Proffesionals or Fellow diabetics??

Hey JConnor!

It depends. The best advice I've had has been from fellow diabetics - but the worst advice I've seen has also been from fellow diabetics! Obviously the advice from people on forums is very variable and can be downright dangerous unless you do your own research and apply your judgement. Having said that, I have had some shockingly-bad advice from diabetes nurses, doctors and especially the dreaded NHS dietician :evil: I've also had some very good advice from a diabetes consultant. I take the view that I'll listen to everyone's advice politely and then make up my own mind how to manage my diabetes.

Smidge

I very much agree with Smidge. I'm fortunate in that our practice has a Doctor who has specialised in diabetes and has been very supportive of some of my (well researched) choices. On the other hand he's a bit 'preventative medication' happy for me. And ultimately the advice (and path) that I follow wasn't supplied by them, I had to go and find it by myself and then do a lot of follow up reading and listening to people's opinions on sites like this before coming to my own conclusions. There has also been an element of 'trial and error' too in order to find out what works for me.

Basically it's dangerous to swallow anyone's advice whole until you've looked at it objectively and done some further research - but that's hard because it takes time and effort. Gone are the days of 'doctor knows best' but I also wouldn't discount what they have to say without applying the same amount of research that I would to something that someone said on here. It's tough when we all want a 'quick fix' to what ails us and to follow the path of someone who says that their way has had huge success for them. We're all a bit different inside so even if the advice is great you still need to work carefully to ensure you apply it in the best way possible to yourself.

The biggest downside of some of the medical professionals I've spoken to is an unwillingness to accept that perhaps I know my own body and reactions better than they do!

JConnor said:

Who do you trust more ?

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Most GPs are not 'experts' Neither are the DNs. The experts are those guys who publish in the peer literature, but you don't get to talk to them. My DN is keen to tell me that she has a diploma and my GP is keen to tell me that he went on a diabetes course where they sent them for half a day reading labels on foodstuffs in a supermarket. My DN also does the flu jabs in winter and my GP also does things like hand out prescriptions for exzema. They are not specialising in any particular field. By necessity, they assume you have no knowledge but they don't have the time to 'educate you'. They are forced to give you bite sized chunk of, often inadequate, advice.

A couple of weeks ago I went for a belated Christmas dinner with a bunch of biomedical scientists from the local hospital, primarily drawn from the Haematology and Biochemistry labs. The difference in knowledge between blood sciences and general practice is staggering, not just on diabetes. As smidge writes, he has had good advice from a diabetes consultant. As you learn more yourself, you start to be able to judge the quality of advice that you are getting.

There are some doctors who dont seem to know much about diabetes, there are also some truly dangerous individuals posting on internet forums who regularly give bad advice and back it up with anecdotal evidence, the problem is no one can know for sure whether what they say is accurate or indeed actually what they are really doing or just a load of bull that they have read somewhere else and simply repeated to make themselves look important, there are many internet experts and they are generally best ignored.

I received some great advice here but have also read a lot of garbage too, I have generally managed my diabetes by discussing what I have read here and elsewhere with my doctor before making reasoned and educated decisions.

Doctors dont know it all especially GP's who by there very names are "General" Practitioners so I would not expect them to be experts in all things. Neither would I trust anything that I read on the internet without doing some research and consulting an expert or at the very least my GP whos opinions I value.



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I take the view that I'll listen to everyone's advice politely and then make up my own mind how to manage my diabetes.

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+1 for that

More difficult to judge is the "Agenda" of the person you are taking that advice from. GP's and DN's have policies, directives, targets, budgets which they are forced to consider in the round, even if this means as an individual you don't get the best possible care. As a taxpayer I understand perfectly, as a diabetic its frustrating.

I trust experience over education everyday of the week - and I am willing to try (almost!) anything to gain that experience.

I trust fellow diabetics more but the most i trust myself and my meter Advice from more experienced people is always great but I need to test it by myself and then see what works for me. Proffesionals Ive met so far are :thumbdown:

I would have to say a bit of both, as my diabetes care is mainly under the hospital diabetes team I do value their their input and guidance, there's never been a time where they ignored a request to meet me or failed to return a phone call so it would be unfair to call them.

Self-education is important and reading and learning from fellow diabetics has been rewarding since taking to the Internet and this forum, as much as everyone else has said there's been some fantastic advice given over the years but there's also been some shocking advice too, it's up to the individual to decipher the good from the bad and not make any rash decisions in the heat of the moment.

So there you are JC, a bit of both from me!!! One thing is for sure that we never stop learning with diabetes and we can learn as much from someone who's only been diagnosed 6 months than we can from someone who's been diagnosed 30.40 or 50 years.

