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How long do you wait for an appointment ??
- Thread starter MadMat
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C
catherinecherub
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MadMat said:
As the number of diagnosed Type2's is on the rise and it is not an emergency then it is a reasonable time to wait IMHO.
Are you sure she/he is a DSN?
viewtopic.php?f=25&t=27742
When the Dr sent me to see her he introduced her as "Our Diabetes specialist", but I've not seen any certificates 
It's a large surgery - around 10 GPs and 5-6 nurses.
I'm having my first HBA1C since being diagnosed soon, was hoping to get the results a bit quicker than that!
Also suspect she is going to try to put me on Byetta, she mentioned it as a possibility last time I saw her, not sure how I feel about that!!
Mat
It's a large surgery - around 10 GPs and 5-6 nurses.
I'm having my first HBA1C since being diagnosed soon, was hoping to get the results a bit quicker than that!
Also suspect she is going to try to put me on Byetta, she mentioned it as a possibility last time I saw her, not sure how I feel about that!!
Mat
Daibell
Master
Hi. If you have had your blood sample taken already for your Hba1C you can always phone the surgery and ask for the result. If it's over 7.0 (in old money %. See website home page for converter to new mmol money). Don't let the result worry you at this stage but wait to discuss it. It's unusual to mention Byetta as a starter medication at first diagnosis without an Hba1C result yet. Normally it would be look at diet first and then onto meds, typically starting with Metformin, if needed. This would be for a typical newly diagnosed T2; there will always be exceptions of course and it's not for me to try to diagnose you!
Daibell
Master
Repeat and corrected message:
Hi. If you have had your blood sample taken already for your Hba1C you can always phone the surgery and ask for the result. The NICE guidelines recommend to keep it below around 7.0 (in old money %. See website home page for converter to new mmol money) . Don't let the result worry you at this stage but wait to discuss it. It's unusual to mention Byetta as a starter medication at first diagnosis without an Hba1C result yet. Normally it would be look at diet first and then onto meds, typically starting with Metformin, if needed. This would be for a typical newly diagnosed T2; there will always be exceptions of course and it's not for me to try to diagnose you!
Hi. If you have had your blood sample taken already for your Hba1C you can always phone the surgery and ask for the result. The NICE guidelines recommend to keep it below around 7.0 (in old money %. See website home page for converter to new mmol money) . Don't let the result worry you at this stage but wait to discuss it. It's unusual to mention Byetta as a starter medication at first diagnosis without an Hba1C result yet. Normally it would be look at diet first and then onto meds, typically starting with Metformin, if needed. This would be for a typical newly diagnosed T2; there will always be exceptions of course and it's not for me to try to diagnose you!
I think the Byetta was mentioned as I also need to lose a significant amount of weight, the nurse was very enthusiastic about it!
I'm not keen on taking drugs, although currently taking 4x500mg Metformin a day. I've lost almost 2 stone since diagnosis just from that and diet changes, so hopefully she won't see the need to put me on stronger medication!
Mat
I'm not keen on taking drugs, although currently taking 4x500mg Metformin a day. I've lost almost 2 stone since diagnosis just from that and diet changes, so hopefully she won't see the need to put me on stronger medication!
Mat
xyzzy
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Yes I'd think carefully about the Byetta Mat especially if you are keeping your BG's relatively good and are losing weight.
This site says
Its the "increasing the secretion of insulin from the pancreas" which would worry me as the risk is that it will shorten the life of your already overworked pancreas. When your pancreas gives up the ghost then you have no option but to go on insulin.
Going on insulin is fine but you'd want to do it on your terms and at a time of your choosing. There's nothing stopping you asking to go on insulin at any time in fact if you have some pancreatic function left at the point you do it you would end up injecting less insulin. The dangers of insulin are that it effectively lets you eat what you want so if you're not use to controlling your weight and diet then you start to run very high risks of heart attacks and strokes. Better to go on insulin when you have slimmed down and are use to controlling your weight imo.
All just my personal opinion so take a wide a range of people views before you decide.
This site says
Its the "increasing the secretion of insulin from the pancreas" which would worry me as the risk is that it will shorten the life of your already overworked pancreas. When your pancreas gives up the ghost then you have no option but to go on insulin.
Going on insulin is fine but you'd want to do it on your terms and at a time of your choosing. There's nothing stopping you asking to go on insulin at any time in fact if you have some pancreatic function left at the point you do it you would end up injecting less insulin. The dangers of insulin are that it effectively lets you eat what you want so if you're not use to controlling your weight and diet then you start to run very high risks of heart attacks and strokes. Better to go on insulin when you have slimmed down and are use to controlling your weight imo.
All just my personal opinion so take a wide a range of people views before you decide.
