Mixed messages from GP practise

[neilalastair]

Just when I think I have seen every GP in the practise another one sneaks on in.
So I have to train another one. I am fortunate because they all suffer from the same lack of ability to read a patients notes before the patient has come into their office.

So my question today was.
ME: Hi Doc. Since getting lower BG numbers I have been experiencing really bad constipation. Could the Metformin be doing this.
DOC: No, stay on Metformin and never ever come off it. You must stay on this drug for the rest of your life.
ME: Are you sure Doc, I mean there is evidence to say that this condition is reversible and your own DN told me last week I seem to have it in remission. (Interesting she used the words remission rather than reversed, I thought)

DOC: I am sure! Why do you hate Metformin so much? And any improvement is down to the Drug and nothing to do with the 4 stone you have lost.
ME: So an HBa1c reduction from 10 - 5.3 in few months without Metformin would not do anything to change your mind. ( i am only taking it really 'cos the other GP said it would help with the neuropathy.)
Doc: You have achieved a reduction of how much?? (now he looks at notes) Well it doesnt matter because you have been diagnosed as a Diabetic and you will always stay a diabetic. The Hba1c is not for diagnosis anyway.
ME: But I haven't had a GTT so how did I get diagnosed?
Doc: You must have had a high fasting test. A high fasting test is the only was to dx.
ME: I did get 1 high test, but no repeat test was done to confirm. Just the hba1c was 9.7 after several weeks of a kidney infection.
Doc: (sensing I was in an argumentative mood) Well come of the Metformin if you want and see if the constipation goes away and then come back in 6 weeks for another hba1c and we will watch your numbers rise.

Anyway I am not bothered about being labelled as a diabetic for the rest of my life and if I really wanted a new clean bill of health there are ways of jumping practise. I see it that I have an allergy to sugar more than a Endocrine disorder.

But lastly has anyone else experience constipation with Metformin. I am on the SR version 1 x 500mg. (well I was)

Another quick question. If I measure fasting at 7:30am - 8am I get a 5 number. But if I have a lazy morning and get up at 9am and test it can be 6.5 - 7. Is this typical Dawn Phenomenon?

Thanks for listening to the rant!

 

[hallii]

I get a bit of constipation and I blame the Metformin, try a bit more roughage or one of the other solutions?

It does look like the "Dawn Phenomenon" I get similar readings, but it's not bad enough to make me get out of bed!

Doctors can sometimes get things wrong, they are human, BUT there is no excuse for not looking through your notes. For that reason I stick with one Doc. who happens to be the Diabetic expert, and I write a letter (yes a proper letter, in an envelope) listing what I think is going on. He has got used to ikt and I now do a list of, say, BP readings, work out the average and ask him to ring me if he wants to change anything. This gives him time to have a look at the notes, the ten minute appointment sometimes doesn't.

I also tend to research a bit and ask for his opinion on this or that. Sometimes he has not heard of some bit of research, but since I give the websites I know he will have a look.

He doesn't seem to mind, probably got me down as a silly old man and makes allowances!

Lastly, I have learned not to disagree with a doc.you can't win, so I just bite my lip and carry on regardless

H