Gp has unsettled and confused me !!

[kimbo1962]

I saw my gp today, my original favourite doctor who I've not actually seen since way before my diagnosis in June, obviously he had read my history before calling me in. The reason I went today was for the last few weeks I am waking up suddenly in the early hours very hot, heart thumping and wide awake and then struggle to settle again, also, I have noticed I seem to be shedding more hair than normal when Washing and brushing. I asked if it could be low potassium, and straight away he was adamant it wasn't and said he had three possible causes, number 1 my diabetes number 2 hormonal (due to age! Ironically it was me querying this back in June that led to bloods and diabetes diagnosis! This was with another doctor) and number 3 anxiety (apparently due to my late father having brief spells of it??!!) I said I wasn't anxious to my knowledge at the moment and he then focused on diabetes and said my recent hba1c of 38 was as good as his and non-diabetic(which I knew of course), did I test? Told him my average fasting and pre and post, he then said I may well be too low - even though I test in the early hours when awake and I'm my usual high 4 / low 5, he asked why I wasn't introduced to metformin more gradually (I couldn't tolerate it and Was swapped to forxiga by nurse practitioner) as then it wouldn't have upset me so much, he said forxiga could give me re-current urine infections ( haven't had ONE since I started on it??!!) He said to stop forxiga after Christmas and do diet only for three months then have a blood test, I reminded him I had my 6 month hba1c in April so he said to leave it until then.
Random points he made were.....
Test, but not same time every day(?!) And not every day (?!)
Diabetes is a silent disease and eventually my pancreas will decline and need insulin!! ( Never been told that by nurse practitioner or diabetic nurse??) I would have thought considering I have reduced levels, lost 4 stone etc meant I was controlling and avoiding damage?!!
He did concede I had dramatically decreased my levels!
All in all, I'm feeling unsettled and wishing I hadn't gone! My diabetic nurse was delighted with me in October and said to continue on forxiga until at least April and that's what I was happy with.
I have to run now as due at a school presentation evening.....I will be back later to see what you lovely folk make to this conundrum!!

 

[mo53]

Oh dear Kimbo how unsettling! You have done so well and now this!,, chin up you've done brilliantly

 

[Brunneria]

Well,

He clearly hasn't been keeping abreast with new diabetic research, in particular Prof. Taylor's diabetes reversal/Newcastle diet stuff. I know docs don't have time to read widely, but it becomes a problem when their advice is so outdated.

And he obviously hasn't encountered type 2s who have low carbed to the point they have come off insulin and other meds. There are a number posting on the forum. Hopefully one will feel like posting.

It really sounds like his knowledge of type 2, BG control and how your body works, is lacking.

Can you see another doc in future? This one doesn't seem to be acting in your best interests, and he's certainly not making decisions that I would trust.

 

[cold ethyl]

I get this and the hair thinning bit too... I suspect if sugars are well controlled which they are in your case that it is a combination of age and anxiety response which sadly can be a result of the hormonal imbalances that menopause brings about. If you google palpitations ( which is what took me to GP at the start of this) then loads of stuff comes up about the link to menopause and advice etc on supplements etc.
Re the progressive nature of diabetes- maybe he hasn't read of the Newcastle stuff yet? I know the figure of 50% on insulin in 10 yrs is often quoted but no one yet knows what the long term outcome of low carbing and/or serious weight reduction will be. I know my CBT therapist was saying that I'd be surprised at how many folk get the diagnosis and do nothing about weight reduction( indeed I know a lady who was on a raft of meds for years, had heart attack and only then started to lose weight and even now she eats carbs for England and is quite overweight)- I think we forget that on here the folk are in the subset of those diagnosed that Prof Taylor calls health motivated individuals.
Worth having a chat with your DN as she will have more experience than GP I bet- it is worth a trial without the meds just to see what your own body is doing I guess but don;t be rushed into doing it if you feel longer would help. I;m not sure how much effect Forziga has on levels- I know Metformin is about 1.5% reduction.

