Seeing Nurse - Any Questions?

[Clarissa]

Hi all

I am seeing my diabetic nurse tomorrow. I booked the appoinment as I was really annoyed that I didnt get told my HBA1C results or what they mean (eventually found out its 7.7%). I am going to ask for a monitor as I dont know how else I will find out what effects me and what doesnt. Especially with the whole carbs thing, I do eat alot of carbs and really dont know what I would eat if I have to cut them out.

What I was wanting to know, is there anything specific I should be asking the nurse whilst im am there. She is very hard to get hold off and I want to make sure I cover everything whilst I am there as I have no idea when I will next see her. So any advice on questions would be most welcome.

Also, although ideally I would like to just do diet control, I do seem to be struggling at the moment. I am also struggling a lot with energy levels, which is effecting my work and every aspect of my life. I was considering asking her about going on metformin for a short time to help with the energy, but dont know if this is the right thing. I do worry about the side effects, especially as I also suffer with IBS.

Again any advice you can give before my appointment would be great. Last time I went, she gave me so much information that it just mentally wore me out and I forgot loads.

I will get there, im sure of it. Preferably before I retire though

Clarissa

 

[sugarless sue]

Hi Clare,first off if you are not on any diabetic drugs your chances of getting a monitor are slim to nil!!I tried but they just won't give out to non medication type 2's,I bought my own,the trouble is that the strips are expensive and this is the NHS's way of cutting costs.I wouldn't be without mine as it is invaluable for finding out what puts up your BS.Your Hba1C should ideally be under 7% You can find out about the test by Googling it but basically it is a measurment of the stored sugars in your blood over the last 120(I think)days,it is written as a percentage and is not the same as the readings you get from a blood monitor.Get your nurse to book you to see a dietition.As you also have IBS you need some expert advice especially about carbs,no matter what they say diabetics should watch the carbs!as these send you BS soaring..Also a chiropodist to check your feet.Best tip is to book a blood test the week before you see the nurse so that you get your HBa1C results back when you see the nurse and don't have to wait too long for them.If she is overlaoding you with info take a notebook and write it down,I have a memory like a sieve so that's what I do. Hope this helps and maybe some of the more seasoned type 2's here will have some more tips.

 

[Dennis]

Hi Clarissa,

I'm not sure that any of us can advise you on what questions you should ask as only you know what doubts and uncertainties you have about your diabetes. From what you say about your last appointment it sounds like you already asked a lot of questions, so this time perhaps take a small notebook and jot down the answers? Please don't take that as a criticism - we've all been where you are now and it is very confusing at first - there is just so much to learn about this condition. However I can give some ideas on other points you raise based on my own experiences.

A blood glucose monitor is absolutely essential if you are to gain any level of control over your sugar levels. But you are highly unlikely to be given one (unless your diabetes nurse happens to have a spare and is feeling generous). They are not available on prescription, although strangely the test strips (which are much more expensive than the monitors) are available on the NHS.

When you say you eat a lot of carbs, what form is this in? If it is pasta then you could try Dreamfields, which has only 5g of digestible carb per serving (the rest passes through without converting to sugar). It tastes exactly like any other pasta. But it is not widely stocked and can be difficult to get hold of (not sure if they do mail order). Their website has a list of stockists. I am lucky - I pass a stockist on my way home from work.

If it is potatoes then you can be more selective in eating only types that have a lower effect on your blood glucosr levels, i.e. those with the lowest glycaemic level. For example peeled and boiled new potatoes are 50% lower GL than jacket potatoes. Here is a link to the most comprehensive GI/GL list of foods that I have come across http://www.gilisting.com/2004/05/bakery ... index.html

One thing that we have all found is that different foods affect each of us in different ways. In my case pasta sends my sugar levels sky high, potatoes raise it a little, but bread has very little effect. Most people seem to find that potatoes and bread have a much bigger impact than they do on me. We all have different metabolisms and you need to understand yours before you can know how to help yourself.

