Diabetes has "Resolved"

[britishpub]

I returned from a week in Spain yesterday to find this letter on my doormat from the practice nurse.

"we both concluded that your diabetes has been resolved, i.e. you are no longer considered to be diabetic"

I'm not really sure how to view this. Nothing much has really changed for 18 months, I still get non-diabetic readings most of the time, but I am also continuing to eat low carb. I do sometimes indulge a small amount, but nothing like a "normal" person would eat, and I have no desire to do so either.

The letter is a bit short on detail.

Does it mean I am now officially not on the diabetes register ?

If I apply for life insurance or similar do I not have to mention the D word ?

 

[bulkbiker]

Have they ever asked you how you have done this?
I mean as we all know diabetes is a chronic progressive disease.....

 

[ickihun]

I'm hoping they checked your without meds first?

 

[Freema]

hmmmm... hope you can get help if you need it .... but well what a happy conclusion anyway.... you are one of the few they do recognize as cured... now you have a paper on that then you might go to the press....

 

[ickihun]

These decisions make me uneasy.
I wonder how many mistakes we are expected to read about, from now on?
@britishpub I've always admired your achievements. This is no different. Very well done!

 

[britishpub]

Have they ever asked you how you have done this?

This practice nurse is very open to the effect of diet and especially a LC diet has on the disease. She also thinks it is the weight loss more than anything that has contributed to my readings.

I tend to agree somewhat, as I think it is weight loss, and in particular the removal of visceral fat that is the key to getting control.

 

[ickihun]

I'm guessing these letters will soon become more and more common as more and more diabetics lose weight.
Well done!

 

[Bluetit1802]

It sounds to me as though they have taken you off the diabetic register. This will mean no more annual reviews with DN, no more blood tests other than any of the routine health check ones they do for anyone over 40, no more foot checks or eye screening. In other words, all the safety nets will be removed.

I was offered the opportunity to come off the register with 5 consecutive HbA1cs between 44 and 46. So not even fully non-diabetic. I was told I could be put on the "at risk" register and keep all my checks although my blood tests would reduce from 6 monthly to 12 monthly. I declined because I want 6 monthly cholesterol, liver and kidney function tests. Not bothered about HbA1c. As I have had 2 more HbA1cs (41) since then I know I am destined for the "at risk" register after my next review.

With your HbA1cs I'm only surprised they haven't done this before.

I think you need to speak to someone about it, and also make enquiries about whether it should be declared on insurance forms etc.

 

[Brunneria]

Well, congratulations!

I think (as has been said above) you need to clarify what the implications are for checkups and the diabetic register.

And then I would be celebrating.

 

[Hiitsme]

Well done @britishpub

 

[Prem51]

Given your consistently low fbg readings I'm not that surprised. I did wonder if you were ever diabetic to begin with!
I suspect that practices wanting to cut testing costs will be doing this more as austerity cuts continue. My GP wouldn't approve a HbA1c test 6 months after my last one, though she wanted a cholesterol test. The DN told me at my last appointment that she didn't consider me to be diabetic now.
So I expect I might get a similar letter after my next HbA1c due in September. In a way I would be happy to hear that officially I am no longer diabetic. I would still be having annual blood tests as I am over 60 and have hypothyroidism, so my thyroid levels need to be checked. But it might be good if I can get cheaper travel insurance.

Well done you though!

 

[AndBreathe]

Well done, @britishpub . You appear to have joined a different club.

My diabetes is also recorded on medical records as "Resolved", and has been for some time now. I have been removed from the Diabetes Register.

Whilst @Bluetit1802 suggests you will no longer have your reviews or tests, my own experience differs to that. At the point of being removed from the register, I was asked to agree to a continuing annual HbA1c test, as "I would always be at risk", and this has indeed continued. I am also still invited for retinopathy screening, which I also accept. The only thing I no longer have (and only ever had it once anyway) is my foot check, but I'm pretty bendy and able to give my own feet a decent examination. If I had any concerns, I would seek help.

In your shoes, I might call your Practice Nurse, or Doctor and ask for their interpretation of "Diabetes Resolved", because it seems as if there is no set protocol practices should follow.

Again, very well done.

