Diagnosed but 8 month wait to see Diabetic Nurse

Alan45 said:

Hi

I was diagnosed with diabetes 3 weeks ago ands expected to here from my local diabetic clinic. Being Christmas I really did not worry that I hadnt heard anything. However as the New Year came and went I decided to check and see what was or indeed wasnt happening.

Imagine my shock and horror to be told "You will be offered an appointment in around 8 MONTHS. In the meantime I carry on as before not knowing if I am doing more harm than good.

I am not only disgusted with the system that leaves me in limbo for so long but the fact I may be doing myself harm.

Surely this is a ridiculous state in this day ans

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I find they are not very good with appointment's. Call the DSN directly and say you need to discuss your condition urgently, they can usually get you in quicker.

Alan45 said:

Hi

I was diagnosed with diabetes 3 weeks ago ands expected to here from my local diabetic clinic. Being Christmas I really did not worry that I hadnt heard anything. However as the New Year came and went I decided to check and see what was or indeed wasnt happening.

Imagine my shock and horror to be told "You will be offered an appointment in around 8 MONTHS. In the meantime I carry on as before not knowing if I am doing more harm than good.

I am not only disgusted with the system that leaves me in limbo for so long but the fact I may be doing myself harm.

Surely this is a ridiculous state in this day ans

Click to expand...

Wow that sounds pretty appalling even for the NHS..

Were you diagnosed by your GP? Does the practice not have a Diabetes Nurse maybe see if you can get an appointment with them or your GP.
In the meantime I'll tag in @daisy1 for the intro to how a lot of us control our T2 with a low carb way of eating so maybe by the time you get seen you will have reversed your condition!

Hello and welcome. You have come to the right place to learn everything you need to know about controlling your diabetes - from fellow diabetics.

That is a very long time before your first appointment, and the likelihood is your surgery has insufficient nurses to cope with demand.
I assume you are a type 2? Can you tell us please whether you are taking any diabetes medication, and what your HbA1c (diagnostic test) result was? This will help us to help you.

Meanwhile, I am tagging @daisy1 for her very informative information post for all newcomers. Have a good read of it and keep it safe for future reference.

I am seen by a consultant every 6 months, I am under a dietitian every 3 - 5 months. I have not seen a DSN for over 30 years!!
That is changing soon as am due to be put on a pump and will need a DSN to speak to. Probably a lot of times

@Alan45

You are receiving replies from both Type 2s and type 1s, which is why it is important you make it clear which type you are - the treatment regimes are very different. You can put this on your profile settings to make it clear. Your medication is also important. Without this information you will get very confused with different replies from different diabetes types.

First of all, hello and welcome! You've found the right place!

I have to say that when I read things like this about waiting times I am shocked. I thought my case was unacceptable when the hospital confirmed I had diabetes, but said no more, and when switching doctors the doctor looked at my hospital results and said "why has nothing been done for this person yet? He's got an appointment with me on Friday, lets get him in earlier!" and I was asked to come in and see the DSN that very day. That was about 3 weeks after the hospital visit and I was dismayed how long it took to switch doctors practices - but since they have restored my faith in the NHS (to a degree.... their fascination with the eatwell plate/guide kinda destroys that faith tbh but I digress).

Waiting weeks for an appointment however - especially if you have not been given any advice or medication if needed - is unacceptable imo. Even if they have a shortage of DSNs surely - there is something they can do - refer you further afield maybe (as an option).

If you have been given nothing apart from a diagnosis - no advice or medication - then go back to them and tell them this is not acceptable. Surely they do not want to be held accountable for any harm you may do yourself while waiting for them to drag their feet?

Welcome to the forum @Alan45. I think that if you have been diagnosed as Type 1, you would have been prescribed insulin and been given an appointment to advise on dosage. I'm not T1 but I'm assuming that is what happens.
So I'm guessing you are Type 2. Unless you have very high blood glucose levels you would probably not be prescribed medication immediately. Usually T2s have a retest after 3 months to confirm diagnosis.

To be honest the appointment with the DN won't tell you much if you are T2. Mine didn't anyway. I was seen by her within a few days. But all that happened was that I was weighed, had blood pressure taken, and given the 'foot tickle test' to check feeling in my feet. I was advised to keep my foot soles supple with foot cream and to protect toes by wearing shoes indoors.
The DN also referred me for the eye retinopathy test, and for the DESMOND course for newly diagnosed diabetics - but I have learned more from this forum than from the course.
You do need to ask your surgery for a printout of your blood test results, which should also be available online.

Alan45 said:

Hi

I was diagnosed with diabetes 3 weeks ago ands expected to here from my local diabetic clinic. Being Christmas I really did not worry that I hadnt heard anything. However as the New Year came and went I decided to check and see what was or indeed wasnt happening.