Your IBS sounds a b.u.m.m.e.r (excuse the pun). Unfortunately one of the worst side effects of metformin is that it can irritate the stomach resulting in a bad case of the runs - the last thing someone with IBS needs! If you have to go onto metformin then ask about Glucophage. This is just metformin but in a slow release form so much less harsh on the digestive system. Just make sure that your diabetic nurse is aware of the IBS.

Last but not least, keep reading these forums. There is an enormous amount of information on here from a great number of people who have lived with this condition a lot longer than I have and are much wiser than me.

 

[Talia]

Hi
I am type 2 diabetic (since 2001)and earlier this year my husband was also diagnosed as T2. Our local health authority held a 2 x 1/2 day course for newly diagnosed T2 diabetics called the DESMOND course. This was run by diabetic specialist nurses and dieticians and gave people a chance to learn about their diabetes and ask questions of the nurses. I attended as my husbands supporter and found it quite useful, when I was diagnosed there was nothing like this and all I was told was not to eat sugary things and lose weight. The DESMOND course is UK wide and may be available in your area if you ask you Dr or diabetic nurse. Such a course can give you some basic details about diabetes and forums like this are full of people who live with diabetes and can give you really good advice which works for them. Unfortunately diabetes is one of those conditions which is not the same for everybody, for instance certain foods may send one persons blood sugar sky high whilst with another person it may not be affected. The only way to know how foods affect you is trial and error. Eat a food and check your blood sugar 2 hours later, if it is high, current UK guidelines are to have a blood glucose reading of 4-6 mmol/l before food and no higher than 10 mmol/l 2 hours after food (a lot of people like to have a lower 2 hour reading than this). To do this testing you do need to be given or to buy a blood glucose monitor and ask to have the strips that go into your machine prescribed. If you diabetic nurse says this is not necessary then explain that you want to be able to control your diabetes and that means testing, the proposed new NICE guidelines for diabetes states that T2's need access to testing strips to help maintain good blood glucose levels. As you are diet controlled you will not recieve help in paying for prescriptions but the cost £6.80 for a prescription is less than £25 for a pot of strips from the pharmacist. The monitors are not very expensive to buy £5-£20 depending on model and you can get then from most pharmacies and some supermarkets. You get 10 strips in with the meter and some lancets for finger pricking. Ask the nurse which model they recommend. I use one from Roche called the accu-chek aviva and find it very good but there are many different models out there. If you start taking medication to help control your diabetes then you are entitled to free prescriptions, your Dr may not tell you about this....Talk to the reception staff at your surgery and they will give you a form to fill in, it needs to be signed by your Dr and have the surgery stamp on it. They send it off to the DHS and eventually you get an exemption card which you show each time you get a prescription filled.
Good luck with the appt and keep asking about monitors and strips.
Talia

 

[Clarissa]

Hi all, thanks for your replies.

In answer to some of the questions:

I eat alot of wholemeal bread, brown basmati rice, wholewheat pasta and jacket potatoes. I really have no idea what I would eat if I had to cut them all out. So fingers crossed they dont all effect me, but until I get a monitor (which I have ordered), I will have no way of knowing. I am really hoping the nurse will give me a prescription for the test strips, Im ready for a fight if she says no.

The only reason I am considering asking about Metformin is that from reading forum postings I believe it helps raise your energy levels. Energy is really big issue with me at the moment. Unfortunately my IBS is also really playing up at the moment and I cant risk anything else impacting on it. Im really not sure what to do for the best.

I am sure listening to you all I will get there eventually, as you all seem to have been through the mill when first diagnosed and then got control. It just seems to be taking longer than I had hoped.

I wish I knew of a support group in really life, where you could actually talk to people face to face, but they dont seem to exist.

Thanks for your advice, it does help.

Claire

 

[Clarissa]

How do I work out carb value's? Its not something I have ever thought about before, I just eat the healthy version of them, but I have no idea what measurements they are or how to work it out. Is there a website I could read?

Claire

 

[Dennis]

Clarissa,

This website will tell you probably everything you could ever want to know about carbs.

http://www.carbs-information.com/facts- ... drates.htm