Disappointing trip to practice nurse

[maureen5752]

It sounds like you need more skilled advice than is available at your surgery.
Can you produce evidence of your readings when hypo? And send or take them to your next appointment? That appointment needs to be soon. You may need another urgent medical review, or a referral to your nearest diabetic clinic.

You most certainly should NOT be experiencing daily hypos and having to eat 'up' to your oral medication.

If you are also becoming hypo unaware, then you could do with some advice around that too, which would be available at a clinic.

. @Brunneria hi. Months ago my profile changed. Don't know why, I informed the necessary people several times that it listed me as insulin dependant, & that I take oral medication, but they never changed it & I got tired of telling them, I take metformin & gliclazide. As for driving afraid I've never had the confidence to drive & with my disability it would be difficult. Nice to hear from you hope your ok

 

[wallydug]

Thanks. I took evidence of the regular evening hypos with me to the follow up appointment. I was advised to cut the dosage of Gliclazide and to stop testing. She was quite angry that I was testing to start with.

I don't want to go back and see that same nurse again. She is completely chaotic and both times I've seen her she stresses me out for days afterwards. I've asked to see a GP or a different nurse but they say I have to see that same nurse, that no one else is available.

I'm eating tins of rice pudding in the evening and that is preventing the hypos. But I'm almost out of testing strips now, it'll be a couple of weeks until I can order more on my repeat prescription. I suppose I could always buy some testing strips privately, but they are so expensive.

 

[Chook]

Sadly the article seems to be available to subscribers only.

Oh - how strange - I was able to read it yesterday but, like you say, its for subscribers only today.

 

[Brunneria]

. @Brunneria hi. Months ago my profile changed. Don't know why, I informed the necessary people several times that it listed me as insulin dependant, & that I take oral medication, but they never changed it & I got tired of telling them, I take metformin & gliclazide. As for driving afraid I've never had the confidence to drive & with my disability it would be difficult. Nice to hear from you hope your ok

Thanks for getting back to me. And yes, I am great thanks.

I believe that if you are on gliclazide that you should still be supplied with strips, but I am not certain of that - this time I will tag in @Oldvatr because I know that he has/is taking glic and he can give you the right info, if he is around.

Regarding your profile, some people have had this problem since we had a forum upgrade. Have you tried to adjust it yourself?
You go to your profile (Personal Details screen), and select from the Type of Diabetes dropdown.
If that doesn't work let me know.

 

[McNicky100]

Hi @AlexMagd ..
Sadly you have just encountered pretty much the same experience that I had back in March .. you will also find that this sort of nonsense from Doc and Nursie is shared by many members here. You will find the same sorry tales littered throughout the forum .. and the most annoying aspect of this is that all these so-called "experts" just keep churning out the same rubbish. So, I have developed a simple little mantra that I employ whenever I receive the same sort of "advice" from any HCPs ..
# Listen
# Nod
# Smile and say thank you
# Ignore

Works for me .. feel free to use it yourself

That is exactly what I do, Australian health care has the same attitude ‍

 

[maureen5752]

@Brunneria hi. Yeh being on gliclazide you do get strips but they've halved my prescription said its nhs rules now but past 18 months doctor tried to put me on to gliptin, said to stop hypos!!!!! I said what hypos???? I don't have hypos got my self under control by cutting the carbs you told me to eat at every meal, gliptin is cheaper @ has more side effects, I'm doing ok so why change, if they get me of gliclazide they can cut my strips completely! But from what was said othere day it seems at my next annual check that's what they're gonna do Remember out Rat friend? Well I've learnt he gets (apologies) free injection meds for problems downstairs!!! & us diabetics have to fight for strips. Makes me so angry.

 

[DCUKMod]

@Brunneria hi. Yeh being on gliclazide you do get strips but they've halved my prescription said its nhs rules now but past 18 months doctor tried to put me on to gliptin, said to stop hypos!!!!! I said what hypos???? I don't have hypos got my self under control by cutting the carbs you told me to eat at every meal, gliptin is cheaper @ has more side effects, I'm doing ok so why change, if they get me of gliclazide they can cut my strips completely! But from what was said othere day it seems at my next annual check that's what they're gonna do Remember out Rat friend? Well I've learnt he gets (apologies) free injection meds for problems downstairs!!! & us diabetics have to fight for strips. Makes me so angry.

Maureen - Would you like me to change your profile status for you, to stop it showing you're taking insulin?

 

[maureen5752]

Maureen - Would you like me to change your profile status for you, to stop it showing you're taking insulin?

