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Questionable GP Knowledge & Advice

Jamesuk9 said:
One way of looking at it. From his own testing it's clear he has impaired fasting glucose, that in itself is meaningful and requires attention. It is after all a precursor to T2D.

Some would say it would be foolish to ignore and carry on as normal regardless.
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It's clear that one particular meter, with one particular batch of test strips, gave that result, on those particular days.
 
Bluetit1802 said:
I have also just noticed your age, from your profile. You should be invited for an MOT, which these days includes an HbA1c. Maybe you had one when you were 60, but they should be repeated every 5 years, more frequently if there is something suspicious. Has this not happened with you?
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My husband and I have never been invited for an MOT not when we were 60 or any time since and I am 77 and my husband is 84. Seems it is not routine everywhere
 
Jamesuk9 said:
In my experience, I find the accucheck mobile to be the most accurate of meters I have tried and my fasting numbers correlated with a venous blood sample analysed in a lab. 6.7 fasting on meter and 6.7 on lab test.

On the other hand, my Sd codefree is always 0.5-1.0 higher than the accucheck.

I was also told I'm not diabetic based on an hba1c of 5.6 (38) by my gp and that they would test again in 12 months. No amount of protesting changed the doctors mind. I think they just see me as a hypochondriac.

What is very clear though is that despite my doctors insistence, I do have glucose tolerance issues, just not at full blown T2 levels yet.

I have made significant inroads to my fasting numbers with LCHF and now sit between 5.0-5.5 most mornings, however if I fast for 12 hours or more it will always rise to over 6 and sometimes closer to 7.

I have accepted what my do tor has said but applied my own due diligence and applied lifestyle changes before it becomes a bigger problem as through talking to people they are all very happy to confidently say don't worry you're aren't diabetic and then allow you to carry on as normal and then drop the bomb in subsequent annual tests without ever mentioning that you are higher than normal and need to pay attention.
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In fairness to your GP he is correct as an hba1c of 38 is not diabetic - pre-diabetes is between 42 to 47 and diabetes is over 48. The main thing is that you are aware of the issues an incorrect diet can cause and are acting accordingly thus, hopefully, avoiding diabetes.
 
Gadget_man said:
A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes.
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This is from Diabetes.co.uk

Non-diabetic* 4.0 to 5.9 mmol/L under 7.8 mmol/L.

So that ties up with what your GP was saying, sounds like she's sending you for an HbA1c anyway, a test that you can do yourself.

https://www.amazon.co.uk/d/Diagnost...1c-Diabetes-Monitoring-10-Test-Kit/B00FNZJJIG
 
Pinkorchid said:
My husband and I have never been invited for an MOT not when we were 60 or any time since and I am 77 and my husband is 84. Seems it is not routine everywhere
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It isn't applicable now because you are a diagnosed diabetic so are now under that care pathway. You should be getting the same health checks as those on the routine MOT.

It is the responsibility of your local authority to put this in practice, as stated by NICE. It has been in operation many years, initially for over 60's, and since 2014 for the over 40's. It was this MOT that discovered my diabetes or I may never have known until it was too late.

https://www.nice.org.uk/advice/lgb15/chapter/introduction

One paragraph from that NICE page says:

Key messages
Successfully implementing NHS Health Checks may help reduce chronic illnesses and avoidable premature mortality, as well as the health and social care costs related to long-term ill health and disability.

The Local Authorities Regulations 2013 set out legal duties for local authorities to make arrangements:

  • for NHS Health Checks to be offered to each eligible[1] person aged 40–74 years once every 5 years and for each person to be recalled every 5 years if they remain eligible

  • so that the risk assessment includes specific tests and measurements, as well as to ensure the person having their health check is told their cardiovascular risk score and their other results

  • for specific information and data to be recorded and, where the risk assessment is conducted outside the person's GP practice, for that information to be forwarded to the person's GP.
Local authorities are also required to seek continuous improvement in the percentage of eligible individuals taking up their offer of NHS Health Checks. Further information on these provisions is provided in the NHS Health Check Best Practice Guidance.
 
Thanks for the reference info Bluetit1802, I hadn't previously registered that this 5-yearly review is a duty of the Local Authorities under Public Health arrangements, and not the NHS. That does seem to be a rather odd arrangement for the Government to make since Public Health and NHS services have been separate for donkeys years. This explains why I have never been called for a review by my current or previous GPs (they are not required to do it) - I have absolutely no expectation of my local authority ever doing anything about it for those 40-74yr olds, legal requirement or not, and I would have to question whether it is within their capability or competence to do so. They may be able to cope with organising checks for schoolchildren, but would, I'm sure, have to enlist the support and probably services of school nurses.

