Some doctors are incredibly unaware of the basics of diabetes

TheGreatGateway said:

While walking around my town today, I noticed I was getting symptoms that ended up being related to high blood sugar. Unfortunately I didn't have any lancets left so I asked a paramedic for help who was patrolling. He asked what my last highest glucose reading was, and I said "The highest I've seen it is 12.5mmol." He said this was perfectly normal. Total nonsense of course, and no lancet to boot.

Today I saw my GP in the same area, and a similar discussion took place. Because my fasting glucose is OK, but my postprandial glucose is extremely high, even 2 hours after eating, a majority of the time, and because I experience the pizza effect when someone normal wouldn't, I thought for sure the doc might do more investigation to help complete the puzzle for me. Unfortunately they also said 12.5mmol is healthy, and they even said ketoacidosis isn't a real thing.

As things stand I'm stuck with a GP who knows nothing about what's normal and what's high in blood sugar, and I can't change it. And of course only the docs word matters. That same doctor also misdiagnosed my mother with anxiety when she actually passed away with brainstem cancer. This is highly frustrating as the average person can find out better information in mere minutes. Has anyone else experienced doctors with poor diabetes knowledge? Were you able to resolve the stalemate situation resulting from it?

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Not yet. But seeing my rheumatology consultant (or his Registrar) for my bi-monthly 4 1/2 mins on Friday and will try to bend his ear.

Next time you feel bad, head to a chemist.

I would be looking to change my gp.

When I explained to my GPs, over the years, that high carb foods make me gain weight - they laughed, scoffed, called me deluded and various other stuff - and a liar to boot.

Can you request an hba1c? Only way to really prove it to the Dr one way or another as there are definite parameters for that.

I wouldn’t want to tar them all with the same brush, but unfortunately many GP’s amount to little more than prescription vending machines. This sounds like an extreme example, though. I would investigate the proper channels of complaint. Telling someone that 12.5mmol/L is a healthy blood glucose concentration must surely be malpractice. I would say unbelievable, but sadly it isn’t.

TheGreatGateway said:

I noticed I was getting symptoms that ended up being related to high blood sugar.

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Which symptoms do you notice. I just feel yugh when my BG goes up and it's usually after eating carbs which is usually less than 50gms per day. I'm no stranger to the dawn phenomenon which is difficult to predict and certainly a reading of 12.5 after not eating for 12 hours is not unusual. Out of interest, what was your BG?

TheGreatGateway said:

I asked a paramedic for help who was patrolling.

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Is that in the U.K.?

TheGreatGateway said:

The highest I've seen it is 12.5mmol.

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That statement needs some more information before anyone can comment. If that was a typical reading 2 hours after every meal, then it's a problem that needs checking out.

TheGreatGateway said:

I can't change it.

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It would be useful if you had some blood work done which sounds difficult with your GP at the moment. I would suggest that you print off several of the charts which you can google, showing target BG ranges.You might have to play a bit of a psychological game with the GP because they don't appreciate being told they're wrong. They've studied medicine for the best part of 10 years to get to being a GP and we haven't. We just have the advantage of being able to study one particular ailment in depth. Perhaps you should also have records of the BG readings that you are taking, obviously showing what time of day and when in comparison to eating.

It might seem like a battle, but it's nothing of the sort. It's more of a game.

Good luck with "enlightening" your GP.

DavidGrahamJones said:

That statement needs some more information before anyone can comment.

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You are of course correct, and a diagnosis cannot be made on the basis of one patient reading. But nevertheless, telling someone that 12.5mmol/L is perfectly healthy is preposterous and downright dangerous. Telling them that DKA is not a real thing is just the icing on the cake.

In my opinion anyway.

I agree with @AloeSvea. About 2 years ago I suspected I had diabetes, bought a meter and measured daily two hours after meals for about 6-8 weeks.

Result in mmol/L
Fasting blood sugar: 5.2-5.9
100-200g white rice and potatoes: 11-14
1-2 slices white bread: 9-12
white flour as sauce thickeners etc 7.5-9
Cakes, sweets, battered/breaded meats: did not eat

I then went to my GP and showed the results, who said I could absolutely not have diabetes because my hbA1C (38) was good and therefore no action was needed. I tried to explain that my blood sugar values always were high after rice, potatoes and bread and that the hbA1c is an average over several months.

Now about 2 years later when I eat the foods above the blood sugar values still shoot up. Avoiding these the values have been 6.1-7.6, except when I have cold or flu when they could be 7-9mmol/L.

https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges
[URL]https://cks.nice.org.uk/diabetes-type-2#!diagnosisSub[/URL]
I would be inclined to write a letter (that has be included on your file) with a list of your tests and if they are random, fasting or 2hr post prandial along with the table attached and copies of the nice guidelines above and ask for further investigation, or the refusal of your request and reasons for such to be explained and noted on your file. I’d send it via the practice manager too.

TheGreatGateway said:

While walking around my town today, I noticed I was getting symptoms that ended up being related to high blood sugar. Unfortunately I didn't have any lancets left so I asked a paramedic for help who was patrolling. He asked what my last highest glucose reading was, and I said "The highest I've seen it is 12.5mmol." He said this was perfectly normal. Total nonsense of course, and no lancet to boot.

Today I saw my GP in the same area, and a similar discussion took place. Because my fasting glucose is OK, but my postprandial glucose is extremely high, even 2 hours after eating, a majority of the time, and because I experience the pizza effect when someone normal wouldn't, I thought for sure the doc might do more investigation to help complete the puzzle for me. Unfortunately they also said 12.5mmol is healthy, and they even said ketoacidosis isn't a real thing.

