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Interesting Gp View.

Discussion in 'Diabetes Discussions' started by DavidGrahamJones, Aug 14, 2018.

  1. kitedoc

    kitedoc Type 1 · Well-Known Member

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    I think it is interesting that a health professional might view A T2D doing BSLs as a bit too obsessive when she is off swimming rivers and in open seas etc, certainly not a middle of the road, non-obsessive activity in itself.
    I seek a GP who is not going to give me their own, generic world view but will try to view and assess things from my viewpoint, needs, knowledge and uniqueness - and a GP who is flexible in outlook and prepared to think outside the square.
    And I resent the arrogant attitude sometimes seen of " the patient will never understand this so I will not bother to suggest, test for or prescribe that". It is a cop-out !
    In my past experience as a patient there have been times when I have noted something which could 'not be readily explained by medical science' - to find later that an explanation had surfaced either through another doctor looking further into things and clinching a diagnosis/cause rather than reading the old notes and copying the same defeatist attitude, or new research yielded answers. Not all these things were diabetes-related, but some were.
    That some (but not all) doctors pooh-poohed my symptoms as being 'psychologically based', 'made-up' or ' as not fitting any disease known to man' was sadly predictable. Some doctors appeared to not be prepared to go the extra distance or think outside the square, or would blame me for having the symptoms yet in one instance via Google I found one good example of a medical condition which fit my symptoms very well. The condition had not been suggested or looked for, and when discussed with the doctor he just carried on about patients looking up the internet. (I was a registered doctor at the time, which he knew but had used the internet to demonstrate that one did not have to be in the profession to find out some possible answers). He dismissed the condition without being able to offer any explanation as to why.
    I do acknowledge that knowledge about health and illness is expanding and no one person can be across it all. And sometimes conditions evolve over time and become more easily diagnosed.
    And I freely acknowledge the medical free-thinkers who are great exemplars of the medical sciences and art.
    But that does not excuse any of the lazy, ignorant, or blaming attitudes of others towards science, the mind, wholism and patients' welfare. End of rant !!!
     
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  2. Daphne917

    Daphne917 Type 2 (in remission!) · Well-Known Member

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    Like any illness and/or condition everybody finds their own way of dealing with it. I rarely test now because I know what foods will push my BS up but sometimes I test out of curiosity and if I have something that I’m not sure about. I was worried as to what my latest hba1c result would be because, after my cancer diagnosis and consequent op in Feb this year, I was not so careful with my diet however although it’s gone up by 3 points from 34 to 37 it is still in the normal range which my DN and I were pleased about given my other health issue. It was, however, a warning of what could happen if I’m not careful in my food choices so have started cutting down on the carbs again - latest test showed 5.4 2.5 hours after cheese (lots of) and crackers (3 of) plus toms etc. Saying that although I have never been one for spreadsheets, food diaries, CGMs, finding alternatives etc I am not complacent and rely on my monitor, memory and ability to read the carb content on labels to control my T2.
     
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  3. Guzzler

    Guzzler Type 2 · Master

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    Well said.
     
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  4. Debandez

    Debandez Type 2 (in remission!) · Well-Known Member

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    The greatest investment I have ever made EVER has been my monitor. With this and testing about 7 times a day I have gone from 62 to 41 (mysugr app now gives estimate of 33) within 6 months. My diabetic nurse was in shock. Nobody has apparently done what I have (not surprised as monitors not given out in fact advised testing unnecessary! Just advised re eatwell plate and offered metformin and see you in 6 months....oh yes and a 1 day DESMOND course that offers tea and biscuits). She was my mum's diabetic nurse for 10 years and my mum passed away 11 years ago. My BP was raised that day (understandably) she asked me to monitor that several times a day! Ironic. Monitoring is the only way you know how your body is coping. It's simple. Quick. Effective. And life saving. If my mum had monitored hers she may even still be here with us now. And while she was alive she may have been able to keep her eyesight. When i mentioned my testing and the LCHF diet working so well to my Dr this last week (Jaws music here...I will never get those 20 minutes back), he told me if i hadnt tested and followed a low cal low fat or similar diet my hba1c would have come down anyway. I have now asked the practice manager for stats for hba1c reductions in 6 and 12 months. He is currently discussing this with the DN. Hope to hear back soon.

