Type 2 Diabetic or not?

moey90moey90 said:

Guys im a gp
I do know what diabetes is and how its diagnosed but i was just confused about tge results. Im just a gp and no endocrinologist so whatever i studied about diabetes during college was not in depth as what an endocrinologist studied.
What i also know is that there is something called obesity related diabetes and thats not only because youre overweight...normal BMI people can even have it. Its because the internal organs that regulated glucose metabolism ( liver and pancreas ) are covered with a thick layer of fat and that causes them to function in a less than optimum manner. Ive had a fatty liver ( not alcoholic fatty liver ) for years and maybe thats the reason but ive always got regular blood check ups and everything was good. So thats why i was wondering if is was a phase or something is actually wrobg with my pancreas( but i think not brcause my OGTT was normal )or my tissue insulin receptors. And i wanted to know now if i stay at about 85 kg now but start eating more carbs but try not to gain a massive amount of food..will this keep my glucose levels normal or not?
And another question.. if i start taking metformin just to keep my weight at about 85kg and normal blood sugars but without qctually dieting...has anyone tried this before ? And did it work?
Sorry for the long post guys and thanks a lot for replying .

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So is this really the level of training on Diabetes given to GP's ? I saw a report that 10% of the NHS budget is diabetes related treatment, if 10% of my money was going somewhere I would take a GREAT interest in it being spent wisely!

moey90moey90 said:

Theres a subspecialty for diabetes here in germany for endocrinologists and theyre called DIABETOLOGIST. A GP has general knowledge about diabetes but nothing in detail...all the epigenetics and this stuff is not what i studied so instead of prejudging people thinl before you type

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Out of curiosity, do all diabetics in Germany get to see a diabetologist? In the U.S., appointments with an endocrinologist areby referral only, and a GP generally will not refer a T2 who “only” needs oral meds and/or basal insulin. Plus, wait times fro an appointment with an endocrinologist can be months out. So, the vast majority of T2s in the US are seen only by a GP. Which makes it all the more disturbing that they get so little nutritional training.

Anyway, back on topic, I had a very high A1c at diagnosis of 11.8%, lost 92 lbs and my BG is totally normal these days even when I eat carbs. All my other blood tests also improved dramatically and are all normal, as well as my blood pressure. I assume, for me, it was obesity that was my main issue. I don’t see why that wouldn’t be the case for some others as well.

moey90moey90 said:

What do you do for a living?

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My point here is that I would not presume to "advise" if I was not correctly qualified. I was hoping that someone would come up and explain what the current level of GP training is. Given the level and scale of this medical issue should more training be provided?

Hi Everyone,

This is a reminder that you are posting on a support forum where personal attacks and rudeness are against our forum rules.
Please bear this in mind whenever you post.

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HSSS said:

Without wishing to insult the op, if dr’s training doesn’t cover this fundamental understanding of diabetes then I think I understand why we get such random and frequently shoddy advice from our own gp’s and why in turn so many people with diabetes struggle to understand and control it. Perhaps like our information, the training is very variable and it depends which institution did their training how much is really taught.

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You might well be right. One of my GP’s had a gastric bypass recently.

Listlad said:

You might well be right. One of my GP’s had a gastric bypass recently.

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My Dr always looks slightly sheepish when talking to me about diet. To be fair she does acknowledge that she needs to lose some and just doesn’t eat the right things.

Let's not forget that the Poster is posting as one of US, a person with diabetes seeking advice and the experience of others. I really don't think he deserves some of these comments.

KK123 said:

Let's not forget that the Poster is posting as one of US, a person with diabetes seeking advice and the experience of others. I really don't think he deserves some of these comments.

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I agree.

Poor soul confided on this forum and he gets a load of rubbish for it.

That’s not supportive. He is a diabetic before he is his job. And he is a human before he is diabetic.

This forum isn’t always as supportive as it should be st times.

If someone actually reads the words I have written, it was neither an attack on the OP, who has my heartfelt best wishes I am a type 1 of only just over 9 months and have not and will not offer advise only state what has or hasn't worked for me in this case the difference between type 1 and type 2 would not let me make any comment, nor was it an attack on GP's in general.

However, I was asking a reasonable question, what level of training IS given to GP's on Diabetes and do WE as the service users need to make a bit of a fuss about this IF we feel its inadequate. In the case maybe the OP would like to comment?

Colin Crowhurst said:

If someone actually reads the words I have written, it was neither an attack on the OP, who has my heartfelt best wishes I am a type 1 of only just over 9 months and have not and will not offer advise only state what has or hasn't worked for me in this case the difference between type 1 and type 2 would not let me make any comment, nor was it an attack on GP's in general.