Imagine my shock and horror to be told "You will be offered an appointment in around 8 MONTHS. In the meantime I carry on as before not knowing if I am doing more harm than good.

I am not only disgusted with the system that leaves me in limbo for so long but the fact I may be doing myself harm.

Surely this is a ridiculous state in this day ans

Click to expand...

I'm assuming you're a T2 here, as weeks of waiting, even over Christmas, and an additional 8 months after that, for a T1 would be unlikely... I would hope so, anyway! So, what can you yourself do while you're stuck in limbo? Educate yourself, if no-one else bothers to! This is a good place to start, so yay, you! Other than that, dietdoctor.com and The Diabetes Code by Dr. Jason Fung could be quite helpful in understanding this condition, how it works, and what to do about it.

Practically all carbs turn to glucose once ingested, so you want to cut those. Potatoes, rice, pasta, fruit (save for avocado, berries, tomatoes and starfruit) corn, cereal/muesli, bread, anything wheaty, really... Brown or white doesn't matter, carb=glucose. So what can you eat without spiking your bloodsugars? Meat, fish, poultry, above-ground veggies/leavy greens, butter, eggs, cheese, full fat greek yoghurt, extra dark chocolate, olives, and guess what: Bacon just became your best friend.

Another best friend you might want to add; a glucose meter. (The bulk of us here self fund). Check before, and 2 hours after first bite, and if you went up more than 2.0 mmol/l, the meal was carbier than you could process back out again, and should be modified or scratched. That's a bunch of 2's right there, so easy to remember. (Type 2, 2 hours, 2 mmol. Easy!).

You can do this.
Jo

Alan45 said:

Just to clarify. Its type 2 diabetes and I am prescribed Metaformin 2x500 mg twice a day. I have no idea what my readings are/were.

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You could request them from the practice. (Sign up to see your testresults online, I hear a lot of UK practices offer that). Better to know where you're starting from, so you know where you're headed.

Lots of help here on the Forum, @Alan45 and as always, excellent advice and tips from everyone. Our practice doesn't even have a DN, I self-funded a foot exam and luckily my optician has one of those fancy scanning machines (my tests are free due to non-diabetic rubbish eyesight). I got very excited when told that they were starting a diabetes group at the surgery, went along and was offered squash and a piece of supposedly low-carb cake. I kid you not! Due to this fab Forum I knew more than the person setting up the group, who did admit she wasn't happy about the Eatwell Plate... Some practices are brilliant (one here has a tremendous DN who promotes LCHF), some are useless - you have to badger. Good luck!

@Alan45
Hello Alan and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it useful.

BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 235,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• 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

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.
Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

• Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
  
  
• Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
  

The nurce normally does a review once a year, often near your birthday so as to spread out the load. As you have been given metformin by the GP, and can go back to the GP if needed, there is little you will grain from seeing the nurce at present.

Your A1c should be checked every 3 months until it is stable.

If you don't get a letter about eye checks within a few weeks, check with your GP.

Alan45 said:

Just to clarify. Its type 2 diabetes and I am prescribed Metaformin 2x500 mg twice a day. I have no idea what my readings are/were.

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Thank you for clarifying that. You can add this to your profile settings so it will show under your avatar when you post. (The diabetes type will show. The medication won't but you can add that to your signature to avoid being asked every time you post)

Your first job should now be to telephone the surgery and ask for a print out of your blood test results. You need to know them. If there is anything on the print out you do not understand all you have to do is ask on here. If you are in England (not the rest of the UK) your surgery should be putting test results on-line. You can ask how to register for this service, but meanwhile a print out is a good option. It is very important you know what these results were. It isn't just the diabetes test (HbA1c) but also cholesterol, lipids, liver & kidney functions. These are all important markers for us.

My Consultant (a few months after diagnosis) told me to make sure that I was pro active when it came to pending blood tests, eye tests, foot tests etc. He said not to sit back waiting for an appointment if it hadn't been sent through when due (for me initially that was every 3 months). He said to ring up for a blood form prior to any appointment because the chances are they won't send you one and the appointment would be useless without it. The nhs do the best they can I am sure but if you sit back and wait, you might slip through the net. His exact words. 8 months?, what use is that on first diagnosis. I would be contacting them on a regular basis and if nothing else, bombarding them with questions I need the answer to.

if its the courses that are eight months wait then i wouldn't worry - I've been diagnosed for years and I've never been on one of those courses. I have got all the information i need either from this forum or testing foods and using my meter to see how my body reacts to them.

If, however, its an appointment with your surgery 's diabetes nurse that is being delayed then phone the practice manager and complain.