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My Doctor Has No Time For Me..

Thanks to JANECEE & LITTLEWOLF. - Just one final question if I may please, confused as what and what not eat. Picking up messages that I should avoid carbs? Is that right? I thought it was sugar I had to avoid.

Man this a toughy! - I don't smoke anymore, i haven't touched a drop of alcohol since I was 19 (I fall over after one pint was the reason I quit) now I can't eat carbs; potatoes, chips, pasta and there are 8 planets, 204 countries, 7 seas, 809 islands and 6.5 billion people and I'm single and now I have to stab myself in the finger 5 times a day, can someone pass the gun here please.

Sorry, have to see the lighter side, truth is I've never been sick before, only ever been in hospital twice and that figure includes delivery, just can't come to terms with the dismissal I got from the GP yesterday. I Need to man up, kind wishes, Q.


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Hi. Sugar is just another carb so it's carbs that you need to think about and not just sugar. Keep to low-GI carbs and keep daily intake under some sort of control and it will help your blood sugar. Nothing is banned but just be sensible most of the time.
 
You have a condition that you need to manage unfortunately no one else will ever be able to do that for you. If you are going to manage it without testing it will take iron will and no weakness but if you are like most of us and yes the testing might be considered obsessive by some but, it is a very effective tool to assist good management.

The running cost of testing is far less than the cost of smoking and is far better for you but unless you are drug controlled many PCTs now adopt guidance (i am convinced based on needing to save money) that says testing is not necessary. You want to put off drug control for as long as you can so you have few choices.

Happiness is the acceptance of reality.


Diagnosed type II 1998 2 x 80 mg Gliclazide, 4 x 500mg Metformin and 1 x 100mg Sitagliptin - HbA1c - 48 mmol/mol
 
Q007 said:
Will I end up on meds because of ageing process? Can I stay in control without meds? Q..


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Well as an addendum, I was put on bolus & basal insulin in 2008, and by eating to my meter I am basically on Diet & Exercise by embracing a low(er) carbohydrate diet and by eating to my meter (knowing how my BG responds to foods and eating accordingly) without testing I could not have achieved this.
Try asking your doc for one of the diebetes educational programmes such as XPERT which NICE say should be offered :thumbup:
 
Q007 said:
Do you get the strips and needles on the NHS then? - my GP is absolutely adamant that I should NOT get a machine he says I'll just confuse myself with rise and fall readings.
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There are two types of GP, those who are paid on profits, ie how much they save the NHS and those who are salaried. The cost of a drug like metformin is a fraction of the cost of test strips. My GP is a walking encyclopedia on the costs of drugs. He is motivated by savings. The fact is, metformin is much cheaper, very much cheaper, than the costs of test strips. When your GP says that you'll confuse yourself, what she means is that you'll be a nuisance and you'll book an appointment to see her and you'll waste another ten minutes of her precious time. Time is money.

My DN is motvated by what she sees as her special status and knowledge. She often makes appeals to authority when I question her, once telling me that she had an A Level in biology. Knowledge of the reproductive cycle of the buttercup is no reason to assume knowledge of diabetes however. She told me not to buy my own blood pressure monitor as I too would only confuse myself.

Your GP seems to be a combination of both of the health professionals who look after me.

Some of the foods to be avoided are obvious, other less so. When I bought my own meter, I quickly discovered that things like white bread were just as bad sweets. I also learned that things like brown rice filled my belly but had little or no effect on blood sugars. With lots of testing, over the months, I learned how to keep my BG levels down by eating foods that suited me. Now I don't need to test as much as things are more predictable. I used to test at the start and and the end of the day and before and two hours after every meal, so 7 or 8 times per day, depending on when I ate breakfast. Now I use it 3 or 4 times per day and I suspect that in the future, that I'll be using it only a couple of times per day.

Lots of people who don't have meters think they are eating the right things but are then surprised when they have high HBA1c readings. They then have a 5 min chat about changing their diet and told to come back in 6 months. It would take you years to learn that way.
 
I have Codefree and checked my BG when I had a nasty reactive hypo and also when I was sick at 15mmol on the way back from Uni. On both occasions someone called an ambulance and the Accu-Chek (aviva??) carried by the paramedics read exactly the same as the Codefree.

