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Diabetic Review with Doctor

NewTD2

Well-Known Member
Messages
1,563
Type of diabetes
Treatment type
Tablets (oral)
I just had a meeting with my GP (General Practitioner) about the results of my last blood test.

The doctor confirmed that my HBA1c has gone up from 38 to 39. This was due to the fact that he suggested way back in February to have 2-3 fruits daily in my diet.

I told him afterwards that I should now eliminate fruits in my diet to lower my HBA1c.

He became quite upset and angry and suggested that I should eat more fruits and expects my HBA1c to go up even higher between 45 to 48 which is the "normal range", according to him, for a diabetic.

I was just ABSOLUTELY HORRIFIED and I was just thinking I might as well shoot myself now and drop dead.

This has just confirmed my fears that my doctor do not necessarily understand diabetes / diabetic control to avoid horrific complications later on.

Two large-scale studies - the UK Prospective Diabetes Study (UKPDS) and the Diabetes Control and Complications Trial (DCCT) demonstrated that improving HbA1c by 1% (or 11 mmol/mol) for people with type 1 diabetes or type 2 diabetes cuts the risk of microvascular complications by 25%.

If I were the NHS Registrar / Senior Consultant in the area, I would have sacked him straight away for giving irresponsible, careless and appalling advice!!!

I'm just going to ignore my doctor and continue doing I know what's best for my health and future.
 
WOW! That is very bad that your GP is saying to raise your HBA1c! I agree that you should do what your instincts tell you on this. Doctors are there to advise ... not to control. He needs to do a course on diabetes to update his tired old ways hee hee
 
Unfortunately, I blame the health system rather than the doctor. It's the same here down under. At least I get on well with my GP and talk to him. The whole public diabetic support network ( and just about everything else from cancer to VD ) is underfunded and looks only to the short term. Public diabetic education is appalling here. The doctor is between a rock and a hard place as the majority of sufferers are poor at self management. The lack of resources means that they treat everybody the same and aim for the generic case.

By the way, I would have thought that the difference between 38 and 39 would be well within the margin of error.
Glenn
 
NewTD2 said:
He became quite upset and angry and suggested that I should eat more fruits and expects my HBA1c to go up even higher between 45 to 48 which is the "normal range", according to him, for a diabetic.
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That is why they generate a whole generation of T2D that are chronic and progressive...because they send everyone on to a fool's errand.
 
NewTD2 said:
He became quite upset and angry and suggested that I should eat more fruits and expects my HBA1c to go up even higher between 45 to 48 which is the "normal range", according to him, for a diabetic.
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I really don't get it. Wouldn't normal levels be better than diabetic levels? Did your GP explain why not?

NewTD2 said:
This has just confirmed my fears that my doctor do not necessarily understand diabetes / diabetic control to avoid horrific complications later on.
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That's my experience too. Before I knew anything about Low Carb or the beneficial effects on diabetics, I was in hospital for something else, but my diabetes was 'rediagnosed'. I was too out of breath to walk to the buffet myself, so someone had to bring me my dinner. "what would you like?". Thinking they had a suitable diabetic menu I asked for that + whatever there was for afters. She looked at me as if I'd lost my mind, and told me I most certainly couldn't have anything with sugar. She brought me quite a large portion of white rice with some brown gravy and meat. It turned out that hospital policy was to have diabetics eat 'normal food'.

NewTD2 said:
I'm just going to ignore my doctor and continue doing I know what's best for my health and future.
Click to expand...

Go for it! I read another post where someone was scolded for her great work on her BG, but can't remember who it was.
 
When you live with a condition 24 hours a day 7 days a week, you know what works, you become the expert. Personally I take all advice with a pinch of salt, no one knows my management better than me and unless they walk in my shoes then they will never understand it either.

However I do believe where possible, if you have a voice then use it, unless people speak out and correct the advice given then nothing will change.
 

I was hoping this was going to be a positive review for a change. Unfortunately, it is all too common. Too many HCPs seem to think that the 48mmol/6.5 per cent figure is perfectly fine; but we know that CVD occurs at lower levels. They are not interested in helping patients to achieve normalised BG levels. What your doctor is telling you is that he's quite happy for you to develop the CVD symptoms which lead to the early death of 8 out of 10 diabetics.

Try getting your head around that.
 
He has no business getting angry/upset at you for choosing what to eat. It's your life, you run it, not him. He clearly knows nothing about diet. He also clearly doesn't care if you A1c goes up too. Negligent.
 
I don't get it - why does he care whether you eat fruit or not? As long as you are eating plenty of veg that should be fine. Why would he prefer your A1c went up? Why does he think you should eat even more? What reasoning did he give you before to make you comply and eat that much fruit before - I know you have lots of knowledge about low carb from dietdoctor - so what did he say about fruit that was so compelling.

My take is that your blood sugar levels are pretty much the same as before - with margin of error accounted for, so no need to worry what he says.
 
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Your A1c has not gone up, a changed from 38 to 39 is well within the standard lab error. Labs can be out by about 5%, therefore a result of 40, means the 'true value is very likely to be between 38 and 42.

(But for example 4 tests each 3 months apart giving 48, 49, 50, 51 is very lickly showing an increase in BG, as there is a low probability of the error being the same in all the tests.)
 
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Your doctor is getting confused, as it is true that someone with type2 should not have a A1c much below 50 if they are taking drugs other then metaformin. The is due the drugs doing harm, hence reducing the drugs is called for when A1c is below about 50.

But when diet controlled with or without Metformin, lower is always better. (Unless it is due to red blood cells not living long, hence the need to comfirm a low A1c with other testing if it does not much a persons own BG testing.)

But as your A1c is now so low eating a little fruit may not be a bad option provided you avoid all added suger and fruit juices, along with not gaining any weight. That just depends on what you wish to do, as there is no health benefit from fruit compared to above ground veg, for example red/yellow peppers.
 

I don’t understand what you are talking about. Why should a T2 not have lower a1c than 50
 
rab5 said:
I don’t understand what you are talking about. Why should a T2 not have lower a1c than 50
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Reread what I said, and thing about the risks of the differnt drugs compared to diet. Remember that the risk of complications from type2 greatly reduce when the A1c is below about 55.
 
rab5 said:
I don’t understand what you are talking about. Why should a T2 not have lower a1c than 50
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Some of the stronger meds come wth signiifint hypo risk. Recent research has shown icreased risks and overall mortality for T2s if lowering hba1c is achievd with increased hypoos. Too tight control in those circumstances is risky so medics seet a higher target range too reducce risk. Lowet hhba1c withoout hypos is seen as best, slightly higher hba1c without hypos next best, high hba1c wwith or without hypo risk worst
 
But how does that relate to the OP?
 
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