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Should I Get A Second Opinion

E

Emmordee

Member
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I was diagnosed diabetic in January 2018 my glucose reading was 7.1 and my hba1c was 38 which I believe is a normal reading for hba1c so why was I diagnosed diabetic. I had my 3 month check up and have brought my reading down to 33 with carb control and exercise. I’d like other opinions.
Thanks
 
Was the 7.1 a fasting reading? Did they check only once or have you had multiple tests reading a little high? I think it strange to be diagnosed with your hba1c plus one slightly high reading. I would go back to the person who diagnosed you to ask questions
 
Antje77 said:
Was the 7.1 a fasting reading? Did they check only once or have you had multiple tests reading a little high? I think it strange to be diagnosed with your hba1c plus one slightly high reading. I would go back to the person who diagnosed you to ask questions
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Thanks for your reply my glucose reading was done fasting twice first was 7.0 then one week later 7.1so then hba1c was done and came back as 38
The nurse sent me on a x pert training session for diabetes and the instructor suggested I should not have been diagnosed with a hba1c reading under 45 and that someone with diabetes bringing their reading below 45 is considered in remission. So I am a bit confused.
 
I agree, you should not have been diagnosed on those fasting readings when your HbA1c was 38. A better procedure would have been a second HbA1c a week later, and if that came back normal, then no diagnosis. The two fasting tests were right on the border, but are not normally used for diagnosis without an HbA1c. You need to speak to the person that diagnosed you.
 
I agree with you but I had my 3 month follow up a few weeks back and brought my reading down to 33 by diet and exercise I told the nurse that diagnosed me what the instructor said but she said she stood by her diagnoses.
Also when she gave me the first diagnosis of 38 she told be I was at 40% risk of heart attack or stroke and could die 10 years early but the instructor said only people with a reading in the 60s and have been there for 5-10 years have risks of complications. I really don’t trust her diagnosis and think I should get a second opinion what do you think
Thanks
 
Emmordee said:
I agree with you but I had my 3 month follow up a few weeks back and brought my reading down to 33 by diet and exercise I told the nurse that diagnosed me what the instructor said but she said she stood by her diagnoses.
Also when she gave me the first diagnosis of 38 she told be I was at 40% risk of heart attack or stroke and could die 10 years early but the instructor said only people with a reading in the 60s and have been there for 5-10 years have risks of complications. I really don’t trust her diagnosis and think I should get a second opinion what do you think
Thanks
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I would make an appointment with the gp and check with them. Maybe say that you were freaked out by the nurses comments.
 
Emmordee said:
I agree with you but I had my 3 month follow up a few weeks back and brought my reading down to 33 by diet and exercise I told the nurse that diagnosed me what the instructor said but she said she stood by her diagnoses.
Also when she gave me the first diagnosis of 38 she told be I was at 40% risk of heart attack or stroke and could die 10 years early but the instructor said only people with a reading in the 60s and have been there for 5-10 years have risks of complications. I really don’t trust her diagnosis and think I should get a second opinion what do you think
Thanks
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I think the GP that the nurse works for should hear about this. It sounds like she's not following the guidelines and could be causing people unnecessary worry about heart attack and stroke. In a small number of people with mental health issues, things like this can potentially cause them to consider giving up on life altogether. Not you, obviously, but alerting the GP could potentially help other patients. Also, she should be focusing more on all the people who do have very high blood sugar and need help with that.
 
I agree Jenny she did freak me out then I felt more assured after speaking to the training instructor who although he is not medically qualified he informed us he is a nutritionist a dietitian and an expert on diabetes. Then at my 3 month check up she frieked me out again by dismissing the instructors comments and standing firm on her advice and diagnosis even though I had brought my reading down to 33
I just wanted someone else’s take on it before I do as you say and speak directly to the gp
Many thanks x
 
Emmordee said:
I agree Jenny she did freak me out then I felt more assured after speaking to the training instructor who although he is not medically qualified he informed us he is a nutritionist a dietitian and an expert on diabetes. Then at my 3 month check up she frieked me out again by dismissing the instructors comments and standing firm on her advice and diagnosis even though I had brought my reading down to 33
I just wanted someone else’s take on it before I do as you say and speak directly to the gp
Many thanks x
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Please let us know how you go on.
 
