tell your nurse. It's more likely to make someone anxious if they don't know what's happening. Her information is a mis-use of a VERY unscientific study. It's total nonsense.
blood glucose of 7 may not worry the PCT, but it's at tha danger point, where complications start. You need to get it down.
My prefered way is to eat very little carbohydrate. Certainly NOT porridge. Nor bread, cakes, pasta, cereals, potatoes, or rice.

 

[Grumpy]

I've been told (by the DSN) that porridge/oats actually helps to lower BS. But oats are carbs, yes? So is that right?

 

[totsy]

porridge affects everybody differently and you need to test regulary after eating it,
im one of the luckyish ones with porridge,on a morning i eat oats so simple and it only raises my bloods slightly and is back to normal rather quickly too so its a matter of trying and testing

 

[sugarless sue]

On the other hand I'm one of the unlucky ones who's blood sugars go double figures if I eat any oatmeal product .As Totsy says ,we are all different and you have to test to find out.

 

[Trinkwasser]

Do you have a badge for target practice? Your nurse would make a good target!

http://loraldiabetes.blogspot.com/2006/10/d-day.html

http://www.bloodsugar101.com/

a couple of useful sites to have a read around: more in the Stickies and Success Stories threads which should give you some ideas

 

[akelarules]

Hi trinkwasser

You're going to like this!? The nurse at my surgery who is supposedly a diabetic expert hasn't completed her diabetic traning yet!? but she's being let loose on the unsuspecting public (I asked her how long she'd been a diabetic nurse when I saw her last night!?)

Anyway she gave me notes to a colleague at the diabetic clinic at the hospital and they have now decided that given my background; my dad has been type 2 for 25 years as were his dad and mum, and what-have-you (I've been feeling **** for months and months and no-one has listened apart from my family planning/asthmatic nurse who organised all my tests) they want me to take metformin every day.

Do'nt ever move into the dark deep fens of cambridgeshire; the doctors are all stuck in the dark ages - I'm surprised that they "bled" me, applied leaches and sent me packing - perhpas thats the next step!

Anyway I'm off to hunt down a good low-carb cookbook and a book that will give me the carb level of everything I eat today - not in Ely though, I'll have to go to the "big city" of Cambridge. Only books in ely are about tractors and Eels!

Bye for now

Karen :lol:

 

[catherinecherub]

You missed a golden opportunity akelarules, you should have pointed your nurse in the direction of this forum. She would have been able to see how some diabetics are ahead of the game and empowering themselves to manage their condition.

On a more serious note, it is not her fault that she has been put in this position and to admit that she is still training is to her credit. The funding comes from your local P.C.T. and they are responsible for her lack of training. They could have put a trained diabetic nurse in your surgery but chose not to. She is probably a general dogsbody at the surgery and has to deal with many and varied situations and diabetes is only a small part of her schedule.
Hope you manage to get your book today and that your diet puts you on the right track.

Catherine.

 

[Trinkwasser]

You missed a golden opportunity akelarules, you should have pointed your nurse in the direction of this forum. She would have been able to see how some diabetics are ahead of the game and empowering themselves to manage their condition.

Yes catch her young before the Conditioning takes a hold!

Several of the nurses here are pretty clueful. The District Nurse who called to check mother's arm this morning wanted to know what the smell of cooking was so I told her about my low carb breakfast and she was all in favour!