I pay about £14 for 100 strips which is just as well because I'd been testing every 5 minutes lol. But if I didn't I wouldn't have had any numbers to tell the GP about and never have been tested.

Everything Yorksman said is spot on as usual. Kind of condescending being told 'it'll just confuse you'. The effect of certain foods on my blood sugar is only a mystery to me until I do some research or ask someone here. (thanks again Yorksman) But seeing your levels is clear enough and we all should know. I can't believe you are practically being told not to bother trying with your condition D:


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I would not be so bold as to tell you what your GP thinks or does or what their his/her motivations are. You stated quite clearly that your GP was adamant that you should NOT get a meter. That is not the same as your doctor refusing to give you one. Your GP is also correct in saying that bG readings can be confusing and can lead you to become neurotic about it. If your GP is miserly why did he/she not say 'buy your own' or did they? There is nothing to stop you from buying your own meter. If you do, try to avoid getting umbilically tied to it. Your GP will be far more interested in HbA1C readings than your charts and not just for monetary readings. For the record, I am not associated with anyone in the medical profession so I am unbiased.
 
gezzathorpe said:
I would not be so bold as to tell you what your GP thinks or does or what their his/her motivations are.
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The opening post was about feeling crushed by the dismissive attitude of the GP. You've got ten minutes, it'll get worse, read these papers. It's not a good approach. It lacks basic humanity.
 
Thanks to everyone who has made a comment, every one is so constructive as opposed to the destructive GP. The cost of the strips to test my BG seems worthwhile compared to the value we'd all place on extended life and not ending up with a stroke or a heart attack. Out of the 10 minutes the GP was prepared to invest if she had just taken 10 seconds of it to say " well done" on the big leaps downward on my hba1c. Never been sick before plus my brother was a 'missed diagnosis' case for several years even though he was back and forth to the nurse weekly to treat a foot wound that just wouldn't heal. By the time they'd tripped over a random thought that he may be diabetic the visit to A&E saw a decision to amputate his foot, he went on to lose the other leg and it got him in the end and he died 2 months ago, I suppose that's the reality check for me it hit me like a train and thinking deeply about the fact this is not an illness to be messed with. For the first time I feel I'm in the right doctors consulting room right here, other peoples experiences and years of their personal research that is so willingly shared is absolutely priceless, kind wishes to all, Q


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gezzathorpe
IMHO It is all about bullying, The GP is inflict his opinions on the patient.
 

I don't respond to threats. I simply answered a statement which I clearly quoted in my response, so it should be quite clear to whom I was responding. I also took the trouble to read the quote carefully, rather than to put my own 'spin' on it. If I am guilty for that, then sobeit.
 
gezzathorpe,
Am I missing something?
Yorksman comments on the GP's attitude and how it lacks humanity, and you see a threat to you in the comment. Where?
 

Yes, threat!! You've got ten minutes, it'll get worse...at least that is what appears to be in your blog but maybe that is not what you meant. It's not for me to interpret.
 
I see where you interpreted this as a threat, I see poor punctuation.
But you say "It's not for me to interpret" and you do.
 
I think your GPs attitude is appalling, in particular the idea that's testing your own blood will just confuse you. What a patronising thing to say! If my GP said that, I would definitely be looking to change practice straightaway, but then I must admit I am very lucky with my GP.

I would definitely be in the camp that would urge you to buy your own meter, as it sounds like your chance of getting one from your GP is Zero. My recommendation, unless money is not an issue at all, would be to buy the codefree meter from Amazon. It is not really the meter that costs money, indeed you can often get them free from the manufacturers, it is the strips. It is quite common for a pack of 50 strips to cost £25-£30. The Codefree strips are £6 for 50, free P&P. I have a Codefree meter in addition to my prescribed meter. The code free reads consistently about 1mmol/l above the other one. This really does not matter at all. It is the trend that matters, and in particular the amount that any meal makes your blood sugar rise, two hours afterwards. You are aiming for a rise of no more than 2, and a maximum level of no more than about 7.8.

So initially, you will need to test both before and after meals. Quite soon, you may well find that you can skip the pre-meal test, if your levels are always fairly consistent. I also don't bother testing after breakfast, because I always have pretty much the same thing. But for now you should test, note the results, and adapt your eating accordingly (otherwise there's no point!).

