Issues with Nurse Practitioner

[jjraak]

If my sugar goes over 10, I get very sleepy and more often than not need to have a nap.

None of your treatment in your post sounds super encouraging, thank goodness for the good advice from many.

I hear you being happy with risperidone, & with being aware of its side affects
And I'm loathe to upset that, with you seemingly well balanced & benefiting mentally from it, But I'd certainly look into it further.

I can only speak from experience. Mum had the beginnings of Alzheimer's, and had become very agitated, the doctors prescribed risperidone.

Mum went from very agitated to docile.

And slept an awful lot.
It was almost like she got up for dinner over (dad cooked)
To her going back to bed and being sound asleep in minutes.

Sure it's a case of doseage , mums was likely quite high.

Just wanted to make sure you were aware of its full affects.
I have heard it referred to as a chemical cosh.

Given how much you have going on,
It might be too much at the minute but when able, it might be time well spent imho.

Best wishes the hospital stay helps identify the underlying bloods issue.

 

[pam_x_pam]

None of your treatment in your post sounds super encouraging, thank goodness for the good advice from many.

I hear you being happy with risperidone, & with being aware of its side affects
But I'd certainly look into it further.

I can only speak from experience. Mum had the beginnings of Alzheimer's, and had become very agitated, the doctors prescribed risperidone.

Mum went from very agitated to docile.

And slept an awful lot.
It was almost like she got up for dinner over (dad cooked)
To her going back to bed and being sound asleep in minutes.

Sure it's a case of doseage , mums was likely quite high.

Just wanted to make sure you were aware of its full affects, I have heard it referred to as a chemical cosh.

Given how much you have going on,
It might be too much at the minute but when able, it might be time well spent imho.

Best wishes hospital stay helps identify the underlying bloods issue.

Thank you.
I been on risperidone for 5 months now and the napping and sleeping during day only started recently. Could be risperidone, I am not saying it isn't. But right now it's the only thing that is keeping me sane and stable so if I sleep a bit more it's a trade I want to make I guess.

My ketones are 0.7 so not high at all but just waiting for diabetic team to come chat me.

Thanks all for help and understanding

 

[Bash_]

Hey all
I been having some issues with my GPs practice nurse. She's the one looking after my diabetes.
I been type 2 for over 10 years, very well managed.
At start of this year my mental health has declined rapidly and I was put on some medication which, unfortunately, mess with my sugars.

I been having readings as high at 10 fasting, on average my fasting reading is between 8 and 9, which I know is too high.
My pre meal readings are anything between 8-10 and post meal (no matter what I eat) are always above 11!
Some days they get ad high as 14, even 17.

I also get hypos at night - know this thanks to libre sensor I bought, but also woke up few times and testes and I can go as low as 2.


I shown all of this to the nurse practitioner who taken my hb1ac and decided everything is fine as my results was 46.

She shad my after meal sugars are fine?! And they always going to be high after food. And my pre meals are single figures so who cares?!

I am on 1000mg metformin twice a day and 10mg of empagliflozin once a day.
I follow lowish carb diet of no more than 100g per day but if feels like anything sends my sugars high.
If my sugar goes over 10, I get very sleepy and moremoften than not need to have a nap.

How do I get her to help me? I am only 31 and I feel like she's dismissing me because of my mental health. I was told to "get my head in order" and "watch what I eat" and lose weight which would obviously help but nothing is working.

Any ideas? Based on the recommendations, my sugarsnare way too high.

What do I do?!

Whilst it could be several reasons for the tiredness one thing that should be checked via blood test is Vitamin D. Without it your in trouble as it also affects your immune system big style. Simple test to rule it out.
Low carbs does also have an issue i.e. low energy, no mojo. You sound like you need a diabetes specialist to confirm your not actually T1. T1 is less of an issue as it makes BS levels more controllable. Most importantly your mental health issues can and will improve once you accept you've an issue so your on the right track. Good news is that mental and vit D are all solvable. Good luck my friend.

 

[pam_x_pam]

Whilst it could be several reasons for the tiredness one thing that should be checked via blood test is Vitamin D. Without it your in trouble as it also affects your immune system big style. Simple test to rule it out.
Low carbs does also have an issue i.e. low energy, no mojo. You sound like you need a diabetes specialist to confirm your not actually T1. T1 is less of an issue as it makes BS levels more controllable. Most importantly your mental health issues can and will improve once you accept you've an issue so your on the right track. Good news is that mental and vit D are all solvable. Good luck my friend.

Thank you.

I'm just out of hospital, my ketpnes were low my hb1ac was 47 and my sugars were fluctuating between 10 and 15 so they gave me some insulin and fluids and wrote urgent referral to diabetic specialist.

As for my mental health, I know I have issue that's why I reached out for help.when I was at my lowest and accepted it. I will get better eventually but never fully as schizophrenia is life long..

 

[EllieM]

Thank you.