    I eat out a lot. I tend to select safe options. But even last week's carvery gave me an unexpected rise. Possibly the gravy, the pig in blanket or the carrots. Who knows. But next time no gravy. Test. Check results and take it from there. Process of elimination. But my trusty monitor will let me know.
     
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  5. TerriH

    TerriH Type 1 · Active Member

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    Perhaps I`m stating the obvious but "one size does not fit all"!! We are all individuals and therefore what is right for one does not mean that it is right for anyone else. We cope as much by self management as by help/advice from medical professionals. As far as my GP is concerned I am coping in that I haven`t seen her for well over 3 years and I have been Type 1 and dependent on insulin for 53 years.
    I rest my case!!
     
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  6. Bluebell_GB

    Bluebell_GB Type 2 · Well-Known Member

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    Like many on here, I tested obsessively in the early days until I had my HbA1c in the normal range using a HFLC diet. Since then, I test only first thing in the morning and last thing at night to confirm that all is well. Interestingly, it does not take much (one high carb meal on holiday for example) for the dawn phenomena to rear its head. This is all the motivation I need to stay on the HFLC path as it reminds me that I am in remission but not “cured”.
     
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  7. lindisfel

    lindisfel · Well-Known Member

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    Must be par for the course, David, she sounds like my daughter who has been a GP for 25 years!
    I wouldnt dare tell her I am now in ketosis and I am checking myself with urine sticks and a breath meter!
    It's all part of life's rich pattern, I just think their too overloaded with work to engage with knowledgeable laymen or laywomen on a time consuming basis.
    D.


     
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    #27 lindisfel, Aug 16, 2018 at 7:19 PM
    Last edited: Aug 16, 2018
  8. spanglepig

    spanglepig Type 1 · Newbie

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    The clinic I attend at the local hospital is fabulous and couldn't be more supportive - I got my HbA1c down to target within six months of diagnosis and have kept it there since, with a great deal of encouragement and a recommendation to do the DAFNE course next year. By contrast, the diabetes "specialist" nurse at my GP's is the exact opposite and on my last appointment in April, told me that I was too controlled! I know which lot of advice I will follow and it won't be that received at my GP's!
     
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  9. pancratic

    pancratic Type 2 · Newbie

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    An interesting discusion about GPs views and the taking of readings with a meter. Nobody has mentioned the DVLA and their diktat (sp?) that any insulin user should take a reading before they start to drive a vehicle and every 2 hours thereafter. If any GP is not issuing prescriptions for Meter Testing strips then are they aiding and abetting you if you are tested by the Police and are below the 4 unit mark?

    As a Type 2 on insulin I test before my Breakfast and Evening Meal to work out how much insulin to take to keep me in the correct range. I would like to add that after being Diabetic for 20 years my HbA1C has been within the "good" range only in the last 3 years, taking note of low carb food and Empagliflozin which was suggested by a Consultant.
     
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  10. kitedoc

    kitedoc Type 1 · Well-Known Member

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    I would point out that your GP is the person who also provides preventive care e.g. screening such as for bowel cancer, prostate, breast cancer, vaccinations, providing assessment for driving etc and BP checks etc. I don't agree that not seeing the GP is to be applauded !!
     
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  11. kitedoc

    kitedoc Type 1 · Well-Known Member

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    My specialist and Diabetes nurse have both pointed out to me, as a TID, that the lower the HBA1C the greater the risk of hypos. And hypos can damage and kill me much quicker that the occasional high BSL can. e.g. the risk of car accidents increases.
     
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  12. bamba

    bamba Type 2 · Well-Known Member

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    The diet may not have changed - but the dieter ( or the dieter's metabolism) could well have.
    We are told diabetes is a progressive illness.
     
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  13. DavidGrahamJones

    DavidGrahamJones Type 2 · Well-Known Member

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    Excellent!

    Interesting concept, a bit like me taking my condition too seriously. If I didn't, why bother at all? If I'm very critical of my successes and my failures, my failures tend to be when I take my eye off the ball, or try to achieve too many different things. Like most humans, I can't multitask properly, but if I concentrate on achieving "one thing" then I can manage that OK. Other tasks might have to wait until I can make them that "one thing".
     