Hi if you want to change it ok by me, thanks. before it said type 2 well known member. Kind of you to offer. I didn't mess to much cos had lots of problems before getting on forum, kept cutting me of for weeks. Thsnks

 

[maureen5752]

@Brunneria sorry it's of subject but could I ask you what kind of foods you eat? Any suggestions on healthy meals. I'm doing ok but always open to try new things which may be better still thsnks

 

[Brunneria]

.

@Brunneria sorry it's of subject but could I ask you what kind of foods you eat? Any suggestions on healthy meals. I'm doing ok but always open to try new things which may be better still thsnks

No worries! Have a look at this thread:
http://www.diabetes.co.uk/forum/threads/what-have-you-eaten-today.75781/page-535
I post on it most days with what i've been eating. The thread is for what some of us low carbers eat come and join in.

 

[maureen5752]

.


No worries! Have a look at this thread:
http://www.diabetes.co.uk/forum/threads/what-have-you-eaten-today.75781/page-535
I post on it most days with what i've been eating. The thread is for what some of us low carbers eat come and join in.

Thank you. I will

 

[david1241]

Hello I got the same rubbish off the doctor ,when i was diagnosed with diabetes in 2015.Although I had diabetes for about 6 years without telling me,despite having routine blood pressure and blood tests.When they sent for me i was told my BG was quite high.I asked her about testing . She said you have no need to test as i was only type 2 diabetes.I said how will i know if my blood sugar is doing .am i eating the right food if i don't test my BG. she said well i can't prescribe test strips. I asked her to take me off Atenolol A beta blocker drug.I read a report that this drug can trigger the onset of type 2 diabetes .I'd been on a 100mg of this drug every day for over 25 years for my BP.She would only reduce the dose to 50mgs per day . Then she told me i should be taking statins. She mentioned this 3 timesI have always refused to take statins. Then she got nasty because i refused to take statins.So i said i would sort it out myself.and walked out of the surgery.never to return.i don't like the patronising way some of these nurses and doctors address me just because i'm elderly.i have never taken any diabetic drug apart from Metformin in which i had very bad side effects .I went to the Philippines for 8 months .there you can buy your meds over the counter at the local pharmacy.No prescription.... . .So i weaned myself off Atenolol.,which reduced my blood sugar readings.i was taking Cinammon which reduced my BG slightly.My BG was still a bit high.I needed to reduce it further. February this year.I developed weeping none healing leg ulcers.and large blisters on my big toes. I had lost the feeling in my feet and toes..complications were setting in.I had to try and reduce my BG..urgently.i did'nt. fancy having my legs chopped off making me shorter than ever.bumming around lol.I had heard about fasting dieting . I went on a 24 hour fasting diet.I bought a book by Dr jason Fung.A Complete Guide to Fasting.Money well spent .6 months my weight was 14 st 10lbs.my BG fasting readings were between 10.8 mml/l to 16mml now i weigh 11st 10lbs my BG fasting are between 4.0mml to 5.8mml. I have now reversed my diabetes. I can eat what i like with no adverse effects.The feeling in my feet has returned.I don't have to get out of bed 13 or 14 times a night for pee I can last all night until morning, no more hot sweats,no more dizzy spells., when out and about, no more trigger finger or blanitis.bleeding gums etc.I try and avoid doctors.Before i retired in 2010 I used to get excellent treatment on the NHS.Once you reach 65 years of age they don't want to know.Anyway I would cetainly recommend trying a fasting diet out.I've tried calorie controlled in the past .I've may be lost a stone in weight.then in a moment of weakness had a load to drink ,raided the fridge and then said ****** it. jacked the diet in and put all the fat back on what i had lost.If i had taken the treatment the so called doctor way offering [yes i've had other issuse with them apart from diabetes.] I would probably weigh 20 st having to have 3 or 4 insulin injections a day and in a wheelchair or most likely 6 feet under.

 

[Oldvatr]

Thanks for getting back to me. And yes, I am great thanks.

I believe that if you are on gliclazide that you should still be supplied with strips, but I am not certain of that - this time I will tag in @Oldvatr because I know that he has/is taking glic and he can give you the right info, if he is around.

Regarding your profile, some people have had this problem since we had a forum upgrade. Have you tried to adjust it yourself?
You go to your profile (Personal Details screen), and select from the Type of Diabetes dropdown.
If that doesn't work let me know.

