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Type 1 diabeties DKA

Discussion in 'Type 1 Diabetes' started by Bladezy, Feb 17, 2019.

  1. kitedoc

    kitedoc Type 1 · Well-Known Member

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    But there will be other checks of health to consider. The GP is responsible for what he or she prescribes. Any issues will be sheeted home to him or her, whatever the specialist has said. There will be yearly or 2 yrly screening health checks for women's health or men's health.. And who refers you fo eye checks? Here is X who I have not seen for 15 years...? Who examines your feet, pulses etc? Who do you see regarding mental health if that is needed?
    This is part of what helps keep GP s blinking well ignorant of diabetes.
    There is something wrong with a system that does that!!!!!
    The doctor who directs the insulin management should therefore sign the prescription.
    It is a waste of training for a GP to become a glorified script-writer for some specialist!!!!
    The only other place where such a thing could happen is Hollywood.
     
  2. Deleted Account

    Deleted Account · Guest

    For women's health, there are cervical smear tests done at the surgery (but not by the GP). Breast scans are done (after a certain age) at the hospital. Foot checks, cholesterol, kidney function, blood pressure, BMI and, to a certain extent diabetes related mental health checks ("have you been frustrated by diabetes in the last year?" type questions), etc are part of the diabetes review at the hospital, retinal scans are done at the surgery (but not by the GP), other eyes test are done by and scheduled with the optician (just like mouth checks are arranged with and by the dentist), flu jabs are done by the pharmacist, ...
    I have zero relationship with my GP and I am not going to start going to more check ups just so they know who I am - they have to many people to deal with to have time for that.

    As for knowing about diabetes, they have no need to know more than diagnosis for type 1 because after that care is handed over to a specialist. I believe the relationship is different with type 2.

    I lived in Australia for two and a half years (before I had diabetes) and the relationship with GPs seemed to be similar. The only time I saw one was when I had a viral type flu thing and needed a sick note for my employer.
     
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    #82 Deleted Account, Feb 26, 2019 at 2:32 PM
    Last edited by a moderator: Feb 26, 2019
  3. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Zero relationship yet GP is supposed to do scripts? Absolutely daft. I can understand others like nurses doing screening but this devalues the GP who is supposed to be involved with gatekeeper functions to keep more expensive hospital treatments, referrals to minimum. No wonder the medical system is under strain.
    Who would wish to be a GP over there??
     
  4. DCUKMod

    DCUKMod I reversed my Type 2 · Master
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    I haven't been taking meds on repeat for 12 months yet, but as far as I can tell from the systems messaging, my repeat is done in a 12 month trache. Obviously 12 scripts aren't signed off, but I imagine the countdown would be to some form of review/chat or whatever.

    As I am currently still titrating and e-consultations are still bouncing back and forth between GP and Endo, the 12 month gate shifts with each treatment adjustment .

    Things like mamography, smear tests, eye screening and so on are handled remotely, with appointments being generated from a centralised point, for services executed remotely to the surgery, or a letter is sent requiring the patient to make their appointment.

    As far as dental services are concerned, if a patient is referred for specialist care (the probably most frequent of which would be adolescents for fixed orthodontic care), the specialist deals with their specialist referral, but the patient still needs to have their routine check-ups at the referring durgery.

    Systems differ over the world.

    Where I am right now, I can walk into a pharmacy and buy thyroid meds, inclusing liothyronine and insulin over the counter, just at my request. For the record I haven't.

    I can recall a T2 member (but can't recall his name, and wouldn't name him anyway), a while ago, who had rocked up and bought himself some fast acting insulin, so that he could have carby meals as and when he chose to without, in his view, harming himself.

    I have been interested to find a reliable source of T3, should it eventually be required, as it is rarely available on the NHS these days, due to cost. The NHS pays c£300 for 30 tablets, wherease I can buy 100 tablets of 100mcgr, including worldwide shipping for £47 from here.

    Whilst no system is ideal, what is clear is patients need to be engaged with their own health wherever they are in the world.
     
  5. kitedoc

    kitedoc Type 1 · Well-Known Member

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    That a person can arbitrarily obtain insulin, a potentially deadly substance to the person , AND To Others, without a script is nuts. It degrades the NHS system to the low third world conditions of the US system. And how does that prevent waste??
    Yet others complain that if they use up insulin more quickly for legit reasons that they have trouble obtaining it ??
    And with T3 and some insulins does not the NHS have the purchasing power to not be ripped off by Big Pharma? Or is the effect of splitting the NHS up into smaller units allowed this to happen ?
    There is either corruption in the system itself or between NHS and Big Pharma !!
    Some much for rights of equal access !!
     
