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Had my consult with Endo, he said I was not a diabetic & would issue a letter to that effect

Congratulations!

Well maybe the stupid among us (Me) do badly because I can't read or understand studies, if I'm lucky I understand about half of what the doctor says, have never taken an exam in my life or finished school, never read a book and spend more time correcting my typos and adding punctuation on here than looking after my diabetes lol I do however take it seriously, Just seriously with a grin.
 
There is also who doesn’t take care of themselves the most, the medical profession mainly doctors as they know best and make themselves worse, well that’s my theory not better.

most diabetic meds all carry side effect and should be told not whitewashed like some are sadly. For me I like to be told not a letter 2 weeks later which scared the **** out of me. Dapagliflozin I’m on for now but not for much longer.

So we have to do a balancing act of high sugars vs the meds but some don’t reduce it enough and then they increase it causing more side effects, or adding another drug to counter act the other. A minefield for sure for some.
 
Mr_Pot said:
For many of us on here A levels would have been 40 or 50 years ago and largely forgotten. It is the job of professionals to communicate in ways their audience will understand.
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100% agree. X
 
You don’t have to be educated to be knowledgeable
 
Mixed messages there to be honest. Prefers lifestyle over pharmaceuticals but wants to put Metformin in the water supply

Anyway, great work so keep it up.
 
Timely post @Ronancastled .
I'm still trying to work out whether to keep complaining to my gp surgery to get my t2 diagnosis registered (they say I never had it. I say put it into remission because of quick and effective action. I just want regular checks).
I sometimes dream of even getting an appointment with a lowly dn, let alone a consultant.
 
Might not be the main takeaway but we’re going to need a LOT more public toilets if that Metformin idea is ever actioned!
 
Wow, what an amazing day you've had! Would SO loved to have been a fly on the wall
 
coby said:
Wow, what an amazing day you've had! Would SO loved to have been a fly on the wall
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I just sort of regurgitated the main points. There was far more which I must post soon.
 
Jim Lahey said:
Mixed messages there to be honest. Prefers lifestyle over pharmaceuticals but wants to put Metformin in the water supply
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He didn't say he preferred lifestyle over pharmaceuticals, he said lifestyle changes were more effective than drugs, which we all know to be true: none of the drugs commonly in use will put a type 2 into remission but weight loss and a low carb diet very well might. He's simply acknowledging that not everyone understands or is willing to adopt and maintain the necessary dietary changes, thereby making drugs the only control option for that (probably very large) group.

I think people are getting unnecessarily offended over the A-levels thing too. Some people seem to have incorrectly interpreted his comment as "You thicko's without exams are too stupid to look after yourselves", but again, that's not what he said. He's a highly trained scientist and he shared a clinical observation, reporting that of the patients he encounters, those with a lower level of education tend to take their condition far less seriously than graduates. Why get offended at this fact?
 
Buster_ said:
He's simply acknowledging that not everyone understands or is willing to adopt and maintain the necessary dietary changes, thereby making drugs the only control option for that (probably very large) group.
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There are many who are, due to complex medical needs, unable to make sufficient dietary changes. And some for whom dietary changes are insufficient to control their diabetes
Buster_ said:
Why get offended at this
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It's not a fact, it an opinion unscientifically formed.
 
coby said:
YES! You must ... I was riveted !
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Right, missus is watching Dr. Pimple Popper so now is as good a time as anyway.
Firstly, I'd like to apologise about his comment on the educated vs those who didn't achieve a high academic level.
One of the first questions he asked me was "what was my profession", I informed him I was a design engineer so he knew he was talking to someone academic. I think this was further enforced by me quoting all the main studies, knowing relevant metrics & units.

Anyway, onto the good stuff.

I described visceral fat as being described as chewing gum in pathology reports on cadavers.
He asked me if I liked foie gras, which I don't, he said "that's duck fatty liver created by force feeding them grains & that's what your liver is coated in".

I quoted my early Kellogg's Shreddies test where I hit 13.3 at the 1 hour, "That's diabetes" he loudly declared leaning forward" . . . then I told him I repeated the test 4 months later & only reached a 7 & he burst out laughing, think he was happily surprised.

I asked him if he believed in Taylors theory on beta cell dedifferentiation & recovery being dependant on restoring original cell function. He was non-committal, said it was a plausible hypothesis but may just be the effect of the remaining cells working harder. I thought about asking about Dr. Longo's FMD but decided to leave it.

I asked him about IF & while he didn't declare himself a fan he was in favour of whatever kept the weight off. Said he was frustrated by private clients who he sees every 3 months who may have only lost a kilo & are delighted with themselves. This Endo was a huge fan of bariatric surgery or weight loss pharmaceuticals. Encouraged me to take Ozempic it to further my weight loss, said it suppresses all appetite cravings. Although he was impressed by Taylors 15kg weight loss in his best responders he claimed bariatric surgery can produce double that & most importantly maintain it for longer remission. On the subject of weight loss I dissed Slimming World & their high carb foods but he defended it on the ground that he's seen results.