The NICE guidelines do allow GP's to prescribe test strips to T2D on certain orals (mainly Gliclazide) because of the chance of inducing hypo events. It is open to negotiation with the GP. I found mine to be very supportive when I discussed it with him, and the guidelines do add a few additional qualifying conditions, Firstly the medication as shown above, so insulin or Glic are mentioned by name, but other hypoglycemic meds may also qualify. Then any evidence of a recent hypo event that may or may not require external assistance or medical intervention. In my case, I further needed to meet DVLA requirements since I was driving regularly to work, Then I was able to use my readings log to show how I correlated readings to meals eaten, and meds taken, and from this I able to make changes to both diet and dosage of my meds so in other words, I benefitted from having a meter,

Since that day when he agreed to give me strips on scrip, I showed that I could get my levels back down to pre-diabetes levels, and we further agreed an increase beyond the 50 strips/ month I was originally on. That was over a year ago, and I am still supplied for one of my meters. The other meter I private fund myself,

One thing is that my CCG and practice changed the meter and strips to one that they approved and which used strips that cost less than £10 for 50 strips, but they supplied the meter and the new strips as before,

Since then I have reduced my meds,and am now on only 40mg of Glic a day (from 320mg) and this is still keeping the door open, thus my GP still meets the NICE guidelines, When I drop that last tab then I expect to lose the strips as well, unless I still get evidence of hypo events, which is now unlikely since my T2D is quite well behaved now. (At least it was until today, when I consumed a complete 400g bar of chocolate on my tod in one greedy sitting, and my bgl jumped to over 8 mmol/l/ So I am NOT cured or in remission. Sigh!)

Edit to add postnote: My 2hr PP rose to 9.6 after a risotto meal with rice, but my 4hr PP is back to 5.6. Overall today's average is showing 8.1. A year ago I would have been in the 30's after the abuse I gave myself today, so I have apparently succeeded in reducing my Insulin Resistance. I think I am 'Resolved'

 

[maureen5752]

My doctors been trying for 18months to get me of gliclazide & onto gliptin, said gliclazide csuses hypos, I said well I don't have any hypos since been put on meds & changed my diet, but if they cause hypos why did you put me on them. My sister has been on metformin /gliclazide for about 18 yrs she said & few months ago was told she doesn't need to test & stopped her strips. She also has leukaemia, I'm not very active or mobile cos of dissability with my legs & other problems, I've learnt so much from this forum, good job my daughter connected me to this forum,

 

[Oldvatr]

My doctors been trying for 18months to get me of gliclazide & onto gliptin, said gliclazide csuses hypos, I said well I don't have any hypos since been put on meds & changed my diet, but if they cause hypos why did you put me on them. My sister has been on metformin /gliclazide for about 18 yrs she said & few months ago was told she doesn't need to test & stopped her strips. She also has leukaemia, I'm not very active or mobile cos of dissability with my legs & other problems, I've learnt so much from this forum, good job my daughter connected me to this forum,

Glic is not a good idea long term because it forces the pancreas to increase insulin output, which stresses it and may lead to burnout (not proven). I had regular hypo's while I was on the high doses, but unlike an insulin hypo, the ones from Glic are much more gentle and in a way predictable, so I was able to counteract them easily without needing help. I was not worried by them once I understood their characteristics and I was hypo aware so it was not a problem. I did up the carb input at bedtime to make sure I woke in the morning if my night reading was less than 5. I don't get them now

 

[Butterfly1960]

Hi!
Just to add my experience with my DN
She's type1 20 years
She advised my low carb diet under 100g per day
My surgery small and She multitasks!
Also advised me to testINg but said I'd probably not qualify for free stuff as a type2. So I bought my kit off Amazon
She also advised I join a forum and so glad I have!
So many threads and posts to choose from at any time of day/night! and always someone to offer avice/support
Thank you!

 

[Butterfly1960]

Glic is not a good idea long term because it forces the pancreas to increase insulin output, which stresses it and may lead to burnout (not proven). I had regular hypo's while I was on the high doses, but unlike an insulin hypo, the ones from Glic are much more gentle and in a way predictable, so I was able to counteract them easily without needing help. I was not worried by them once I understood their characteristics and I was hypo aware so it was not a problem. I did up the carb input at bedtime to make sure I woke in the morning if my night reading was less than 5. I don't get them now

Thanks @Oldvatr
I am type 2 diagnosed March. I have good DN!! (she's type1 20 years) a locum recently advised gliclazide 40mg per day then 80mg and Monday advised 2x 80mg doses per day. Her husband is diabetes consultant. I think I've been really lucky so far at my small surgery! But unfortunately I've not been given free BG test kit. I bought mine off Amazon July. But I will ask for appt before review date to check if I can get BG testing on NHS
I use my P.I.P. to buy mine as I test min 4x daily
BG down from 16s July to regular 6s and sometimes 5s to date.
Thanks to all for support and advice