Grazer
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I agree with xyzzy. Try and see what you can do with diet first. No harm with the metformin, but personally I wouldn't want to rush onto stronger drugs unless necessary, although we of course don't know the rerst of your medical circumstances and aren't doctors. Here's some ideas I've sent to someone in the past which they found useful; maybe it will help you get your BGs under enough control that you won't need the byetta.
In general terms you will need to reduce the total number of carbohydrates you eat per day. All carbohydrates turn to sugar when we eat them, and no type 2 diabetic on diet only, or on diet and metformin only, can control their blood sugars (BGs) without controlling their carb intake. Even those on strong medication normally choose to control their carb intake to keep the level of medication they take down. The total number of carbs per day you can eat depends on how advanced your diabetes is. It’s perhaps worth starting at about 50% of normal levels for a non-diabetic then adjusting up or down according to how you get on. That’s 150 grams of carbs per day for a man, 125 for a woman. You can read the total carb content of food under “nutritional info” on the packet or wrapping, or look it up on the internet for loose food. Just google “carb content..”
You also need to stop or reduce the bad carbs; that is the starchy ones that make your BG go up quickly.
So obviously no sugar or glucose! But also no white bread, white rice, pasta, flour products like pastry, cake and batter. You can eat a little basmati rice, wholewheat pasta or the tri-color pasta fusilli ones in small quantities. Boiled new potatos are OK but not old pots mashed, boiled or in their jackets. (Roast is not so bad, the fat slows their absorption and conversion to glucose in the blood) Amongst other veg, parsnips are about the worst for BG, and carrots not great but ok in smaller amounts.
Multi grain bread (not wholemeal) is not SO bad, but lots of us eat Burgen soya and linseed bread from tescos and sainsburys, although all bread should be in limited amounts.
All fruit has carbohydrates, and needs to be included in the amounts of carbs you eat in a day. For most people, bananas are about the worst for pushing our BG up and berries (like strawberries, raspberries etc) are the least bad.
No sweeties!
Exercise is important. I tend to exercise about an hour after eating when I know my BG will be peaking. This helps to bring it down quicker and further. I do ten minutes hard work on an exercise machine, but you could run up and down stairs for ten minutes or go for a brisk walk.
Returning to types of food and quantities of carbs - you can only find out how many you can eat by testing. Most type 2’s are not given access to testing equipment, so you should get your own if you haven't already – although try arguing with your Doc that you want to manage to NICE guideline blood sugar levels, and can’t do that without testing! If you have to buy a meter, they are cheap and most manufacturers will give them away for free. They make their money on the strips you have to use! So go for the meter with the cheapest testing strips. Some people test before and after eating, on waking (fasting test) and before bed. But if you have limited strips because of cost, the key to me is testing 2 hours after eating. If your BG is above, say, 7.8 at that stage, you need to cut down on the carb content the next time you have that meal. Test after various different meals and you soon get to see a pattern of what you can and can’t eat, and in what quantities. You can then reduce your testing. I said “below, say, 7.8” because NICE guidelines are below 8.5 but most of us think that’s a little high. 7.8 is the max. Level at 2 hours after eating that a non-diabetic normally gets to so is perhaps a better target. Some then set progressively lower targets.
Do ask lots of questions; there is normally an answer on here. The more you get to learn about your diabetes, the better it will be.
Good luck!
In general terms you will need to reduce the total number of carbohydrates you eat per day. All carbohydrates turn to sugar when we eat them, and no type 2 diabetic on diet only, or on diet and metformin only, can control their blood sugars (BGs) without controlling their carb intake. Even those on strong medication normally choose to control their carb intake to keep the level of medication they take down. The total number of carbs per day you can eat depends on how advanced your diabetes is. It’s perhaps worth starting at about 50% of normal levels for a non-diabetic then adjusting up or down according to how you get on. That’s 150 grams of carbs per day for a man, 125 for a woman. You can read the total carb content of food under “nutritional info” on the packet or wrapping, or look it up on the internet for loose food. Just google “carb content..”
You also need to stop or reduce the bad carbs; that is the starchy ones that make your BG go up quickly.
So obviously no sugar or glucose! But also no white bread, white rice, pasta, flour products like pastry, cake and batter. You can eat a little basmati rice, wholewheat pasta or the tri-color pasta fusilli ones in small quantities. Boiled new potatos are OK but not old pots mashed, boiled or in their jackets. (Roast is not so bad, the fat slows their absorption and conversion to glucose in the blood) Amongst other veg, parsnips are about the worst for BG, and carrots not great but ok in smaller amounts.
Multi grain bread (not wholemeal) is not SO bad, but lots of us eat Burgen soya and linseed bread from tescos and sainsburys, although all bread should be in limited amounts.
All fruit has carbohydrates, and needs to be included in the amounts of carbs you eat in a day. For most people, bananas are about the worst for pushing our BG up and berries (like strawberries, raspberries etc) are the least bad.
No sweeties!