 

[sally and james]

I'm not medically trained, so can't comment on the sleep problems or hair loss, but I have read a huge amount about T2 over the past 20 months and observed my husband's huge improvements and greatly increased health. So, my opinion, for what it is worth, is that you have just seen yet another medical practitioner who actually knows not much about T2, possibly cares less and certainly doesn't keep up with current thinking. With your drop in weight and improved diet you have broken the cycle of deterioration. Keep the weight off, keep the carbs low and test as much as you feel you need to and my guess is that you may be able to come off all diabetes drugs and will probably never see insulin.
Don't medics just love that phrase, "silent disease" or "silent killer", doesn't matter what you say or do, it's out to get you and only I, the doctor, can save you. Banish such thoughts from your mind!
Good luck
Sally

 

[douglas99]

Test, but not same time every day(?!) -
That is actually a good idea, to throw in some random tests, while you're on top of the HbA1c, and you'll get a picture of other highs and lows.

Diabetes is a silent disease and eventually my pancreas will decline and need insulin!! ( Never been told that by nurse practitioner or diabetic nurse??) -
That is also technically true.
But as Diabetes UK pointed out at their 'Living with Diabetes Day', the trick is indeed to control it, and push the dates back so far, you'll need insulin at 150 years old, by which time something else will have killed you.
(My diabetes nurse has also told me there's nothing they can do for my diabetes, all they can do is help me outlive it, with no complications, which is good enough for me. We get on quite well, she also said she would be counted as successful if I did die of something non diabetes related, and her departments stats would look better. I'll try my best to please her.)

I also tend to take whatever tests are on offer, due to cutting my meds, my blood tests are about 2 months apart this last year.

Change in BG can cause you to wake in the night, with anxiety like symptoms, as your body wrongly reacts to the new low BG level, and wakes you up. You should get over that if a few weeks, as you re-adjust though, and your sleep pattern will improve again.

 

[douglas99]

I'm not medically trained, so can't comment on the sleep problems or hair loss, but I have read a huge amount about T2 over the past 20 months and observed my husband's huge improvements and greatly increased health. So, my opinion, for what it is worth, is that you have just seen yet another medical practitioner who actually knows not much about T2, possibly cares less and certainly doesn't keep up with current thinking. With your drop in weight and improved diet you have broken the cycle of deterioration. Keep the weight off, keep the carbs low and test as much as you feel you need to and my guess is that you may be able to come off all diabetes drugs and will probably never see insulin.
Don't medics just love that phrase, "silent disease" or "silent killer", doesn't matter what you say or do, it's out to get you and only I, the doctor, can save you. Banish such thoughts from your mind!
Good luck
Sally

You have a better doctor than me.
Mine have never said they can save me.
Just told me to lose weight.

They did facilitate that, with a low GI/GL diet, and an exercise program, so I guess maybe indirectly, they did save me though

 

[vit90]

I haven't been asked to go on medication and I have never been on medication so I am speaking from a slight disadvantage in terms of experience but from all the research I have done there is a very strong argument that medication to boost insulin really only addresses the symptom and not the actual underlying cause and, hence, the real disease that needs to be tackled; insulin resistance. Medication can, in the long term, put more strain on your pancreas which is probably not good. Of course for some there is no option but to use medication but for others if they can address the insulin resistance by losing weight (even if they might think they don't need to - up to a point) and maybe tone up and build up some muscle through exercise, then medication might actually no longer be necessary.

 

[vit90]

Yes, one doctor told me - lose weight and the diabetes will go away and the other, who I don't think is as senior and was in a bit of a rush when seeing me simply declared I'm a diabetic for life. To say I was bemused is an understatement. By choosing not to believe the second doctor I am motivated to do everything I can to get the best long term outcome. I doubt that would have happened if I had only spoken to the second. More surprising is that the second doctor was much the younger of the two and I would have expected to be more up to date with modern trends. I am not trying to dis doctors, they do a tough job, but frankly with diabetes such a big and growing problem in society I would have thought it was a pretty high priority to be up to date on the topic.