Emmordee said:
I agree Jenny she did freak me out then I felt more assured after speaking to the training instructor who although he is not medically qualified he informed us he is a nutritionist a dietitian and an expert on diabetes. Then at my 3 month check up she frieked me out again by dismissing the instructors comments and standing firm on her advice and diagnosis even though I had brought my reading down to 33
I just wanted someone else’s take on it before I do as you say and speak directly to the gp
Many thanks x
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A person with a nutrition degree can be an expert on diabetes and if they are also a registered dietitian then they are a health professional, arguably with more seniority than most nurses. Probably though, working in a job such as a training instructor means they aren't allowed to comment as if they are a registered dietitian. I'm sure he didn't overstep professional boundaries by what you report he said. IMO he did the right thing by suggested you ask the nurse or a doctor for clarification.

In terms of formal diagnosis, I thought that had to be done by a doctor, and the nurse's job is to carry out nursing support of diabetes management only. In general, nurses are not given sufficient training and authority to make diagnoses (such as whether a person has diabetes mellitus or not.) I assume they are equipped to diagnose minor or short term medical conditions or the worsening of symptoms, that then require a doctor assessment.

Professional scope of practice is an issue that gets people's backs up when they work as a doctor, nurse, or other health professional. The nurse would be wise to start getting it right.
 
Hi. You need to Google the web for NICE Diabetes guidelines and this will show you the HBA1c limits for diabetes diagnosis. Show these to the DN or mention to the GP. Insist that if the HBa1C is below the limits that this si properly recorded on you medical records. Note that a fasting blood test should not be used for diabetes diagnosis as the overnight glucose dump by the liver makes it fairly useless.
 
Thanks Jenny some good points perhaps your right maybe the doctor did diagnose and then left it to her I won’t know that till I speak to him I have had no dealings with him in this at all. I was originally checked out at a well woman clinic then the nurse contacted me when they received that report so it all came completely out if the blue for me.
 
Daibell said:
Hi. You need to Google the web for NICE Diabetes guidelines and this will show you the HBA1c limits for diabetes diagnosis. Show these to the DN or mention to the GP. Insist that if the HBa1C is below the limits that this si properly recorded on you medical records. Note that a fasting blood test should not be used for diabetes diagnosis as the overnight glucose dump by the liver makes it fairly useless.
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That is a good point. Having a diagnosis recorded on your file can exclude you from insurance coverage for that condition if you wish to purchase private insurance, which some people do. If you don't even have the condition then this is unjust. It can have other implications too.
 
Emmordee said:
Thanks Jenny some good points perhaps your right maybe the doctor did diagnose and then left it to her I won’t know that till I speak to him I have had no dealings with him in this at all. I was originally checked out at a well woman clinic then the nurse contacted me when they received that report so it all came completely out if the blue for me.
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It's potentially sort of OK to do it this way if the nurse tells you the doctor has diagnosed you but I don't think it's good practice. Looking at your whole health picture through diabetes-tinted glasses is a trap we can all fill into, including doctors, but I think they are very good at looking at the whole person, in most cases.
 
Jenny15 said:
That is a good point. Having a diagnosis recorded on your file can exclude you from insurance coverage for that condition if you wish to purchase private insurance, which some people do. If you don't even have the condition then this is unjust. It can have other implications too.
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Your absolutely right just a few days ago a company called us to see if they could get us cheaper life insurance but nobody would touch me thankfully we already have a policy in place.
If I am diabetic then I have to accept it it’s not that I’m in denial I’m just not convinced that she has gig it right and it seems you all feel the same. X
 
Emmordee said:
Your absolutely right just a few days ago a company called us to see if they could get us cheaper life insurance but nobody would touch me thankfully we already have a policy in place.
If I am diabetic then I have to accept it it’s not that I’m in denial I’m just not convinced that she has gig it right and it seems you all feel the same. X
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I don't know if life insurance is affected much by diabetes but medical insurance would be as it almost always excludes pre-existing conditions, at least for a few years. Travel insurance probably just requires you to show evidence of proper management. My life insurance premiums were a bit increased by my BMI and having once been a smoker for a few years, but I could still get cover. Others here know more about these things but that's my experience in general.
 
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