On the subject of Ozempic he said there's a game changer injectable in Phase III trials that surpasses it's results. Should be on the market in 2022.

I covered his low belief in long term remission in my first post but there were a few incidentals I left out. He said I was always predisposed to develop T2, it was my lifestyle choices that hastened it to my age of 47 at diagnosis. He did say he has seen bariatric surgery patients delay it into their 70s but did say it would return regardless of weight loss. In other cheery news he told me that as my wife had GD on our 3rd child she would also get T2 & because both of us had it then our children were 80% likely to get it.

On the subject of CGMs he was a big fan though did believe that the Dexcom was far more accurate than the Libre. His problem with the Libre was the lows read too low & the highs read too high. He wasn't aware of the 2019 study I mentioned where 153 non-diabetics wore a Dexcom to establish normal non-diabetic glucose levels, he asked me to email him on the links.

On the subject of Desmond, Xpert & other dietary courses advising the food pyramid/Eatwell plate/wholegrain carbs he glanced it off saying people should tailor their own balanced plan. I did tell him that was a rubbish answer & he laughed. I pushed the idea that all newly diagnosed T2s should be a CGM to show them the effect of carbs but said not all patients would even put it on. His experience was that most patients think that tablet allows them to eat their previous diet, even finding a T2 who regularly pricked their finger was an oddity.

I did quiz him on a full Kraft 4 hour OGTT with insulin but he said even his private clinic don't run them. He did give me the name of a private company which I've since forgot but said they were expensive & needed to be interpreted correctly.

On my FBG being low 4s & my average glucose on the CGM being 4.6 he was very impressed, more impressed when I told him some days were upward of 200gs of carbs. He did pick up however that I spike up to 8 sometimes, especially on breakfast or lunch, said it looked more dramatic on the graph cause it came from such a low baseline. I did ask him if I could be doing any microvascular damage & he shook his head stating that at my levels damage was impossible.

As you can see we had a report & he repeated to me that I was an outlier, the type he's lucky to see once every 3 months. As we departed I joked that I appreciated his honesty & would attend his private clinic in the future if I needed but hoped I never see him again unless to bring him for a pint of carby Guinness.

So that was it, only had 30 mins so I think I did well to remember 90% of it. I remember seeing posters going blank when they had their consults & I had notes prepared, luckily on the day it flowed because of what I schooled up on thanks to this forum.
 
Thanks for sharing those 30 minutes with us. Very interesting
 

Back then, there was plenty of reason why people would leave school without A levels. Reasons which had little to do with intellect or cognitive ability.
I’m sure most here can work out the reasons for themselves!!
 
If people with A levels were better at looking after their health then no uni student would ever smoke, take illegal drugs or get drunk. My son shared a house with some medical students...

I would think that perhaps those without qualifications are maybe more likely to respect their doctors too much and follow the advice given to the letter thinking it is the best way. Perhaps that's why someone would only lose a kilo in 3 months. They are qualified medical practitioners after all, you wouldn't expect them to be giving bad advice to a newly diagnosed diabetic would you?

At diagnosis I already knew the advice my doctor and DN gave me was wrong. It was the same advice that had led me to T2 in the first place.

Edit: @Ronancastled weren't you lucky that you had to wait 2 years for the appointment?! You did far better without the endo's 'help '.
 
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lucylocket61 said:
It's not a fact, it an opinion unscientifically formed.
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There are very many published, peer reviewed studies which show a definitive link between higher educational attainment and healthier lifestyles, longer lifespan and reduced incidence of sickness. This is not opinion, it is well establish fact, proven scientifically.

This endocrinologist stated that his clinical observations concurred with this mountain of evidence.
 
There's definitely a link between educational achievement and salary. Which leads to better housing, expensive food, regular holidays and private medicine.
 
The comments about 'A levels' versus 'no/little education' make me smile. Do people really think that just because someone may not have stayed on at school to do A levels or get a degree that they are somehow inferior educationally, because they don't have a certificate? What is actually being talked about is intelligence and the ability and will to understand the subject matter, people either can do that or struggle to do that regardless of schooling or poverty or any other factor. Absolutely s*d all to do with whether you managed to answer questions on a subject and pass a written exam at the age of 18. I have worked across all so called 'classes' and believe me when I say many of those with a higher education are not what you would call intelligent and many of those without a higher education most definitely are, it is about the person whichever end of the social spectrum you happen to sit at. Of course access to higher education and its lifelong benefits (as someone above said) might influence health as money often does but it's a shame when people confuse that with an individual's personal intelligence. Some people really do have this superior attitude, 'What do you do?, oh.......' and then that's it, you are treated in a manner pertaining to your educational/employment status as perceived by them. That Consultant should be in a different job in my opinion. Oh well, rant over.
 
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