Diabetic clinic at GP surgery - first visit

Hi Ash,

Welcome to the club! When I had my first appointment it was a mixture of all the usual things - weight, height, blood pressure, - the DN then did a prick test on my feet to check I could feel it (I could) and took blood to see how I had done since I first saw the doctor. She then gave me a few sheets outlining the NHS guidelines to what you should eat and said that I would be receiving an appointment at the hospital soon for eye scaning. I started to discuss low carbs with her but realised very quickly that she wasn't interested so I decided just to do my own research. She offered to make me a dietician appointment but I declined!

Obviously all DN are different and I hope yours is open minded but the appointment took around 1/2 an hour, if that helps at all.

Good luck with the appointment! My teenage daughter is doing her AS levels at the moment so is chained to her desk revising but usually when she is out I eat a roundtree ready made strawberry jelly (no carbs or sugar), ice cold from the fridge, with some double cream - quite a good substitute for chocolate. Just have find some antidote to the teenage son now!

You can expect all of the things mentioned above and in my case my toes are tickled by the nurse and I have to agree that I can feel it with my eyes closed. I also got nagged by a senior nurse for whom I have the highest respect but even she was not too clear on some points concerning diets.

I was given some paperwork about dieting. One advice sheet was produced by the British Hypertension Society and the other one was entitled "Diet to Reduce Cholesterol. There was nothing about diabetes. A local charity was more helpful but I still have doubts about them too. I asked them a question about processed foods and they evaded the question.

I have been referred to a dietician, an eye photographing service (the charity does that) and three colonoscopies so far (but that may just be coincidence). I am also asked regularly if I want to see a psychiatrist but I have refused the offer so far.

Anyway, expect some or all of the above and don't get depressed about it. It keeps you busy and gives the NHS employment.

Ah yes Blondage you can expect to receive medication. How much of depends on your surgery. Anything from Metformin to more Metformin and possibly statins and blood pressure pills.

As to your question about the varied support I am creeping up on the opinion that you never take such an interest in diabetes unless you have it yourself. It has the flavour of a personal journey about it since each individual starts from a diet they like and slowly move to one that is different but hopefully enjoyable. The health care professional on the other hand is not going to go through every single meal you eat and tell you in detail if it is fine. The patient may see this as a lack of interest on the part of the professional.

My opinion is the same as many people on this board that the blood glucose meter is the best thing to advise you.

Yes have to agree with the Squire. . Can't see the point in discussing diet with NHS people as I knoow we are bound to disagree bu they are just saying what they are paid to say .

My only discussion about diet was on first diagnosis. the Gp advised me to consider a GI diet, I had been doing that for years.
As I was on the verge of being underweight I was not subjeced to the bad advice and bullying some others have experienced.

A couple of years after diagnosis and taking large amounts of glimeopiride I at last started to put on weight. I was tlold this could NOT be due to the glimepiride. Thyroid tests were done - all was well. Then I was given Januvia after refusing insulin.
I had to stop taking the glimeoiride almost immediately. I had just arted to reduce my carbs after discovering his forum and guess what? All the excess weight disappeared in a month! About 2 stone. And it has never reurned.

You are far beer to find your own way with diet. You can get lots of help and advice here . Don't expect oo much of your Practice staf. Some people are very lucky with theirs bu it can be a lottery. Same is rue of dietitians

The Squire's last paragraph says it all. I think the same is rue of many chronic conditions. We are all different and must find what works for us. Unless your HCP is also diabetic they will never understand the finer details. It is too much to expect. The best ones recognise his , Problems can arise when hey don't and seem o blame the patien for not conforming to type.

They might offer you medication automatically. It's up to you whether you take it or not.

I take metformin because it helps with weight loss (supposedly!) and gives some sort of protection against heart disease and stroke and possibly (new research) some cancers. Make sure they ease you on to it - 1 first week, 2 next, etc - and if you have bad gastric problems, ask for the SR (slow release) version.

I won't take statins -my personal choice, I suggest you read up on them and make your own mind up, particularly if your cholesterol is reasonably good. Low carb will improve it anyway.

BP - if you have raised blood pressure, why not take the meds. Again, low-carb will help as well. If your BP is fine and they still offer you meds, ask why and think carefully. I think some of them protect our kidneys, but if you don't have kidney problems, or high BP - why take them? I've recently come off them as my weight and BG have come down.

If you decide to accept any/all of the meds, make sure you read the leaflets carefully, and if you have time, Google for side-effects and interactions. Or ask your local pharmacist - they know more than the GPs and are usually only to happy to answer questions.

Good luck!

Viv 8)

Agree with all Viv said, except I take low dose statins. No side effects fir me, and all reports suggest prevent lots of nasties. That's me though.
If they offer Metformin, I'd take it. No real downside, and lots of protection against cardio issues. Won't do much for blood sugars though, you'll have to do that on diet. I'd try and get the ST (slow release) version from the outset to avoid tummy probs. invent a reason why that would be very inconvenient for you! SR is just a bit more expensive.
Regarding your OGTT; I got 14 from eating a tiny steak and kidney pudding! So don't worry about that. I'm not a doctor, but 14 sounds pretty good to me.

Pudding ....with flour in it. My problem is that I can't even sniff flour without a reading like 14. Most other things are fine. Charlotte new potatoes have no bad effect. Chips are no problem. Basmatti rice is fine ....ish but nice. Anything with flour in it sends my reading skywards. I had two crusty rolls and got 14, perhaps I should have only had one.

My tip: Anything with flour in it should be treated with suspicion or halved in quantity.

Squire Fulwood said:

Pudding ....with flour in it. My problem is that I can't even sniff flour without a reading like 14. Most other things are fine. Charlotte new potatoes have no bad effect. Chips are no problem. Basmatti rice is fine ....ish but nice. Anything with flour in it sends my reading skywards. I had two crusty rolls and got 14, perhaps I should have only had one.

My tip: Anything with flour in it should be treated with suspicion or halved in quantity.

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Crusty rolls is sadly a no for most of us. A slice of burgen soya and linseed bread is ok for most.