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Newly diagnosed - and very frustrated!!

Discussion in 'Diabetes Discussions' started by julie54, Jun 16, 2013.

  1. julie54

    julie54 · Well-Known Member

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    At age 58, I took the opportunity of going for a free health check at the G.P's, and was totally shocked to be told that my blood levels were high and that I was type 2 diabetic! Had had no symptoms and had always felt well - so a total shock! However, was also a shock in the almost flippant way the news was given to me. I was told to come to see Nurse and given an appointment for 2 weeks time - which seemed an eternity away with all of the confusing thoughts I had! I insisted on somebody talking to me and so was eventually phoned by the nurse that afternoon, who said she would leave a prescription and some leaflets! No discussion about diet etc, and when I questioned this, she said that it was the practice policy to put all newly diabetics and people with pre-diabetes straight onto medication. As I am overweight and always have been (despite the plethora of diets over the years!) I wanted to know if losing weight could assist in managing/reversing the diabetes. I went to see a G.P. last week who was adamant that I should take the medication and would not even enter into a discussion about diet first as an option. I again found this confusing, as the medication which I was given states that this would have been prescribed when diet and exercise have failed. She was not at all supportive of my not taking the medication. She also would not give a blood monitor, stating that the local Trust will no longer supply these. This may sound as though I am being arrogant in not following the route of medication, which is not the case as I do generally respect the advice of G.P's, but would have appreciated the opportunity to at least try diet and self management before taking tablets. I wondered whether other newly diagosed Type 2's have also found that the medical approach is purely to give medication?
     
  2. BobCornelius

    BobCornelius · Well-Known Member

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    Welcome to the forum, Julie!

    I have heard that a lot of GP Practices go for medication first and foremost, but that does not mean you cannot control using diet alone! Diabetes medicine, in my experience, takes place over a long time, so no surprise about a two week appointment!

    There are some great people here, who are very knowledgeable, and can offer all kinds of help and support!

    :)

    Bob
     
  3. charon

    charon Type 2 · Well-Known Member

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    Hello Julie54,
    I was in a similar situation but asked for an earlier diabetes nurse appointment and got one the following day.
    All that was suggested was that I should stop eating chocolate and jam and eat weetabix for breakfast.
    They did give me a monitor though and I used that before and after every meal rather than once a day they suggested.
    Fortunately I soon found this site and changed my diet completely and exercised.
    At the next meeting in a couple of weeks they looked at my record and said I was doing fine - no medication, come back in 3 months for another test.
    I would suggest getting a monitor so that you know what is going on, cut down on carbs and exercise - low stress like a walk in a park.
    Record everything you eat and readings so you have something to discuss at the next meeting.

    Ask them about side affects of the medication and whether it would be better not to take it if possible.
    Ask them why, if it is so good, they don't suggest it for non-diabetics just in case.
    They will probably say that diabetes is progressive and you will eventually end up on insulin - probably true if you don't change and rely on medication.

    Of course there may be something they have detected that indicates medication but I would question why that should be the first option.
    And ask for a print out of your results so you can see what's going on.
     
  4. pav

    pav Type 2 · Well-Known Member

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    Welcome to the wonderful world of the type 2 post code lottery of care. Daisy will be along shortly to post some useful information.

    Did the doctor or nurse say what your levels were? If not I would ask for them as at least you will have a starting point reference.

    They should of referred you to the podiatrist for an annual foot screening clinic, along with a referral to the hospital for an annual eye screening (photo's of your eyes).

    You are also entitled to free eye tests at your opticians and free prescriptions (prescriptions free as long as you are on meds), both of these you will need a form/s which the doctor has signed.

    With attitudes like that from your nurse and doctor I would be looking around to see if there is an alternative GP practice. Though on this when I looked around the ones that were taking on patients did not have a good reputation and ended up staying put, and put in complaints about their lack of care and treatment.

    With regards to the meter these are not a prescription item and the GP practices that issue them have been given them by the suppliers, or have struck a deal with a particular company so the practice can get the strips cheaper. You can normally get a free meter by ringing up the suppliers like Bayer, Abbott Medisense, Life Scan, Accu Check etc. They will go through a few questions to see which meter they offer you or to see if you qualify for a free one. Have a look at their web sites see which meter you like the look of, some meters are reserved for people on insulin though they may well offer an alternative.