Good thread btw

noblehead said:

I would have to say a bit of both, as my diabetes care is mainly under the hospital diabetes team I do value their their input and guidance, there's never been a time where they ignored a request to meet me or failed to return a phone call so it would be unfair to call them.

Self-education is important and reading and learning from fellow diabetics has been rewarding since taking to the Internet and this forum, as much as everyone else has said there's been some fantastic advice given over the years but there's also been some shocking advice too, it's up to the individual to decipher the good from the bad and not make any rash decisions in the heat of the moment.

So there you are JC, a bit of both from me!!! One thing is for sure that we never stop learning with diabetes and we can learn as much from someone who's only been diagnosed 6 months than we can from someone who's been diagnosed 30.40 or 50 years.

Good thread btw

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I have to agree here noblehead :wave: I think it's experience, understanding your own body, mangement and requirements and advice and support from your diabetes team. Knowledge is powerful and I, for one, am always learning. My signature says it all and also go with your'gut' instinct. A good subject to discuss :thumbup:

Best wishes RRB

Most GPs are not 'experts' Neither are the DNs. The experts are those guys who publish in the peer literature, but you don't get to talk to them.

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Those experts make the NICE guidelines that your doctor bases his decision on - e.g. if he recommends statins then that is because the experts have concluded that statins are a good idea for people like you based on all the available evidence.

Personally I'm am extremely weary of the self-selection bias inherent to "crowd wisdom", in particular online; given the large number of diabetics, you're bound to find lots of people who are successful on some regime by pure chance. When in doubt, I'd believe the experts.

Hi AMBrennan.

Those experts make the NICE guidelines that your doctor bases his decision on - e.g. if he recommends statins then that is because the experts have concluded that statins are a good idea for people like you based on all the available evidence.

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Yes, but quite a few GPs as we have seen from postings on the forum do not take proper notice of the NICE guidelines and do not keep up to date. It must be difficult for GPs to keep up to date in all of the vast number of areas of medicine they cover. As a result you can't just assume that your GP is representing the expert's guidance. This is why I quite often quote the NICE guidance in my postings on this forum so readers can reach the experts and be able to challenge their GP if they suspect the advice is not correct. I've been reading forum postings now for a few years and it becomes quite easy to ascertain what is good concensus advice and what is a bit off the beam. I agree newbies may find it difficult at first to know what info on the web to trust; but it's the same for that newbie when they see their GP diabetes 'expert' for the first time.

AMBrennan said:

Those experts make the NICE guidelines that your doctor bases his decision on - e.g. if he recommends statins then that is because the experts have concluded that statins are a good idea for people like you based on all the available evidence.

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Well it was the cardiology consultant who prescribed atorvastatin which my GP went along with, until the new GP came and switched to simvastatin, a cheaper statin.

"NICE quality standards are a set of specific, concise statements that act as markers of high quality, cost effective patient care, covering the treatment and prevention of different diseases and conditions." They select what they feel appropriate from the peer research which is considerably broader in scope and more detailed in depth than any advice given to GPs. It is nothing more than a subset.

To quote one article from Diabetes Journals:

"Before addressing glucose and A1C, it is important to consider the factors that impact the results of any blood test.While laboratory medicine journals have devoted some discussion to the sources of variability in results of blood tests, this topic has received little attention in the clinical literature."

(A1C Versus Glucose Testing: A Comparison. Diabetes Journals 2011)

Daibell said:

Yes, but quite a few GPs as we have seen from postings on the forum do not take proper notice of the NICE guidelines and do not keep up to date.

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The doctors in hospitals sometimes don't follow their own protocols as any cursory glace at the Clinical Incident Reports will confirm. And those are just the ones that do get reported. They hate whistle blowers.

Failings at every level with 290 recommendations for reform at the Staffs Hospital ought to be a warning that people don't always do what they are supposed to do.

Interesting thread guys.

I agree with a lot of the statements said by you all. Myself I probably trust what I've learned over the years with the help of my mum, she took it all on as I was only a child. I was lucky to have her explain it all to me in english once I was old enough to start taking care of myself. I think I would come to you guys first and trust your advice before presenting the question to my DSN or consultant at the hospital. My GP is very good but as mentioned previously we all agree that they are not diabetes specialist GP's so I do tend to ignore there words of 'wisdom'.

I think that we are all different in our routines and our own management of diabetes that the best thing to do is to soak up as much knowledge from fellow diabetics and find out what works best for you.

JConnor - I've had diabetes for 16 years and still want to punch non diabetics that tell me what to do!! It's so annoying! The other day I got told off for eating a yoghurt because apparently diabetics aren't allowed that! I smiled and walked off!