Please don't be too downhearted or discouraged. I have found adapting to a low carb diet much easier than I thought, and enjoy the testing and watching the levels come down. And through testing I have also found things that I can eat that I wouldn't have thought would be ok, so that's nice.
 

The reference is to the opening post as stated. An ad hoc mining of any thread can lead to all sorts of spurious inferences but it serves no purpose to repeat every point raised in every post. One has to assume the reader is familiar with context. I am nt the only person to have condemed this particular GP's attitude but I have also pointed out that they are not all like that.
 
May I firstly say what a well dressed post this is; with all those suits, black ties and kilts...

As to the GP they are meant to be providing a service; if you were paying directly for their advice I'm pretty sure you'd have fired them by now. Because the NHS is free at the point of use doesn't mean we should be treated like naughty children wasting the good doctor's time when we attend. You mustn't know what's happening because you'll get confused?!!

The simple practicality of this is that it's madness that any diabetic should guess what their blood sugars are doing; you have to know what happens when you eat food and you have to know what foods to avoid; you can only reliably do that by checking your blood sugars before and after eating. To do that you need blood testing equipment.

The most effective way of reducing blood sugar swings would be to reduce your carbohydrate consumption to a point where your blood sugars are normalised but to find that point you'll need to be testing.

A good example of all this is that lots of people, dieticians, GP's DN's all like to say what a healthy food porridge is; I find, and many others I know do too that a bowl of porridge will send blood sugars through the roof; will that be the case for you? You can't tell unless you test; a 6 month or 3 month HbA1c will shed no light on it.

Read, test, ignore your GP, take control.

All the information is here.

Best

Dillinger
 
If only testing were as simple as some make it out to be...

I for one eat meals which are comprised of a number of different foods. If I were to test afterwards I wouldn't know which of the foods had spiked me. So to understand what actually spikes me I would have to eat single item meals e.g. just rice, and then test or just carrots, and then test.

This is madness as when those foods are recombined they actually have a different effect in combination. So then I would have to test every combination - more madness. Furthermore, I could test one type of potato and find a one reading and then another type of potato and get a different reading. Then there's the way its been prepared - a raw carrot is going to be different to a boiled one which will be different to a roast one. So I have to test every variety and every preparation method . And then each of these will react differently when combined with other foods cooked in a variety of different ways. Whatever anyone else says it is impossible to accurately predict what will spike you, and this is why doctors say BG testing is so confusing.

I'm not a dietician, but I'm not scientifically inept either. For me, I believe the best method is to avoid those foods which convert to sugars i.e. avoid carbs as much as possible and have the lowest GI carbs you can and do plenty of exercise to improve your insulin resistance. These changes have been shown to improve Hba1c readings. True there may be spikes along the way but that will also be true for people who test.
 
Dillinger said:
May I firstly say what a well dressed post this is; with all those suits, black ties and kilts...
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At least no clichés about flat caps, whippets and black puddings

Yorks
 

I think this is a glass half full/glass half empty matter. Yes, of course each meal is going to consist of various different foods. I personally try to keep the majority of the foods I eat as low carb as possible, and generally it is the overall effect of the meal that I am interested in. If I were to have a huge spike after a meal, I would then take a closer look at the meal to see what the culprit might have been. But to be honest, I am unlikely to be eating more than one thing that may be a bit
high carb per meal. So if for example I spiked, as I did, to 8.8 after a meal consisting of salami, olives, and a slice of French bread, it was pretty clear that it was the French bread that was the problem. I haven't eaten it since. Conversely, if I know that a roast Sunday dinner consisting of meat, gravy, vegetables, one roast potato, and a Yorkshire pudding, will raise my sugars to around 6.8, I can live with that, and I don't really care which of the individual ingredients did that. That's what I eat when I have a roast dinner, and I will stick with that. Similarly, if I know that a meal from the fish and chip shop, consisting of a small battered cod and six chips, will raise my sugars to 8.5, then I won't be having it again. That is all I needed to know.

If anybody can explain why a square of chocolate fudge Rocky Road cake with biscuits, marshmallows, and glace cherries, doesn't raise my blood sugars at all, at any point, on three separate occasions, I would be very grateful! It freaks me out a little bit! And it is taking a supreme effort of will to not eat more of it
 
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