    The next problem is getting a prescription for the test strips as again being type 2 its down to the post code lottery, though as newly diagnosed you should be offered the chance of getting the means to identify what food/s react with you. It not a straight forward to say cut out sugar as different things affect different people in different ways.

    If you have to self fund your test strips and want to test, some suppliers you can buy the strips at a discounted price compared to what you pay at the chemist. There are a few cheaper meter / strip options for self funders like the SD code free or the supercheck2 system. Have a search on the for comments on these meters.

    Next is diet, this is my weak area and still working things out. Sugar itself should be cut out ie in tea coffee, with me my main problem is white bread and any thing made from white floor. Also granary bread affects me a lot as well, yet decent wholemeal bread is ok. There are plenty of food experts on here who can offer good guidance including the low carb option.
     
  5. daisy1

    daisy1 Type 2 · Legend

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    Hi Julie and welcome to the forum :)

    I hope that this information that we give to new members will be useful to you. Carry on asking questions and you will get lots of help from more experienced members.


    BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

    Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

    A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find well over 30,000 people who are demonstrating this.

    On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

    The role of carbohydrate

    Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

    If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

    The bad news

    Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

    The good news

    People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

    Controlling your carbs

    The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
    There are two approaches to controlling your carbs:

    • Reduce your carbohydrate intake
    • Choose ‘better’ carbohydrates
    Reduce your carbohydrates

    A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

    The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

    Choosing better carbohydrates

    Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
    http://www.diabetes.co.uk/food/diabetes ... rains.html

    The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

    Read more on carbohydrates and diabetes

    Eating what works for you

    Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

    To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

    The blood sugar ranges recommended by NICE are as follows:

    Blood glucose ranges for type 2 diabetes
    • Before meals: 4 to 7 mmol/l
    • 2 hours after meals: under 8.5 mmol/l
    Blood glucose ranges for type 1 diabetes (adults)
    • Before meals: 4 to 7 mmol/l
    • 2 hours after meals: under 9 mmol/l
    Blood glucose ranges for type 1 diabetes (children)
    • Before meals: 4 to 8 mmol/l
    • 2 hours after meals: under 10 mmol/l
    However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

    Access to blood glucose test strips
    The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

    • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
    • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

    Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

    You may also be interested to read questions to ask at a diabetic clinic

    Note: This post has been edited from Sue/Ken's post to include up to date information.
     
  6. julie54

    julie54 · Well-Known Member

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    Thank you for the replies and support!! I can see that this is going to be the place to go!! Just to further what I previously wrote - when I was told I was type 2 diabetic - and then given the two week wait to see/speak to somebody - I resorted to looking at the internet for information and through these threads found information on the Newcastle Diet. Apart from scientific research (albeit a small study) there seemed to me to be a sense of logic and common sense about the diet and the effect on type 2 diabetes. As I said, I am overweight and so it was the next logical step for me to commence the diet - as losing weight can only be a good thing - diabetic or not diabetic!! So this is what I did and have been doing it for 2 weeks. It is hard going - but the situation now is clearly that not only do I want to lose weight - but there is a NEED to do so!! When I did see the G.P., I asked if she had heard of it, and she hadn't, but I had printed off the 'information for doctors' sheet for her. This made no difference in her stance of medication as the preferred option. With regard to the monitor, a friend who is also type 2 loaned me his and so I had been able to check them myself over the course of the first week (his Nurse gave him a monitor!!). At my blood test at the doctors, my blood was 19.4 (I know - horror!! and no symptoms!) I charted my blood results over the week which came down to 10.3 initially, then progressively down to as low as 5.4. Now I know that this is of course because of the diet, which involves shakes/vegetables and absolutely no carbs (proteins are in the shakes) - but even though I showed the results chart to the G.P. she dismissed them as being because I had been on the diet - and then refused to give me a monitor of my own. As I say, I am not arrogant, not opposed to medication when necessary - but would have appreciated a more flexible response - even to the extent of just to see how things go over the next few weeks. Having obviously been an undiagnosed diabetic for some time (who knows how long?) - another few weeks were not going to be detrimental to me - and then if meds is the only route, I would of course go with it. So I feel as though I shall just carry on alone without G.P./Nurse support, and look after myself! I will also buy a monitor! But thank heavens for these forums, where it reassures me that I am not alone!! I would rather try diet and fail, than not try and never know.
     
