Difference in quality of NHS treatment between type 1&2

[HLW]

Since being diagnosed as having type 1 diabetes I have been shocked at how much better the treatment is (than when they thought I had type 2 diabetes). I have been given blood sugar targets of 5.5 fasting and 9 2 hours after meals, and have been told they will lower these in a few weeks when I am used to using the insulin. I have been given much more detailed information now, and have been told to test 6 times a day, and the nurse reviews my blood sugar level dairy when I go for appointments (of which I will have had 3 in six weeks).

When they thought I had type 2 diabetes and had a high hb1c of 9.something (9.8 I think, not sure though), all they did was prescribe a different type of tablet and said 'come back in 3 months after another hba1c'. So I could have had high blood sugars for 3 months! And I was told a hba1c result of 7 was fine, which it is not, it is too high.

Why on earth does the quality of treatment differ so much?

 

[candyfloss]

A very good question HLW. I wonder why. I'm T2, diagnosed about a year ago. I cant compare the approach to treatment because I have never been T1. I think I may have been lucky with my UK doctor though because she could have put me straight on to drugs (as I was for hypertension - 3 of them plus statin and aspirin). Instead I got referred to the dietician, eye check, courses etc. As I have said many times before, thanks to the forum here I learnt much about diabetes, the need to test regularly and general advice on ways to keep BS down and in control.

Maybe it comes down to cost, like most things NHS, as I understand there are less T1 than T2. Or maybe there is an attitude that those of us who are T2 brought it upon ourselves somehow (result? prejudice). When I phoned my surgery for HbA1c results I was told it was 'normal'. I said yes, well what was it?! "Oh, I dont know if I can tell you the figure, let me check". That seemed nicely to some up the attitude i.e. why do YOU need to know. We're the experts, (blindly) follow our advice. No thanks - I'll trust my own intuition.

I've come to the conclusion that I dont owe the NHS much, in fact the opposite because I have spent my own money on test meters, extra blood tests, health screens and private consultations with endocrinologists. These have all been done abroad, mostly by western trained and qualified specialists and at a fraction of the cost compared to rip-off private British clinics otherwise no way could I afford it. I'm fortunate I can do this now (although not for ever)

I think you are right to highlight the wide differences and approach from the medical profession.

 

[Synonym]

When they thought I had type 2 diabetes and had a high hb1c of 9.something (9.8 I think, not sure though), all they did was prescribe a different type of tablet and said 'come back in 3 months after another hba1c'. So I could have had high blood sugars for 3 months! And I was told a hba1c result of 7 was fine, which it is not, it is too high.

Why on earth does the quality of treatment differ so much?

In my opinion there are several different aspects one of which is the easy 'blame culture' that is generally fostered in society. Another is the lack of knowledge in the general population about diabetes and even amongst medical staff. :shock: There were adverts on tv recently in our area warning people of the possible risks of diabetes if they didn't eat properly or exercise etc. etc. It gave the impression that there is only one route to diabetes and it is your own fault if you get it and that is patently untrue.

I had already been ill for some time, and was totally inactive, when my doctor said that "we must keep an eye on your sugar levels" but did and said nothing else. If I had known more perhaps I could have prevented diabetes - I really don't know but it is entirely possible.

The current dietary advice does not mitigate the possibility of diabetes onset since they advocate a 'healthy diet' and don't tell people to control the intake of foods which their body cannot deal with or even enable self testing unless their criteria is met.

Since my own diagnosis, and the education about diabetes I have attained mainly through this forum, I have been appalled at the lack of knowledge amongst my friends and particularly amongst my T2 friends whose condition I had never previously suspected since their diet is entirely uncontrolled. Apparently they are allowed to eat anything now that they are on medication! To a man (and a woman) they really do not want to know about controlling their condition with diet and exercise themselves even after I have tried to tell them about possibilities. There is quite a fear amongst them that they might be 'rocking the boat' and they do not want to go against the acknowledged and perceived wisdom of the establishment. Sadly, it could cost them dear.

 

[Ardbeg]

Since my own diagnosis, and the education about diabetes I have attained mainly through this forum, I have been appalled at the lack of knowledge amongst my friends and particularly amongst my T2 friends whose condition I had never previously suspected since their diet is entirely uncontrolled. Apparently they are allowed to eat anything now that they are on medication! To a man (and a woman) they really do not want to know about controlling their condition with diet and exercise themselves even after I have tried to tell them about possibilities. There is quite a fear amongst them that they might be 'rocking the boat' and they do not want to go against the acknowledged and perceived wisdom of the establishment. Sadly, it could cost them dear.

I must admit, my experience has been exactly the same. There are loads of T2's out there, blindly carrying on as normal, not eating or drinking the right things and only getting to see their GP once or twice a year if they are lucky.

Speaking of which, I must go and see my DN again......it's been over 4 months now.

 

[rogbert]

I find there is not much difference wether you have type 1 or 2 at my hospital we all get treated the same. however I think its the pateints them selves that are to blame I run a local group in the wgc and hatfield area for local people with diabetes since the group started with the help of the hospital we had over 200 members nowdays its lucky we have just a handfull that come to our meetings i know there must be at least 2000 diabetics in the area so where do they go for help or advice when they need it they dont come to us i also know that only 10 per cent belong to diabetes uk . The 2 nurses at the hospital are not overworked although you can ring them if you have a problem .No the majority of patients dont want to know they have the desease some just cannot be bothered until of course when they get problems .