Perhaps I've got hold of the wrong end of the stick completely o_O :confused:
 
Salvia said:
Thanks for the reference info Bluetit1802, I hadn't previously registered that this 5-yearly review is a duty of the Local Authorities under Public Health arrangements, and not the NHS. That does seem to be a rather odd arrangement for the Government to make since Public Health and NHS services have been separate for donkeys years. This explains why I have never been called for a review by my current or previous GPs (they are not required to do it) - I have absolutely no expectation of my local authority ever doing anything about it for those 40-74yr olds, legal requirement or not, and I would have to question whether it is within their capability or competence to do so. They may be able to cope with organising checks for schoolchildren, but would, I'm sure, have to enlist the support and probably services of school nurses.

Perhaps I've got hold of the wrong end of the stick completely o_O :confused:
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If you read the link http://www.legislation.gov.uk/uksi/2013/351/pdfs/uksi_20130351_en.pdf paragraphs 4 and 5, you will see it is statute law, so they are breaking the law if they don't comply. They are only told to arrange it etc. The GP practices carry it out.
 
Yes I did read the first few pages of the link, though admittedly, not all 16 pages. I did pick up that it is statue, and I've no doubt local authorities would be breaking the law if they didn't arrange for the checks to be done. My confusion arose from the fact that local authorities (via their Public Health functions) were asked to take on the task in the first place, not NHS; although I'm not exactly into the minutiae of English law!!

Either way, I have never received an invitation to attend for a check, but I now realise that it's only been implemented sometime since 2012 there's still time yet to meet the 5 yrs specified.
 
Salvia said:
Yes I did read the first few pages of the link, though admittedly, not all 16 pages. I did pick up that it is statue, and I've no doubt local authorities would be breaking the law if they didn't arrange for the checks to be done. My confusion arose from the fact that local authorities (via their Public Health functions) were asked to take on the task in the first place, not NHS; although I'm not exactly into the minutiae of English law!!

Either way, I have never received an invitation to attend for a check, but I now realise that it's only been implemented sometime since 2012 there's still time yet to meet the 5 yrs specified.
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My son-in-law was invited in 2016. He was 48 at the time, likewise my daughter who was 46. I suppose they roll it out.
But, are you already on regular health checks due to pre-diabetes? If so, you may not be on the list as you are already being catered for.
 
My friend who was 60 two years ago says he hasn't been invited for the check up yet.
 
Bluetit1802 said:
If you see this multi-tasking nurse she can't do an HbA1c test, but she can refer you for one, so you must insist.
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I've been referred to the blood clinic at the local hospital for a HbA1c test, BUT there's a 1.5 week wait for a fasting blood sugar test
 
Bluetit1802 said:
Why? That discrepancy is quite normal, even the same meter could produce that.
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Yes, but using known test samples on them would show the deviation from those values and give you the accuracy of each meter instead of guessing
 
douglas99 said:
Because there is no point in going for a test to see if you are diabetic, and artificially fixing it beforehand so you get a none diabetic figure.

It really depends on whether or not the op want's a meaningful test as he is now or not.
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I think that a test as a non-diabetic unaware is probably the best way as then you know for sure earlier if you're diabetic now
 
Gadget_man said:
None in stock and don't know when they're getting an more unfortunately
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Amazon are not the only place where they are available from, just one of many. I purchased mine at the beginning of January from https://www.pharmacy2u.co.uk/onlinedoctor/healthtest.html. It's dearer than amazon although I might have been lucky, there's two tests in the box I received??????
I've no idea how they compare with the tests done in the labs in a hospital. I'll be testing mine at the end of March for comparison purposes.
 
Gadget_man said:
I've been referred to the blood clinic at the local hospital for a HbA1c test, BUT there's a 1.5 week wait for a fasting blood sugar test
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Why do you need a fasting blood sugar test? You only need an HbA1c to diagnose diabetes. You don't need a FBG test.
 
Bluetit1802 said:
Why do you need a fasting blood sugar test? You only need an HbA1c to diagnose diabetes. You don't need a FBG test.
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I've no idea, the GP told me it was a fasting test, so that's what it is, she made out the paperwork
 
My GP always arranges a fasting test, but she is also checking my thyroid and cholesterol levels.
 
Gadget_man said:
I've no idea, the GP told me it was a fasting test, so that's what it is, she made out the paperwork
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The HbA1c isn't a fasting test. It measures your blood glucose over the previous 2 to 3 months so anything you eat before the test won't have any effect. However, if the test includes a cholesterol break down it does require fasting.
 
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