 

[sally and james]

Earlier this year I downloaded the "GP Update Handbook" almost certainly from a link on this site. At the end of the chapter on diabetes it has the following:

Diabetes that ‘goes away’

Some people, given the diagnosis of diabetes, radically change their lifestyle, lose weight and their HbA1c drops out of the diabetic range. What do you do?

There is little guidance on this, but bear the following in mind:

• They are at high risk of ‘relapsing’ and becoming diabetic again – in our practice we do an annual HbA1c to look for this (and BP, cholesterol, etc.).
  
• They continue to need retinal screening. In order to ensure they are called for this use the code ‘Diabetes in remission’ (C10P) NOT ‘Diabetes resolved’ (212H) as this latter code doesn’t trigger recall. Do
  
  note that ‘Diabetes in remission’ does NOT exempt them from QOF – but should they not be getting QOF- style care anyway? (National Diabetes Retinal Screening Programme, 2014).
  

Note the difference between "remission" and "resolved".
Sally

 

[AndBreathe]

Interestingly, @sally and james I am marked Diabetes Resolved, and still receive an annual blood panel, and retinopathy. I am called for retinopathy screening. I am not calling to drive the appointments.

As we all know, practices and areas all seem to make it up as they go along.

 

[Bluetit1802]

Earlier this year I downloaded the "GP Update Handbook" almost certainly from a link on this site. At the end of the chapter on diabetes it has the following:

Diabetes that ‘goes away’

Some people, given the diagnosis of diabetes, radically change their lifestyle, lose weight and their HbA1c drops out of the diabetic range. What do you do?

There is little guidance on this, but bear the following in mind:

• They are at high risk of ‘relapsing’ and becoming diabetic again – in our practice we do an annual HbA1c to look for this (and BP, cholesterol, etc.).
• They continue to need retinal screening. In order to ensure they are called for this use the code ‘Diabetes in remission’ (C10P) NOT ‘Diabetes resolved’ (212H) as this latter code doesn’t trigger recall. Do
  
  note that ‘Diabetes in remission’ does NOT exempt them from QOF – but should they not be getting QOF- style care anyway? (National Diabetes Retinal Screening Programme, 2014).

Note the difference between "remission" and "resolved".
Sally

Thanks for that Sally. I Googled and found it for winter 2016/17 and will have a good read later.
https://www.gp-update.co.uk/SM4/Mutable/Uploads/medialibrary/gp-update-handbook-au16-diabetes.pdf

 

[walnut_face]

congrats @britishpub
For insurance purposes I would tell them "Diabetes - resolved" It probably doesn't fit a box to tick, but it is up to them, you have told them. FWIW my diabetes did not effect any travel or motor insurance. I am sure it might impact life cover, and I am more than happy to tell annuity providers I am diabetic

 

[Bluetit1802]

congrats @britishpub
For insurance purposes I would tell them "Diabetes - resolved" It probably doesn't fit a box to tick, but it is up to them, you have told them. FWIW my diabetes did not effect any travel or motor insurance. I am sure it might impact life cover, and I am more than happy to tell annuity providers I am diabetic

Snap. My diabetes has not affected any insurance policies for travel or car, but it did give us a much better annuity!

 

[douglas99]

I returned from a week in Spain yesterday to find this letter on my doormat from the practice nurse.

"we both concluded that your diabetes has been resolved, i.e. you are no longer considered to be diabetic"

I'm not really sure how to view this. Nothing much has really changed for 18 months, I still get non-diabetic readings most of the time, but I am also continuing to eat low carb. I do sometimes indulge a small amount, but nothing like a "normal" person would eat, and I have no desire to do so either.

The letter is a bit short on detail.

Does it mean I am now officially not on the diabetes register ?

If I apply for life insurance or similar do I not have to mention the D word ?

I refused to be taken off the register after my last consultation, and I consider I eat 'normally'
I would make certain they know that you are diet controlled, and discuss what you want with them.

 

[walnut_face]

Thanks for that Sally. I Googled and found it for winter 2016/17 and will have a good read later.
https://www.gp-update.co.uk/SM4/Mutable/Uploads/medialibrary/gp-update-handbook-au16-diabetes.pdf

Page 60 is telling!!!

 

[Bluetit1802]

Page 60 is telling!!!

Indeed!