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  14. DavidGrahamJones

    DavidGrahamJones Type 2 · Well-Known Member

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    Me neither, just as well my GP and DN are much more supportive. My DN is especially positive and supportive about my low carb approach. The interesting thing about my GP, and I've been able to discuss this with her, my approach works well for me because I am relatively very disciplined and I put that down to decades of watching what I eat very carefully in an effort to lose weight.

    She has mentioned that a lot of her patients haven't had that "battle" with weight issues so the very idea of cutting carbs is out of the question, mainly because they don't want to make the effort. My father fits into that category and interestingly while he's been in hospital where the nurses have confiscated the chocolate a family member took him (nobody will admit who it is, probably because I asked "which idiot took him chocolate, which bit of diabetes isn't understood?"), they've had to reduce his insulin twice. They don't give him Muesli, shredded wheat, or weetabix either. Less carbs - reduced insulin, who would have thought? LOL
     
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  15. rolypolypudding

    rolypolypudding Prediabetes · Well-Known Member

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    The GP, like most of us, will have been bombarded over the years with promises of miracle diets and contradictory research results regarding healthy foods. That may be why she is rather cynical about LCHF diets. She has probably also encountered overweight people who have tried one extreme diet after another, and failed to stick to them. Then there are the people who become so obsessive with their habits that it interferes with normal life and becomes a mental illness.
    The other problem is that most of the staggeringly successful results reported from people following the LCHF diet are anecdotal, and therefore not taken as seriously by some doctors as a comprehensive properly funded research project.
    Still it's a shame that this GP felt it necessary to be so negative, and didn't balance out the scepticism by praising the hard work and effort that went into improving health. Too often, type 2 diabetics are sterotyped as fat lazy ignoramuses who have brought type 2 on themselves and ought to be charged for their treatment. Doctors should encourage all attempts at self-help even if they think the patient is misguided. They should intervene more forcibly only if the patient is putting health at risk by being too extreme in their eating and monitoring habits.
     
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  16. Guzzler

    Guzzler Type 2 · Master

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    The same goes both ways. Dr. David Unwin saw a remarkable upturn in the (health) fortunes of a single patient (there is your n=1 anecdote) and decided to see how one woman changed her prognosis. Do not dismiss anecdotal evidence so blithely.
     
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  17. zand

    zand Type 2 · Master

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    I prefer anecdotal evidence. It's real and unbiased. Studies that are funded by companies who have vested interests in the results are just a farce.
     
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  18. Guzzler

    Guzzler Type 2 · Master

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    Agreed. Dr. Unwin even put the question of using n=1 evidence to a panel at the recent Swiss Re Conference and was given such a patronising response that I was angry on his behalf. Aseem Malhotra was given the same kind of response when he asked a question on healthy weight and how that can differ from person to person. Statisticians? Pah!

    Edited for typo.
     
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    #38 Guzzler, Aug 17, 2018 at 10:47 AM
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  19. donnieboy

    donnieboy Prefer not to say · Member

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    I agree and suggest the the pancreas doesn't take time off.
     
  20. Kyambala

    Kyambala Type 2 · Well-Known Member

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    Good evening kas16. I also agree. I was testing myself several times each day and my BS was always high. My fasting BS was usually about 9 and my Doctor advised me to stop testing so often. He said that "if you test before every meal and 2 hours after every meal then you will start to worry that your BS is high and that will cause you to worry which causes your BS to become higher". My highest reading was 28 but on average was in the mid 9's.

    He said " Just test every morning BEFORE you eat and let the rest of the day take care of of itself.

    So I followed his advice and only tested BEFORE I ate breakfast - but I also bought a Libre so that I could see what was happening to my BS. The Libre helped me to understand "Liver Dumps" but other than that it just kept my mind focused on my Diabetes problems. I also at this time started the LCHF Diet which reduced the amount of Insulin I needed from 100 units per day to 58 units per day. So I stopped using the Libre and gradually my fasting BS came down from the 9's to between 4.3 and 6.5. My HbA1c also came down gradually to 8.3 and 3 months ago was 6.8.

    Conclusion: LCHF is a MUST, and fasting BS is a MUST, and avoiding WORRYING about being Diabetic is a MUST - so, at 76 I feel healthy - I am Diabetic on Insulin - so what else can I do to continue ENJOYING living.

    Have a nice day.
     
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