As things stand I'm stuck with a GP who knows nothing about what's normal and what's high in blood sugar, and I can't change it. And of course only the docs word matters. That same doctor also misdiagnosed my mother with anxiety when she actually passed away with brainstem cancer. This is highly frustrating as the average person can find out better information in mere minutes. Has anyone else experienced doctors with poor diabetes knowledge? Were you able to resolve the stalemate situation resulting from it?

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Your case seems extraordinary and a total lack of knowledge or is it plain ignorance? How is 12.5 is healthy and DKA isn't a real thing, seriously? DKA doesn't exist?.... absolutely shocking imo. And this kind of appalling practice should be reported. He should not be in practice imo, based on his history.

TheGreatGateway said:

While walking around my town today, I noticed I was getting symptoms that ended up being related to high blood sugar. Unfortunately I didn't have any lancets left so I asked a paramedic for help who was patrolling. He asked what my last highest glucose reading was, and I said "The highest I've seen it is 12.5mmol." He said this was perfectly normal. Total nonsense of course, and no lancet to boot.

Today I saw my GP in the same area, and a similar discussion took place. Because my fasting glucose is OK, but my postprandial glucose is extremely high, even 2 hours after eating, a majority of the time, and because I experience the pizza effect when someone normal wouldn't, I thought for sure the doc might do more investigation to help complete the puzzle for me. Unfortunately they also said 12.5mmol is healthy, and they even said ketoacidosis isn't a real thing.

As things stand I'm stuck with a GP who knows nothing about what's normal and what's high in blood sugar, and I can't change it. And of course only the docs word matters. That same doctor also misdiagnosed my mother with anxiety when she actually passed away with brainstem cancer. This is highly frustrating as the average person can find out better information in mere minutes. Has anyone else experienced doctors with poor diabetes knowledge? Were you able to resolve the stalemate situation resulting from it?

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I gather it was the paramedic who mentioned 12.5 as normal but to be fair they are used to scraping diabetics with low blood sugars off the ground and wouldn't be called out for hyper unless it was a DKA situation which would be highly unusual for a type 2 still making their own insulin.
My GP and even my diabetic specialist (I am type 1) is a gateway for getting my prescriptions and my pump and not much else other than nagging me to take a stain and checking my eyes, kidneys and feet aren't rotting.

If you are concerned that you are diabetic or heading that way then why not behave as if you are diabetic and eat accordingly by dropping those foods that cause your bg to spike and remain high after 2 hours which is a sign of insulin resistance or LADA. But 1 sparrow doesn't make a Summer so as others have said you should continue the experiment yourself..
This is just a diet based on healthy fats and proteins rather than lots of starch and is likely to be healthy for most adults who are not underweight.
Yes it would be great if the doctor had the time, knowledge and professional curiosity to investigate you more thoroughly but he is probably limited to HBA1c , fasting glucose or OGtt but may not even get to the latter 2 if the HBA1c is normal which doesn't mean you don't have a problem with your insulin levels. Even with a diagnosis you obviously don't trust his advice. but armed with blood test strips you can certainly investigate your own bgs and then act intelligently upon those results.
Because you are feeling frustrated would it worth calling the Diabetes UK helpline or booking an online consultation to get a second opinion if you really can't change your GP?

I am controlling my diabetes with my diet which makes my figures look almost normal, and there lies the problem, most HCP can not believe that you can control your BS much by changing your diet. They are so used to seeing with results over 14-20 that to your GP probabely thinks thats OK. The paramedic was just probabely thinking , phew, I do not need to do anything, he is practicing emergency medicine.
I can remember 40 years ago a consultant saying he was aiming for 4.5, which was astounding and scary because it was drummed in to us about hypos.
Is it possible to see another GP in the practice or the diabetic nurse within the practice, sometimes they are more up to date?

TheGreatGateway said:

Has anyone else experienced doctors with poor diabetes knowledge? Were you able to resolve the stalemate situation resulting from it?

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I did. I changed GP. That worked.

"According to my Hba1c and fasting glucose I'm not diabetic (5.1% and 5.2 mmol average) but I'm terrified that these spikes are causing me harm and that I actually do have diabetes after all, especially as it takes ages for my post meal glucose to decline. What's going on?"

@TheGreatGateway - isn't that you?

If my HBA1c was 32, with a BG of 5.7 average I would not be on this forum. I would be too busy celebrating with my friends and family about how good my blood glucose regulation was, and how I got 10 years of my life expectancy back .

Understood that the high BG spike is something to worry about - you could go to an endocrinologist and have a good discussion about that with the specialist? With your BG readings with you. There is no way your ordinary GP is going to get into the details of your readings, especially when you do not, as yet, have a medical condition, even though we all get where you are coming from.

Absolutely - don't go to a doctor you do not trust and get along with! If s/he misdiagnosed your mother - change your GP for sure!

Jim Lahey said:

Telling them that DKA is not a real thing is just the icing on the cake.

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That is stupid! As for the paramedic and then the GP saying that 12.5 was normal, I wonder if it was said to re-assure someone who they thought was anxious.

DavidGrahamJones said:

That is stupid! As for the paramedic and then the GP saying that 12.5 was normal, I wonder if it was said to re-assure someone who they thought was anxious.

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Yeah maybe. Although it's still a lie.

Jim Lahey said:

Yeah maybe. Although it's still a lie.

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Agreed, I don't want a HCP of any kind lieing to me.