 

[douglas99]

I haven't been asked to go on medication and I have never been on medication so I am speaking from a slight disadvantage in terms of experience but from all the research I have done there is a very strong argument that medication to boost insulin really only addresses the symptom and not the actual underlying cause and, hence, the real disease that needs to be tackled; insulin resistance. Medication can, in the long term, put more strain on your pancreas which is probably not good. Of course for some there is no option but to use medication but for others if they can address the insulin resistance by losing weight (even if they might think they don't need to - up to a point) and maybe tone up and build up some muscle through exercise, then medication might actually no longer be necessary.

It depends on the meds.
I'm certainly off ones that stimulate insulin production, but Metformin doesn't fall into this class, so even if you can get past the insulin resistance, it's possible there may still be benefits from this one particular drug.

 

[douglas99]

Yes, one doctor told me - lose weight and the diabetes will go away and the other, who I don't think is as senior and was in a bit of a rush when seeing me simply declared I'm a diabetic for life. To say I was bemused is an understatement. By choosing not to believe the second doctor I am motivated to do everything I can to get the best long term outcome. I doubt that would have happened if I had only spoken to the second. More surprising is that the second doctor was much the younger of the two and I would have expected to be more up to date with modern trends. I am not trying to dis doctors, they do a tough job, but frankly with diabetes such a big and growing problem in society I would have thought it was a pretty high priority to be up to date on the topic.

In context,, both statements are true, but possible,

'Lose weight and the diabetes symptoms will go away' may be more accurate.

 

[Bluetit1802]

Oh Kimbo, what an unsettling appointment. He sounds like an old fashioned doctor who only ever sees uncontrolled diabetics, and lumps people like you in the same bag.

Personally, if it were me, I would be delighted to come off medication if I were on it. I hope come New Year you will think about it. If your levels go right up again you can always return to it. It would be good for you, I believe, to see how your body reacts to diet only. Hopefully it will be fine, but make sure you get 3 monthly HbA1c tests., and ignore his "don't test every day stuff". Most GP's and nurses tell us that. It's probably because he fears you may have anxiety issues (even though you haven't)

Have you looked in to the full side effects of your meds? Could that be causing your hair loss and night time problems?.

 

[Mushroom]

Hi, weight loss may explain your hair. I am HFLC and lost 4 stone very quickly. 2 - 3 lbs a week and I started to get hair loss after about 3 stones. Could run my hand through my hair and pull it lots. Now weight has stabilised and hair back to normal.

 

[nancyb]

I think I read somewhere that metformim can cause hair-loss in some people as a side effect..
Your waking up at night could be menopausal - does it subside after a few minutes? My hot-flushes/ night sweats go like this:- feeling of malaise, followed swiftly by getting VERY hot - as in having to throw duvet off, and racing heart beat. Over in a few minutes. This is just one possibility though - could be diabetes related.
By the way, I recently met someone who had been managing his type 2 for 15 years with diet only and had no complications - now in his 70s and still going strong.

 

[AnnieC]

For a lot of women some hair loss and thinning is quite common with the menopause

 

[cold ethyl]

thinking about complications etc.. my grandad has been diabetic about 20 years and doesn't run a particularly tight control ship- rice pudding for lunch, lots of bread, bananas( which he only took up as DN said he needed to eat more fruit!!) and sugars about 9 at last review- he is 95 now and has no sign of the usual complications so I sometimes wonder if some of those are more a case of luck of the genetic draw as much as control?