 

[Oldvatr]

Thanks @Oldvatr
I am type 2 diagnosed March. I have good DN!! (she's type1 20 years) a locum recently advised gliclazide 40mg per day then 80mg and Monday advised 2x 80mg doses per day. Her husband is diabetes consultant. I think I've been really lucky so far at my small surgery! But unfortunately I've not been given free BG test kit. I bought mine off Amazon July. But I will ask for appt before review date to check if I can get BG testing on NHS
I use my P.I.P. to buy mine as I test min 4x daily
BG down from 16s July to regular 6s and sometimes 5s to date.
Thanks to all for support and advice

Good to hear that some practices are supportive like yours and mine. Can I suggest that you find an App that shows graphs over time (I use a spreadsheet and do mine manually) so that you can give graphic pictures that show how you have progressed. The GP has limited time to absorb your input, so it is best to take some effort to simplify the data, and graphs or charts are easier to understand rather than trawling through a load of numbers. If you can use your data to suggest medication changes needed as you progress, then that is extra bonus points and a NICE goal to get to.

I log food, meds dose and timing, weight and bgl readings along with things like HbA1c, formal test results. etc. I used to colour code my hypo events too so it was clear when I was needing a meds change. My spreadsheet works out averages and trends easily, and this helps to condense the info I present, again to save GP time. I also send him a letter with the results in advance of our meeting, so we spend our time discussing the way forward rather than getting bogged down in a presentation of results in detail. I enclose an example showing an Xmas and an Easter and how I recovered from these binges,

 

[RFSMarch]

I am guessing that my second set of bloods which will be scheduled for the end of the month will determine whether I am put to see a Diabetic Nurse, but when I trotted to the doctor to get him to sign a certificate to have my Freestyle Libre Scanner and Sensors in my hand luggage for a three week jaunt all around the US, he told me that because he had put me on metformin (I had also got him to switch me to the slow release) then I had wasted my money on a blood sugar scanner as I don't need it anymore. I was aghast. Wait... so being proactive... was worthless? What?

He then told me that actually once I had been able to get up to three metformin a day (that is soooo a different story) he wanted to put me on MORE tablets and perhaps STILL MORE to protect my liver and kidneys... that is also disregarding he had deferred putting me on statins for high cholesterol until these next bloods and that he was also considering something for the high blood pressure. He also just dissed my using MyFitnessPal to change my habits and log carbs, snacks, exercise and medication. Thank heavens we didn't get onto the whole "what do you mean you hate walking as an exercise...and you prefer the gym to combine with rehab for a lack of cartilage in your knees" conversation.

None of this took into account:
1) I had suffered the sudden bereavement of my mother at the start of the year
2) No chance to even remotely demonstrate that I could manage my diet (at least when at home - when away at tournaments it is pretty hard to be fair)
3) The fact that I was being proactive in trying to understand my condition and more importantly what affects me - everyone is different.

So you have my sympathy.

The good news is that since getting an astronmical hbA1C of 111 (12.3%) it has come down to 41.5 (6%) with average blood glucose coming down from 18mmol to 6.9 on today's readings.

That has been despite being away at tournaments and in the US (where pretty much every menu is a killer!) and away again to Singapore at the end of next month.

So... my philosophy is - with high blood pressure, high blood sugar (at the time) and high cholesterol, keep focussing on moving from high GI foods to low, and keep exercising where possible when at home, and ... screw him.... keep scanning, keep logging what carbs I have and when, and what that does so that *I* understand my condition and can take ownership of managing it.

Because I am NOT down for taking as many tablets as he wants to give me. No. sir.

 

[Alexandra100]

Thanks. I took evidence of the regular evening hypos with me to the follow up appointment. I was advised to cut the dosage of Gliclazide and to stop testing. She was quite angry that I was testing to start with.

I don't want to go back and see that same nurse again. She is completely chaotic and both times I've seen her she stresses me out for days afterwards. I've asked to see a GP or a different nurse but they say I have to see that same nurse, that no one else is available.

I'm eating tins of rice pudding in the evening and that is preventing the hypos. But I'm almost out of testing strips now, it'll be a couple of weeks until I can order more on my repeat prescription. I suppose I could always buy some testing strips privately, but they are so expensive.

Might you consider changing GPs in order to get a new nurse?