Exercise is important. I tend to exercise about an hour after eating when I know my BG will be peaking. This helps to bring it down quicker and further. I do ten minutes hard work on an exercise machine, but you could run up and down stairs for ten minutes or go for a brisk walk.
Returning to types of food and quantities of carbs - you can only find out how many you can eat by testing. Most type 2’s are not given access to testing equipment, so you should get your own if you haven't already – although try arguing with your Doc that you want to manage to NICE guideline blood sugar levels, and can’t do that without testing! If you have to buy a meter, they are cheap and most manufacturers will give them away for free. They make their money on the strips you have to use! So go for the meter with the cheapest testing strips. Some people test before and after eating, on waking (fasting test) and before bed. But if you have limited strips because of cost, the key to me is testing 2 hours after eating. If your BG is above, say, 7.8 at that stage, you need to cut down on the carb content the next time you have that meal. Test after various different meals and you soon get to see a pattern of what you can and can’t eat, and in what quantities. You can then reduce your testing. I said “below, say, 7.8” because NICE guidelines are below 8.5 but most of us think that’s a little high. 7.8 is the max. Level at 2 hours after eating that a non-diabetic normally gets to so is perhaps a better target. Some then set progressively lower targets.
Do ask lots of questions; there is normally an answer on here. The more you get to learn about your diabetes, the better it will be.
Good luck!
Thanks to both of you!
In my case going on Insulin or any other medication that could cause hypos would mean the loss of my job, as I'm a licensed private hire driver, and so subject to the tougher group 2 driver medical rules, the nurse is aware of this, I was diagnosed as T2 during the medical
I've been testing myself on waking and 2hrs after meals, so far the worst spike came from having a grapefruit for breakfast! but in the main my BG levels seem under control it's rare I get a test over 7.8, and have hit as low as 5.1 after some really low carb meals.
I was told to book a HBA1C test for 6 weeks after I started taking the metformin and then book a DSN appointment to discuss where we go next, seems I have a bit longer to wait :roll:
Mat
In my case going on Insulin or any other medication that could cause hypos would mean the loss of my job, as I'm a licensed private hire driver, and so subject to the tougher group 2 driver medical rules, the nurse is aware of this, I was diagnosed as T2 during the medical
I've been testing myself on waking and 2hrs after meals, so far the worst spike came from having a grapefruit for breakfast! but in the main my BG levels seem under control it's rare I get a test over 7.8, and have hit as low as 5.1 after some really low carb meals.
I was told to book a HBA1C test for 6 weeks after I started taking the metformin and then book a DSN appointment to discuss where we go next, seems I have a bit longer to wait :roll:
Mat
lucylocket61
Expert
May I ask why wholemeal bread is bad for type 2's please?
lucylocket61 said:
It's still quite high carb, although a little better than white, also it tastes like eating the scrapings from the bottom of a hamsters cage!
Personally I've taken the decision that if I can't have proper white crusty from the bakers then I'm not going to bother with bread at all
Mat
borofergie
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It's full of carbs.
It usually only has a slightly lower GI than white bread, so it will spike your blood almost as much.
You should try the Burgen, it's actually very nice. I used to eat it sometimes a slice or two at a time.
It usually only has a slightly lower GI than white bread, so it will spike your blood almost as much.
You should try the Burgen, it's actually very nice. I used to eat it sometimes a slice or two at a time.
borofergie
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MadMat said:
+1
MadMat said:Personally I've taken the decision that if I can't have proper white crusty from the bakers then I'm not going to bother with bread at all
Me too.
Snacking on bread was one of the main reasons I caught the old diabetes in the first place. Toast and sandwiches are too easy to knock up. I don't have it in the house anymore, in fact, I try not to eat anything made from grains (apart from the occaisional beer).
lucylocket61
Expert
Oh, I see.
My Dh makes slow bread for us with fresh yeast and stoneground organic flour. he like to do it. And it taste wonderful. He uses olive oil and stuff too.
so I allow myself to still have one slice with my poached eggs in the morning.
So far, it seems OK blood glucose wise. perhaps cos it doesnt have any **** in it like soya flour or hydrogenated fats or flour improvers either.
My Dh makes slow bread for us with fresh yeast and stoneground organic flour. he like to do it. And it taste wonderful. He uses olive oil and stuff too.
so I allow myself to still have one slice with my poached eggs in the morning.
So far, it seems OK blood glucose wise. perhaps cos it doesnt have any **** in it like soya flour or hydrogenated fats or flour improvers either.
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Having to forswear foods I have loved all my life.
Trying to find low carb meals when eating out.
Spookily, my review appointment (just made) is on the 17th April.
Diabetes day is Tuesday, so there is normally a couple of weeks lead time.
This does provide time to book in the blood test before the review
Diabetes day is Tuesday, so there is normally a couple of weeks lead time.
This does provide time to book in the blood test before the review