  7. Daibell

    Daibell LADA · Master

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    Hi. I'm afraid you have come across the more arrogant and ignorant of the NHS 'professionals'. Many on this forum have had similar problems. Fortunately my current surgery isn't too bad with an excellent DN. You should have been given the opportunity for perhaps 3 months to go diet only as I was. As Metformin is a good safe drug and I suspect that's what you've been started on I wouldn't worry too much as it does help with insulin resistance in the overweight. Keep going with the diet and if you set your carb target low enough your weight and blood sugars should come down. Your surgery will, of course, say any improvement will be due to the medication. Metformin only makes around 1-2 mmol improvement in blood sugar readings so any other improvement will be due to diet. If you have been started on statins you may elect to refuse these; it's your choice. They have nothing to do with diabetes as such but the mantra is that most diabetics are put on them to keep the blood thin. There are pros and cons but they are not a diabetes drug.
     
  8. julie54

    julie54 · Well-Known Member

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    Thank you Daibell!! The irony was that having said to the G.P. that I wanted to pursue the diet option first rather than go straight onto medication, she quite sternly just wrote on my notes on the computer that I was refusing to take the medication and was following diet by choice - and them promptly gave me a prescription for statins! I do have metformin but they to date remain in the box - so any improvement in bloods cannot be attributed to them! Having said that, she refused to give me a monitor, and so I have borrowed a friends until mine comes in the post, having had to purchase it myself. I am not saying that I know better than my Doctor, but I do feel the meds route should be tried after diet fails - which is actually what it says on the metformin leaflet! Oh - to have been given the chance! My philosophy in life has always been to at least try - and fail - rather than not to try at all! I have been doing the Newcastle diet for two weeks, which I aim to try for a few more weeks (8) and then look at continuing to lose weight by introducing foods but low carb. (maybe have one or two meals with shake replacements and evening meal with food. I must admit I look forward to that - this diet is hard, but will hopefully give a good start! Thank you for your reply and support.
     
  9. lrw60

    lrw60 · Well-Known Member

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    Hi Julie,

    I was diagnosed type2 several years ago. Two years ago, aged 58 I went on a diet, not particularly low carb, I didn't know about such a thing, mine was the Weight Watchers diet. Any way, two years and 5 1/2 stone weight loss later I no longer have to take medication for the diabetes. Losing weight was the best thing I ever did for my diabetes, the second best was finding this site! I don't 'do' vigorous exercise, just good old fashioned easy walking.

    Lee
     
  10. julie54

    julie54 · Well-Known Member

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    Thank you Irw60! What a wonderful set up - these forums are!! Felt really alone with this problem initially - it came out of nowhere - as I am sure it does for everybody!! That'll teach me for going to the Doctors for a bit of an MOT health check!!! Went in feeling great - came out in tears with having been told I have diabetes!! And this was further compounded by a G.P. who wouldn't listen to me!! Of course I am not totally adverse to medication - 12 years ago I had cancer and consequently chemo, one of the most toxic drugs out there. I had no hesitation because this was a situation of necessity rather than choice. On the other hand, I do strongly believe that medication for diabetes should not be the option for me when diet/exercise has failed. But I know I am in my G.P's bad books now - stubbornness comes at a price!!
     
  11. julie54

    julie54 · Well-Known Member

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    Sorry - just read that back and what I meant to say was that medication[SHOULD BE an option when diet/exercise has failed!
     
  12. charon

    charon Type 2 · Well-Known Member

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    Remember, your GP might know more about medicine but you know more about you and you can spend a lot more time on the subject.
    I suspect a lot of people can't stick to a regime and for those medication is the right option.
    I think GPs assume that either that will be the case or that sticking to a diet reduces your quality of life (for me it is the opposite).
     
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