However, I was asking a reasonable question, what level of training IS given to GP's on Diabetes and do WE as the service users need to make a bit of a fuss about this IF we feel its inadequate. In the case maybe the OP would like to comment?

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Then start a new thread discussing the usefulness of GP system.

But this guy posted for assistance in his diabetes not a discussion on his job or how good he is at it.

It’s completely irrelevant.

JoKalsbeek said:

A GP has to know about every single thing that can go wrong in a person... That's a lot. Seriously. Ever seen a medical textbook? You could bash someone's head in with those. Considering a doc has just a few minutes per patient, has to do paperwork, be on call... There's no way they can keep up with developments as they happen and still find time to have a life. (Besides, magazines like the Lancet are often specialism specific.) That my endo dropped the ball, that irks me no end, as it's her specialism. But a GP.... They're overtaxed as it is, so yeah... I think the OP is a genuine GP, and being on the other side of the doc's desk, is going to be a learning experience that'll help their own health and that of many, many patients in the future.

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Hi Jo...of course a GP needs a vast amount of knowledge, I understand that. I just find it peculiar this particular GP seems clueless about their own condition. Most of us take to Dr Google to read up on anything we get diagnosed with...I guess I think they are full of bs...and yip, I’ve dealt with big text books, anyone at uni has...not to get into any debate, I’m simply looking for advice I can trust...we get minutes with a gp, who can open google and search like a newbie...anyway, take care

EddyC said:

Ahh your a German?

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...I'm Dutch. Am I not welcome? There are Australians here, Americans, Canadians, people from India, Denmark, we come from all over the world with the same purpose: To heal what can be healed, control what can be controlled, and support one another... While the site is British indeed, and the Queens' English is the way to communicate, it is mentioned on the forum start page (on the app at least, off the top of my head) that it is "A Global Community".

Nothing wrong with being a GP, nor with being German. Seriously... If he's not welcome, then so's quite a few other people here. Personally, I think a GP looking for knowledge, especially as the usual stuff being touted obviously isn't helping and the route the most of us are taking is both unorthodox as well as effective... It's commendable AND will help not just this GP, but the patients in the practice too. Please, for the sake of hundreds of their future patients, don't chase someone off who's willing to actually listen to us.

Edited by mod to remove text from the quote which breached our forum rules on civility.
Jokalsbeek’s text has not been edited.

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https://www.diabetes.co.uk/forum/threads/community-ethos-forum-rules.50278/

Thanks to OP for posting. Your weightlifting may well have counterbalanced your overconsumption of carbs (for you). Stopping that and increased weight pushed you into diabetes. I think things have changed now so one can't order tests (or px) for oneself (good old days - or perhaps more ethical attitude?)
So suggest OP confirm T2 controlled by diet rather than T1.5 or Lada/Mody etc by requesting c-peptide, insulin and Gad ab blood tests. Then going fwd, may I ask if there's a reason you've not gone back to weight lifting? I presumed you've had the hernia repaired, but does that indicate a general weakness so no more weights?
Please read around here. Others have found intermittent fasting, eg 16:8, or 5-2, various exercise from gym to walking, helped.
Most successful to many here is not eating the food stuff your body metabolises poorly, so lower carb than nhs eatwell plate. Success particularly by avoiding simple sugars, ie fruits except a few berries, starches, ie rice, potato, root veg, floured products., ie breads, cakes. Suggest you have regular hba1c as you try to work out what works for you. Better would be using a (self funding?) glucometer to check what different meals do for you.
I would strongly recommend Dr Unwins module on the RC GP site, specially for GPs. And please spend some time training up on this area for both your own and your patients benefits. Likelihood is diabetes will increase in the population for some time unfortunately (due to eatwell plate and food industry lobbying).
Good luck!

Edited to correct grammatical errors.

I don’t normally post but have done so in this instance for the good doctor. Yes, it is possible to have a normal diet and still maintain a normal HbA1c ie. below 42. When I stopped taking my glicazide medication for diabetes about three years ago, I initially tried the eatwell plate diet as recommended by my GP and dietician and this worked beautifully for the first two years.
Approximately one year ago, my circumstances changed and since that date I have not been on any diets. I try eating healthily by cooking at home but do indulge in takeaways at least once a week. Takeaways are normally Chinese, Indian or Burger King Whoppers. Like you, I am not overweight and there is no history of diabetes in the family.