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Oh dear, lack of faith in the system sometimes

HSSS

Expert
Messages
7,675
Location
South of England
Type of diabetes
Type 2
Treatment type
Diet only
Yesterday I had the dubious experience of an ambulance ride to hospital for non diabetic issues (fortunately scary stuff ruled out and I’m home). All hcp were great at looking after me on this issue but it has also identified a few more worrying things that I’m grumpy enough due to pain to whinge about today.

First the paramedic taking my history was surprised as a T2 diabetic I wasn’t on insulin. Do they really all think every diabetic is on insulin? What do they teach them?

Then today I was notified via the hospital records app of my discharge note. In taking a look at that I noticed the last hb1ac I had a few weeks back was resulted twice on consecutive days. With different results !

So I message my surgery, that has only one result, explaining and asking about the duplication and what had happened. I just got a text back from a dr just giving me the result they have and telling me 45mmol is in the diabetic range but not too bad! Last time I checked it was prediabetic and diabetic range starts at 48 and better than many t2. Worrying he doesn’t seem to know this and that he also totally failed to comprehend the request. I’ve had to repeat the message trying to get to the bottom of the duplicate results as he failed to answer the question actually asked or doesn’t care about inaccurate results
 
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Hi. I'm flabergasted that the paramedic thought T2s would always be on insulin. One or both HBA1Cs may have been done using the high speed ward tester that takes about 20 minutes and I suspect gives a less reliable reading than the standard one. As your HBA1C results are very good I wouldn't worry about the duplicates.
 
Reactions: ert
My cousin is now doing a degree to become a fully fledged paramedic but there are several steps of qualification in this profession and most of his jobs involving diabetics probably did involve too much insulin or too little. But yes it is surprising that for a condition affecting 7-8% of the population, that the differences in treatment aren't better known.
Don't have any faith in the system but have faith that the doctors et al are trying to do their best and hopefully are open to learning from their patients.
Never understood why the arbitrary pre diabetes classification for an hba1c of 42-48 which is essentially diabetic though I guess it is a threshold for drug treatment.
 
Well painkillers are working and I’m less grumpy now.

Investigating the hb1ac I’ve found that one is a misdated older result on the summary page with the correct date elsewhere in the system. So an IT error. Doesn’t explain the first GP thinking 45 was a “not bad” for someone not on meds or at “diabetic levels”. The second gp was much more positive in that it was a “very good” result. Perspective and opinions on the same result for the same patient eh?

so three small increases in a row for me now
 
Not all ambulance crews are paramedics regular ambulance crews may not have as much knowledge

Also a lot of GP’s aren’t very knowledgeable either

Paramedics again need good general knowledge of things that they can encounter.. but may not be very good with specifics of certain illnesses… but would be good with the extreme issues like hypo or dka which is what they are more likely to deal with in an ambulance
 
Yes indeed. I have forty years experience of living with this condition and I have found that more GP's than less have just a very basic knowledge of the condition. I never try to get too worked up with what they state regarding my Diabetes.

A GP is a jack of all trades but master of none. Not saying there are no fabulous ones out there. My surgery has many fantastic GP's but if they were all Diabetes Consultants then they wouldn't be GP's! (and some Consultants are not great either!)

I remember a poster at my Diabetes Clinic (St Mary's Praed Street) many years back and it stated "Be more an expert on your Diabetes than your Consultant" I've always remembered that..
 
I work in healthcare and I'm always educating other nurses and healthcare staff about diabetes. Healthcare staff only have general basic knowledge of most illnesses/diseases. That's what specialists are for and they don't always not a lot. It's not always about their knowledge but how they practice.
 
I appreciate that specialist are there for a reason. But there’s basic and there’s basic. I was just surprised how little the paramedic knew and that a gp that presumably diagnoses Patients with diabetes didn’t appear know the levels relevant to that.
 
Could the GP have possibly been trained in another country as I know different countries have different levels at which diabetes is classified?

Even more alarmingly those levels are set based on average bg across the population and as more and more people get diabetes that average will go up. I think USA is due a review soon and there threshold is expected to rise
 

I'm just amazed you only lack faith "sometimes".
 
I have to agree- my faith in the medical profession has taken a battering. Not because they don't know much about diabetes particularly type 2 but because my doctor has no interest in why my levels are now so good and therefore will not educate herself. This is very sad as that means her other patients have so much less chance of controlling their levels and stop it being progressive.

I am a lawyer- I am always interested in other lawyers or clients approaches to issues- I can always improve or learn. I am just sad that my doctor isn't like this. It has made me decide to change doctors- not necessarily easy but something I need to do.

I don't expect any doctor to know everything but I do expect them to be interested and excited if someone is dealing with a problem in a way that has unexpectedly good results.
 
HCP's are like a box of chocolates, you never know what you're gunna get.


Glad your feeling better!
 
bulkbiker said:
I'm just amazed you only lack faith "sometimes".
Click to expand...
Yeah the list of mis diagnosis, either completely or partially, is long for me. Some more worrying than others.

But hey they still save a lot of lives and in the main are trying to do the right thing so I try not to be too down on them all the time. Especially right now when so many hcp particularly in hospitals have worked themselves to the bone mentally and physically over the last year.
 
I reckon we know so much about our own T1 or T2 that we can, in moments of stress, be astonished at how little others know. However, I always give great respect to any medic who says they don’t know something rather than try to bluff their way through for the sake of it. I suspect, too, that the most frequent users of emergency medicine will be people whose insulin use denotes either more vulnerability regarding complications or the awful situations that occur through hypo or hyper glycaemia.
 
Yes others in general, but we are not talking about members of the public. We are talking about people (especially gp’s) that should know this basic stuff.

I totally agree I’d rather a medic told me they were not sure and would check than be one who bluffed and bull’ed me. Honesty goes a very long way. It is possible to be reassuring and professional without lying or guessing.

Whilst I agree diabetics that encounter emergency medicine may have complications from bgl they equally could be experiencing A&E for non diabetic reasons, both still require a little general, accurate, knowledge of the condition so I’m not quite sure of the excuse you seem to be providing here.
 
Some of the best Doctors in LC had a patient experience, asked them what they did, and then have gone on to treat and change the lives of 1000's of others. Imagine the ripple effect that has had on families.

Doctors, diabetic nurses and the like who can't be ....to be intrigued miss opportunities to save lives or alleviate misery.
 
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