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Today's appointment

Indiana91

Well-Known Member
Messages
706
Location
UK
Type of diabetes
Type 1
Treatment type
Insulin
So, I went to my appointment this morning.

I got told that I'm obese (I'm a size 12).

Also got told that I've put on the weight that I have because of the increased dose of levimir that I've had, he then said that if he changed my insulin to something else like lantus that he will guarantee that I'll put on half a stone in six months.
My hba1c is 8.4 which he said is perfect and if it's lower than 7 then I'll probably die of heart disease. This left me VERY confused, I thought that the whole idea was to get it as low as you can with minimum hypos.

He also said that he doesn't think I need a pump because they're "pointless" because they're only a machine and humans are much better but he will send my letter of application again because they haven't heard anything back from last time.

An over all confusing appointment!!

Indiana x


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Wow ! I'd be confused too ! I though a size 12 was about avg ? ( unless you're 3ft 1in ! ). Can't see how he can foresee half a stone weight gain ? A lower HbA1C is better ( as long as not regularly experiencing hypo's ) and the majority of those with a pump swear by them ! Are you sure you were not seen by a cleaner or caretaker by mistake ?
 
Oh dear God. These points sum up some of the many reasons that I try not to attend medical appointments and when I do I take most of it with a pinch of salt.
F...wits.
 
I know! I don't know what to think now!
It was basically a case of you're dammed if you do and you're dammed if you don't!

Indiana x


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Who did the appointment? They are so wrong on many points.

I wouldn't call a size 12 obese and quite surprised they said that, also why would they think changing insulin to lantus would result in half a stone weight increase in 6 months, as you were previously on lantus at a lower dose than levemir I don't see the logic.

8.4 is above the NICE guidelines which is 6.5 for type 1's, however were you to get an Hba1c of 7 I think that is an achievement in itself provided it's not at the expense of hypo's, so again I'm puzzled why they would say 8.4 is fine.

As for insulin pumps, as Mo says all we ever here of is good news story's about how they have improved people's lives, yes they are hard work in the initial stages but well worth it by all accounts.

Sorry you've had such a bad appointment today Indiana
 
It was a diabetic consultant that did it.
He said that if you aim for the lower end of the NICE guidelines then that's when you're likely to get heart disease because you'd get more hypos.
I said that I was on lantus before anyway and he said that I'd put on more weight now because of my age. I tried to argue against it but he said that it would be fixing something that isn't broken because my levels are good because of my dose that I'm on now.

I've always thought that pumps were good too and according to the NICE guidelines 8.5 qualifies for a pump so I'm not far off that at all! He said that most people go on to the pump and lose all control and end up worse off anyway.

Load of poo!

Indiana x


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I have no idea who gave that person a qualification and or a job. Outrageous!


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I'm shocked too.
Shocked and confused! No one has every told me anything of what he said, he asked why I'm trying to lower my levels and I said that it was because I'm too high and that's when all of this heard disease stuff came about. I don't know what to think now!
I'm now feeling fat and confused!

Indiana x


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Indiana91 said:
I've always thought that pumps were good too and according to the NICE guidelines 8.5 qualifies for a pump so I'm not far off that at all! He said that most people go on to the pump and lose all control and end up worse off anyway.
Indiana x
Click to expand...
If this is his top quality care that he gave to you, then I'm sure his pump people would be worse off.
time for a new Dr
 
Just ask if you can see someone else next time. In my experience they all tell you different things anyway. You will also find as the years go on they will change the position on what is good and what is acceptable and what is bad for you concerning Type 1. Meanwhile throughout all those years you have been living with the condition and managing it well despite, not because of, the information that "professionals", like to give you.

In my experience they fall into 3 categories:

1) Those that are OK and seem to know what they are talking about yet continually try and point out faults and improve your control without any concept of how hard a condition it is to manage every day. Example "Oh you're doing really well Mr Canary, lets see if we (always like the use of the word "we" when talking about MY condition)can get those levels raised by 1mmol before bed etc. They usually fail to notice that if I could have done that I already would have.
2) Those that are arrogant, spiteful and treat you like a halfwit. Example " I've been a doctor for 20 years so you must listen to me". Really I've been a diabetic for 30 years, how about you listen to me"
3) Those that are just downright dangerous. Example "See above"
 
Hi Indiana

Sorry you've had such a bad appointment. I know how it makes you feel when it happens.
From my experience seeing the consultant has never done me any good. Luckily I see just the diabetic nurses and the dietician at my hospital for all my care. Although the nurse doesn't always seem to listen or really give the best advice, my dietician is absolutely fantastic. She has encouraged me to carb count, and has organized funding for a pump. She is the only one that seems to talk to me like I am a person, and gives considered advice that is right for me.
How is the rest of the diabetic team at the hospital? If not great could you try and change hospitals?
It sounds like you need to find someone else as he is talking utter rubbish.
Good luck x

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I see a different doctor every time and they all tell me something different. I've only seen one really really good one and he's part of the pump clinic so I'll have to have a pump to have him.
I'll be remembering this guy and will be avoiding him from now on!!

Thanks for all your replies guys, I'm glad I'm not the only one who found it confusing!!

Indiana x


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Hello,

It's worrying isn't when you get this sort of nonsense from professionals?

Here is something I found about hypos and heart disease (CVD);

"Taken together our data do not support the hypothesis that in type 1 diabetes, severe hypoglycemia increases the risk of CVD."

http://care.diabetesjournals.org/content/35/7/1598.full

The DCCT Trial which is the basis for all of our treatment under the NHS said this;

"Intensive therapy aimed at achieving glycemic levels as close to the non-diabetic range as safely possible reduces the development and progression of all diabetes-specific complications by as much as 76%."

Here is a summary of that trial:

http://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/GetPdf.cgi?id=phd000390

So, your consultant is wrong on all points. I think he just sees some diabetics with terrible control and therefore when he sees your HbA1c thinks 'well, not as bad as some I've seen.' That is not medical advice; that is laziness.

You need to get that HbA1c down and it sounds like you are making concerted efforts to do so; so keep going don't listen to your doctor! If possible get transferred to a teaching hospital with a specialist diabetic clinic because what has been said to you by this buffoon is dangerous.

Best

Dillinger
 
Thank you, that's what was confusing me.
He said that it was hypos that caused the heart disease because it affects your heart. So aiming for a hba1c the same as a non diabetic would cause hypos and therefore cause heart disease.
Surely though if you lower it a bit at a time with minimum amount of hypos this can only be a good thing?
I'm going to continue to try and lower mine anyway!

Indiana x


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My 5 year old granddaughter ( type 1) would be more clued up :-o
 
An

And he lived?

I'm a pretty controlled, considered person, but I would still be there asking for someone sensible.
 
I tried to argue! He had an answer for everything.
I just thought that I've not killed myself or ended up in hospital yet so I'll keep plodding on trying my best!

Indiana x


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