I have normally had annual screening around June for a diabetes risk assessment after having had a stroke in 2014 "an acute lacuna infarct affecting the posterior aspect of the left putemen, extending to the corona radiata" . ( Funny how some things can stick in the memory ).
Blood pressure at time of event 200/120 mmHg - Put on ACE Inihibitor, Calcium uptake blocker, Beta-blocker, Anti-coagulant and Statin.
This year the test was late and I chased it up with GP - twice.
On both occasions I had fasted in preparation for expected blood test, on the second time surgery phlebotomist had
finished for the day so I took form to local hospital blood test service. This was on the last day of July.
I heard nothing in August, which is a very busy time where I work at an FE college, and chased the result mid September
after main enrolment rush had ended.
I was asked to make an urgent appointment.
In the surgery my blood glucose was 22 mmol/L - retested on another meter - 21 mmol/L.
My foot was tested - I could feel the bristle on my toes and also the tuning fork on my ankle and could see but not feel it vibrating.
I was told I would have an appointment with a diabetic nurse, but as they were very busy it might take up to six weeks.
My GP put me on 2x500 mg Metformin and Glicazide, given a meter + strips and told to stop taking the Glicazide if my glucose levels reached 5 mmol/L.
(A week later I had a text message from the surgery - saying I was at risk of Diabetes and to make an Urgent appointment. I actually found that funny - but so much for my sense of humour).
Over a month I brought my blood glucose down to 7 to 8 and was told to stop taking the Glicazide daily, but to take half a tablet if it got "too high" (value unspecified) and to "only test twice a week". Metformin increased to 3x500mg per diem.
I also had another HbA1c test.
At the end of the month I asked the reception staff about the DN appointment, as on a timeline of six weeks - a date should have been set.
Was assured appointment had been made.
At two months I asked again.
At three months I phoned up the Community Health organisation which runs the Diabetic Nurse service, they had had no booking for me.
I phoned the surgery reception and they said that they would "Fax the booking again".
At the end of December an appointment notification arrived - for a Dietician.
I rang up the surgery to query this and was given a telephone appointment. Was told to see dietician - but left a form for more blood tests.
Due to holiday times I had the (fasting) blood tests on 2nd January before work at 08:00.
I rang up the surgery for the test results prior to seeing the Dietician. I also ask for the historical HbA1c values to gain idea of progression.
I was told:
2016 January:_48
2017 July:____53
2017 October:_62
2018 January:_63
I was rather discouraged by this, as between September and January I had dieted and lost a fair amount of weight - 106.4 kg to 89.0 kg and had blood sugar readings between 5.0 and 6.5. ( Apart from a spike of 15.4 mid-December which I blamed on the mashed potato in a Wetherspoons Xmas dinner).
I also put it down to not being strict enough with myself over Christmas.
When I see the Dietician I am told that:
The surgery had specifically requested a Diabetic Dietician appointment - not Diabetic Nurse.
There is however a free slot the following week.
I am weighed - given a further appointment for April and told about the eatwell plate.
I finally get to see the Diabetic Nurse.
He accesses my data from the Surgery.
The January HbA1c was apparently mis-reported - it was actually 31.
He is surprised (I get the impression - appalled) by the amount of testing my graphs show.
[ notes say "this is a very empowered patient" - I think may need a 'translation' of this]
I am set a new HbA1c target of 53.
Metformin increased to 2x1000mg.
I am told there is no real need to test.
I have been following a moderately low carb diet - I seem to be able to tolerate about 30g in a meal.
I shall of course go on testing - even if I have to pay for the strips myself.
Blood pressure at time of event 200/120 mmHg - Put on ACE Inihibitor, Calcium uptake blocker, Beta-blocker, Anti-coagulant and Statin.
This year the test was late and I chased it up with GP - twice.
On both occasions I had fasted in preparation for expected blood test, on the second time surgery phlebotomist had
finished for the day so I took form to local hospital blood test service. This was on the last day of July.
I heard nothing in August, which is a very busy time where I work at an FE college, and chased the result mid September
after main enrolment rush had ended.
I was asked to make an urgent appointment.
In the surgery my blood glucose was 22 mmol/L - retested on another meter - 21 mmol/L.
My foot was tested - I could feel the bristle on my toes and also the tuning fork on my ankle and could see but not feel it vibrating.
I was told I would have an appointment with a diabetic nurse, but as they were very busy it might take up to six weeks.
My GP put me on 2x500 mg Metformin and Glicazide, given a meter + strips and told to stop taking the Glicazide if my glucose levels reached 5 mmol/L.
(A week later I had a text message from the surgery - saying I was at risk of Diabetes and to make an Urgent appointment. I actually found that funny - but so much for my sense of humour).
Over a month I brought my blood glucose down to 7 to 8 and was told to stop taking the Glicazide daily, but to take half a tablet if it got "too high" (value unspecified) and to "only test twice a week". Metformin increased to 3x500mg per diem.
I also had another HbA1c test.
At the end of the month I asked the reception staff about the DN appointment, as on a timeline of six weeks - a date should have been set.
Was assured appointment had been made.
At two months I asked again.
At three months I phoned up the Community Health organisation which runs the Diabetic Nurse service, they had had no booking for me.
I phoned the surgery reception and they said that they would "Fax the booking again".
At the end of December an appointment notification arrived - for a Dietician.
I rang up the surgery to query this and was given a telephone appointment. Was told to see dietician - but left a form for more blood tests.
Due to holiday times I had the (fasting) blood tests on 2nd January before work at 08:00.
I rang up the surgery for the test results prior to seeing the Dietician. I also ask for the historical HbA1c values to gain idea of progression.
I was told:
2016 January:_48
2017 July:____53
2017 October:_62
2018 January:_63
I was rather discouraged by this, as between September and January I had dieted and lost a fair amount of weight - 106.4 kg to 89.0 kg and had blood sugar readings between 5.0 and 6.5. ( Apart from a spike of 15.4 mid-December which I blamed on the mashed potato in a Wetherspoons Xmas dinner).
I also put it down to not being strict enough with myself over Christmas.
When I see the Dietician I am told that:
The surgery had specifically requested a Diabetic Dietician appointment - not Diabetic Nurse.
There is however a free slot the following week.
I am weighed - given a further appointment for April and told about the eatwell plate.
I finally get to see the Diabetic Nurse.
He accesses my data from the Surgery.
The January HbA1c was apparently mis-reported - it was actually 31.
He is surprised (I get the impression - appalled) by the amount of testing my graphs show.
[ notes say "this is a very empowered patient" - I think may need a 'translation' of this]
I am set a new HbA1c target of 53.
Metformin increased to 2x1000mg.
I am told there is no real need to test.
I have been following a moderately low carb diet - I seem to be able to tolerate about 30g in a meal.
I shall of course go on testing - even if I have to pay for the strips myself.