I'm just out of hospital, my ketpnes were low my hb1ac was 47 and my sugars were fluctuating between 10 and 15 so they gave me some insulin and fluids and wrote urgent referral to diabetic specialist.

As for my mental health, I know I have issue that's why I reached out for help.when I was at my lowest and accepted it. I will get better eventually but never fully as schizophrenia is life long..

Great to hear you are out of hospital. The diabetes referral sounds very useful - there are a lot of diabetes medications and I suspect it may be easier to change your diabetes meds than your mental health ones. (Personally if I were in your position I would prioritise my mental health).

And I would hope that, given your age at diagnosis and family history, they did rule out the T1 possibility then. (A Lada diagnosis can come in at any age or weight but youth and weight loss are just some red flags that mean T1 should be ruled out). To be honest, if you are considering non T2 possibilities, then I'd hope your endocrinologist would also test for MODY (a genetic form of diabetes that doesn't always need insulin) which would allow them to tweak your treatment in favour of drugs that are known to work for your variant of MODY. (That is not a suggestion that you have MODY, I am not a doctor, don't know your medical history and forum rules don't allow us to diagnosis).

Have they given you a meter or test strips so that you can test for ketones yourself? Did they give you any suggestions as to what you should do while waiting for that referral?

Lots of virtual hugs and well done for going to the hospital to get checked out - much better safe than sorry ...

 

[HSSS]

Well that’s one way to speed up the very necessary referral to the specialist Lol Glad you’re ok tonight and the trip may very well have gotten you the best outcome. When you do get to see them make sure you ask about the other forms of diabetes being ruled out if they don’t mention it. And as said it looks like the diabetes medications are going to be the ones to adjust more then the mental health ones. Then you can focus on that issue without the distractions of the diabetes.

 

[jjraak]

Thank you.
I been on risperidone for 5 months now and the napping and sleeping during day only started recently. Could be risperidone, I am not saying it isn't. But right now it's the only thing that is keeping me sane and stable so if I sleep a bit more it's a trade I want to make I guess.

My ketones are 0.7 so not high at all but just waiting for diabetic team to come chat me.

Thanks all for help and understanding

Excellent news.

And sad to say, but I agree the trip to hospital might have been for the best all round.

Also agree it's a mixed bag as to what might be most responsible for the sleeping.

And in your shoes, I think I'd accept the trade off for a little mental clarity & balance .

Best wishes from here on its answers AND solutions, not more questions & problems.

 

[AndBreathe]

Thank you.

I'm just out of hospital, my ketpnes were low my hb1ac was 47 and my sugars were fluctuating between 10 and 15 so they gave me some insulin and fluids and wrote urgent referral to diabetic specialist.

As for my mental health, I know I have issue that's why I reached out for help.when I was at my lowest and accepted it. I will get better eventually but never fully as schizophrenia is life long..

All good news there Pam. I hope your referral comes through promptly. That you r numbers are showing you 10-15, but your A1c is 47 suggests you might be having a few lows too, which could be passively impacting how you feel about all manner of stuff.

You have done really well reaching out and pushing at each stage for proper care. The harsh reality is, we have to be looking after ourselves, and doing just as you are doing. I know it is very hard, and I am glad you have a good partner by your side and looking out for you.

Don't be a stranger. Stick around and let us know how you get along.

 

[pam_x_pam]

Thank you, everyone.

It was a challenge for me to go in, but I did it, and the doctor looking after me was absolutely lovely. He tried his best to put me in a quiet spot so I don't have to worry about my mental health, he's done all the tests and assured me i done the right thing coming in as what the nurse practitioner said and done sk far was absolute poop.

I didn't get a ketone kit, but he said I need to have one, and he will send a letter to the GP. He actually knew my GP personally (my GP used to work in paediatrics), so hopefully, that helps my case.

I'm hoping the specialist won't fob me off and will test for other types of diabetes given the issues and family history.

Thank you all for the help and encouragement, its really appreciated

 

[AndBreathe]

Thank you, everyone.

It was a challenge for me to go in, but I did it, and the doctor looking after me was absolutely lovely. He tried his best to put me in a quiet spot so I don't have to worry about my mental health, he's done all the tests and assured me i done the right thing coming in as what the nurse practitioner said and done sk far was absolute poop.

I didn't get a ketone kit, but he said I need to have one, and he will send a letter to the GP. He actually knew my GP personally (my GP used to work in paediatrics), so hopefully, that helps my case.

I'm hoping the specialist won't fob me off and will test for other types of diabetes given the issues and family history.

Thank you all for the help and encouragement, its really appreciated

Make sure you go to your specialist appointment prepared with the issues you want to discuss. In these appointments our brains are both racing and frozen a the same time. A list just helps make sure nothing you feel is important is missed.

My former GP (who was fabulous, but moved area - Boo hoo!), used to ask me at the end of appointments if we'd finished my list. She didn't mind at all.