 

[AndBreathe]

Yes, one doctor told me - lose weight and the diabetes will go away and the other, who I don't think is as senior and was in a bit of a rush when seeing me simply declared I'm a diabetic for life. To say I was bemused is an understatement. By choosing not to believe the second doctor I am motivated to do everything I can to get the best long term outcome. I doubt that would have happened if I had only spoken to the second. More surprising is that the second doctor was much the younger of the two and I would have expected to be more up to date with modern trends. I am not trying to dis doctors, they do a tough job, but frankly with diabetes such a big and growing problem in society I would have thought it was a pretty high priority to be up to date on the topic.

I think in fairness to GP, it's not the only mass issue requiring constant updates. As well as diabetes, there's lipids, arthritis, asthma, hypertension, back problems, stress, smoking cessation, substance abuse, dementia and not forgetting that end of life catch-all palliative care.

Would I be a GP for a starting salary of £30k? Not a hope. Not ever.

 

[eddie1968]

I've had low potassium levels, you feel like ****, weak and your legs and ankles start swelling, ended up having an ECG as low or high levels are not a good thing. Kimbo, I agree that you have been unsettled by this GP and can always seek a second opinion. Keep well.

 

[Kezzer4321]

I saw my gp today, my original favourite doctor who I've not actually seen since way before my diagnosis in June, obviously he had read my history before calling me in. The reason I went today was for the last few weeks I am waking up suddenly in the early hours very hot, heart thumping and wide awake and then struggle to settle again, also, I have noticed I seem to be shedding more hair than normal when Washing and brushing. I asked if it could be low potassium, and straight away he was adamant it wasn't and said he had three possible causes, number 1 my diabetes number 2 hormonal (due to age! Ironically it was me querying this back in June that led to bloods and diabetes diagnosis! This was with another doctor) and number 3 anxiety (apparently due to my late father having brief spells of it??!!) I said I wasn't anxious to my knowledge at the moment and he then focused on diabetes and said my recent hba1c of 38 was as good as his and non-diabetic(which I knew of course), did I test? Told him my average fasting and pre and post, he then said I may well be too low - even though I test in the early hours when awake and I'm my usual high 4 / low 5, he asked why I wasn't introduced to metformin more gradually (I couldn't tolerate it and Was swapped to forxiga by nurse practitioner) as then it wouldn't have upset me so much, he said forxiga could give me re-current urine infections ( haven't had ONE since I started on it??!!) He said to stop forxiga after Christmas and do diet only for three months then have a blood test, I reminded him I had my 6 month hba1c in April so he said to leave it until then.
Random points he made were.....
Test, but not same time every day(?!) And not every day (?!)
Diabetes is a silent disease and eventually my pancreas will decline and need insulin!! ( Never been told that by nurse practitioner or diabetic nurse??) I would have thought considering I have reduced levels, lost 4 stone etc meant I was controlling and avoiding damage?!!
He did concede I had dramatically decreased my levels!
All in all, I'm feeling unsettled and wishing I hadn't gone! My diabetic nurse was delighted with me in October and said to continue on forxiga until at least April and that's what I was happy with.
I have to run now as due at a school presentation evening.....I will be back later to see what you lovely folk make to this conundrum!!

Hi kimbo,
I hate it when I go to the doctors and come away feeling worst off. Whilst I am not an expert my baby sister who is 32 recently lost about 2 stones + following the Atkins diet, which is very similar to Lchf. She lost it very quickly and she also started to have kinda panic attacks and hair loss. The Dr told her that the strain in her body from loosing the weight so quickly was the cause. I am now sure how fast you lost your weight, but it's worth considering. Personally if I was you, I would ask for a second opinion.

 

[cold ethyl]

How low carb do you go, as recently I read an article by a low carb dietician and there is some evidence that levels below 50g a day can interfere with the functioning of the thyroid and hair thinning is a sign of thyroid issues, overactive I think.
It could be just menopausal as it is a part of that sadly and stress can cause it too - I think being diagnosed as diabetic is stressful even if we seem to cope with it well. You have lost a lot of weight rapidly which my be playing a part- perhaps get some multivits and take them.