sanguine
Well-Known Member
- Messages
- 3,340
- Location
- Devon
- Type of diabetes
- Type 2
- Treatment type
- Diet only
- Dislikes
- Intolerance, career politicians, reality TV and so-called celebrity culture, mobile phones in the quiet carriage.
This follows on from another thread http://www.diabetes.co.uk/forum/threads/unmedicated-vs-a-little-metformin.56291.
Just had my first meeting with my DN this morning, and it went pretty well really. Headline outcome is that I continue what I'm doing, unmedicated, pending further review and discussion when I have my next bloods in 3 months.
Fairly quickly I established that the nurse was someone who was amenable to pragmatic feedback and discussion. She initially wanted my BP readings which was the only formal request made by the GP three weeks ago, so as well as handing her the handwritten form I passed over my own (longer term) data and graph. The graph shows a downward trend, yet all they do is average the lot, which on a downward trend just skews the number to higher than it is currently (more opportunity to prescribe more smarties perhaps?). She asked if I had been offered any BP drugs, or if I was interested in them, I said thanks but no thanks as I was doing fine with diet and exercise in bringing it down.
She noted that the GP had prescribed statins 3 weeks ago. I said yes he had but that I wasn't taking them. She asked why, I said I wasn't convinced by the cholesterol/heart disease relationship, and neither was I convinced about the long term (lack of) side effects issue, especially on suppression of Q10 and impact on cognitive function. She didn't pursue that.
I said I was already taking steps to improve things, notably diet and exercise. The exercise was already showing results in BP reduction, and the diet in lowering of BG levels and weight. At this point I introduced my BG numbers and obviously the fact that I had bought a meter and was testing. No argument there, in fact at this point she suggested herself that I carry on doing the same things and we'll see what the next blood tests show. Fine by me I said. She then (maybe felt she had to) introduced the 'carbs with every meal' line. The conversation then went:
Me: I don't really understand that, because as far as I'm concerned it's the carbs (bread etc) that have got me into this situation, and my BG testing has demonstrated that the carbs spike my levels. For me, carb might as well say sugar.
She was nodding and even smiling at this, and then said: My take on this is that, however many carbs you are eating, make sure you distribute them as evenly as you can across all your meals rather than have them all in one lump. That is good advice, and I thought it was interesting that she said that rather than push the 'healthy plate'. She volunteered that she had another T2 patient who was doing hardcore Atkins, and 'he is doing fine'.
She then weighed me and checked my feet for circulation and sensitivity (no problems) and said I would be booked in for a retinal exam to start their annual sequence to check for any issues there.
She asked if the GP had wanted to prescribe any medication for the diabetes. I said no, and took the opportunity to say that I was unhappy with his manner when I was diagnosed (You've got diabetes, this is life changing (that was OK), get yourself a BP meter and fill in this form, here's a prescription for statins, make an appointment to see the nurse, thank you and goodbye). We agreed (again) for me to carry on doing what I was doing until the next 3 month review. She said I can see any GP in the practice I like in future.
We had a laugh about erectile dysfunction (now you're diabetic, if you need them any pills are free, so that's a bonus!).
I asked to see details of my 2008 blood tests - apparently fasting BG around 6.5, HbA1c 45, total cholesterol 5.9. She thought that had that been now, I would have been notified as pre-diabetic.
She phoned later to tell me a couple of things she forgot at the time - I need to do a 'baseline' ECG and have a urine test (can do that just before my next review).
I'll ask to see her in future!
(At this point I'd like to thank this forum for the education over the last 3 weeks, I would not have been able to pre-arm myself otherwise.)
Just had my first meeting with my DN this morning, and it went pretty well really. Headline outcome is that I continue what I'm doing, unmedicated, pending further review and discussion when I have my next bloods in 3 months.
Fairly quickly I established that the nurse was someone who was amenable to pragmatic feedback and discussion. She initially wanted my BP readings which was the only formal request made by the GP three weeks ago, so as well as handing her the handwritten form I passed over my own (longer term) data and graph. The graph shows a downward trend, yet all they do is average the lot, which on a downward trend just skews the number to higher than it is currently (more opportunity to prescribe more smarties perhaps?). She asked if I had been offered any BP drugs, or if I was interested in them, I said thanks but no thanks as I was doing fine with diet and exercise in bringing it down.
She noted that the GP had prescribed statins 3 weeks ago. I said yes he had but that I wasn't taking them. She asked why, I said I wasn't convinced by the cholesterol/heart disease relationship, and neither was I convinced about the long term (lack of) side effects issue, especially on suppression of Q10 and impact on cognitive function. She didn't pursue that.
I said I was already taking steps to improve things, notably diet and exercise. The exercise was already showing results in BP reduction, and the diet in lowering of BG levels and weight. At this point I introduced my BG numbers and obviously the fact that I had bought a meter and was testing. No argument there, in fact at this point she suggested herself that I carry on doing the same things and we'll see what the next blood tests show. Fine by me I said. She then (maybe felt she had to) introduced the 'carbs with every meal' line. The conversation then went:
Me: I don't really understand that, because as far as I'm concerned it's the carbs (bread etc) that have got me into this situation, and my BG testing has demonstrated that the carbs spike my levels. For me, carb might as well say sugar.
She was nodding and even smiling at this, and then said: My take on this is that, however many carbs you are eating, make sure you distribute them as evenly as you can across all your meals rather than have them all in one lump. That is good advice, and I thought it was interesting that she said that rather than push the 'healthy plate'. She volunteered that she had another T2 patient who was doing hardcore Atkins, and 'he is doing fine'.
She then weighed me and checked my feet for circulation and sensitivity (no problems) and said I would be booked in for a retinal exam to start their annual sequence to check for any issues there.
She asked if the GP had wanted to prescribe any medication for the diabetes. I said no, and took the opportunity to say that I was unhappy with his manner when I was diagnosed (You've got diabetes, this is life changing (that was OK), get yourself a BP meter and fill in this form, here's a prescription for statins, make an appointment to see the nurse, thank you and goodbye). We agreed (again) for me to carry on doing what I was doing until the next 3 month review. She said I can see any GP in the practice I like in future.
We had a laugh about erectile dysfunction (now you're diabetic, if you need them any pills are free, so that's a bonus!).
I asked to see details of my 2008 blood tests - apparently fasting BG around 6.5, HbA1c 45, total cholesterol 5.9. She thought that had that been now, I would have been notified as pre-diabetic.
She phoned later to tell me a couple of things she forgot at the time - I need to do a 'baseline' ECG and have a urine test (can do that just before my next review).
I'll ask to see her in future!
(At this point I'd like to thank this forum for the education over the last 3 weeks, I would not have been able to pre-arm myself otherwise.)
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