  6. DCUKMod

    DCUKMod I reversed my Type 2 · Master
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    To be clear, Kitedoc, I am currently in SE Asia, hence the ability to rock up to a pharmacy counter and buy those meds, if I chose to.

    Well, one would have hoped that all those thousands of folks with thyroid glands unable to efficiently convert their T4 to T3 would be supported, it's just not the case, with thousands being declined or having their NHS prescritions stopped, with sometimes immediate effect.

    I know of a number of people buying T3 from overseas, for c10% of the UK costs. That is a 100% sad reality.

    To date, my thyroid is simply not catching on with the programmes, so I'm a bit unclear where I'll eventually end up in the meds lottery, but if I need something, I am resolute I will source it. My health and wellbeing is very important to me.
     
  7. kitedoc

    kitedoc Type 1 · Well-Known Member

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    HI @DCUKMod, Thank you for clarifying about scripts and location. I agree that the medical bureaucracy and NHS are a nightmare where lack of commonsense and understanding have evolved. Some parts of Australia are I contend heading towards this type bureaucratic decision-making by at least one Medical Colleges with ludicrous research findings used to back its recommendations and theGovernment lamely following on.
    Where are the appeals processes and the specialists who will argue for the proper medical knowledge and understanding?
    I also contend it is easier if the bureaucracy sidelines General Practice and takes away its experience and learning base.
    But then we have Dr Unwin. So how is he so effective where other GPs do not appear to be??
     
  8. DCUKMod

    DCUKMod I reversed my Type 2 · Master
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    I think Dr Unwin had a real lightbulb moment when his patient came to him to tell him how she had achieved her then very unexpectedly good results, after some time of probably floundering.

    Dr Unwin is also no longer a Partner at his practise, so I could speculate (and it is pure speculation), that he may have a little more time for things he enjoys.

    Many, many of us are indebted to Dr Unwin ( @Southport GP ) for the work he has done and continues to do. Some is now in conjunction with DCUK, presumably (again my speculation), to maximise resources and impact.

    I have met Dr Unwin a number of times and a more genuine, humbler man you'd struggle to find. He really, really is interested in people, whomever they happen to be. He doesn't know what a pedestal is, never mind appearto have any interest in mounting it.

    I make no mistake of my fandom and respect for the man.

    Edited to correct the man's name. Sometimes I detest my iPad!
     
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    #87 DCUKMod, Feb 27, 2019 at 9:35 AM
    Last edited: Feb 27, 2019
  9. Knikki

    Knikki · Guest

    @kitedoc Your concerns about how the system works in the UK is valid however the problem we have is too many people using a resource that is over stretched and where in some cases moral is low.

    As and example when we moved to where we are there was/is a health centre that serviced around 3500 people may be more and over the last few years the place, as in amount of house built and people moving in to the area, has certainly doubled if not more.
    The Health Centre is still the same size it does seem to have more people in there but still the same amount of Doctors servicing the now increased amount of people.

    So our place works in the same way that @helensaramay does and I do not see my GP for any diabetes issues as in regular check ups, eye screening etc. I do see him if I have other issues, like needing some pain relief when I wreaked my muscles after a massive hypo a couple of years ago.

    All diabetic stuff is handled by a DSN who runs through a whole series of tests etc, then all information is recorded in the computer which can be accessed by any of the medical staff. He does read it as I sometimes get request from him for some info.

    Its just the way it now works and considering that he is a GP and probably not specialise in one particular subject I'm happy with way things work with the DSN.
     
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  10. Deleted Account

    Deleted Account · Guest

    One final (I promise) thing to add this discussion is as a patient, I am happy with the service I am receiving for my healthcare. I have no need to see a GP about my diabetes, I get the medication I need, can discuss it with my diabetes team at any time as I have email and phone contact with my DSN and I don't want to waste anyone's time (mine included) with more appointments.
    Reading the comments from @kitedoc I realise I had never seen this from the GPs point of view. Thank you for the education.

    And apologies for derailing the conversation about DKA.
     
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  11. Bladezy

    Bladezy · Member

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    @DCUKMod thank you that is a great idea, I will give it a try.

    @BeccyB yeah iv been on a few different antidepressants and that but not anything that iv got along with. Tbh it's something iv lived with for about the last 12 - 15 years. It's does make things a bit awkward because I struggle to talk to people face to face, and I barely leave the house, it's hard to get anything sorted out with anyone when I get like that. Yes I will take DCUK's advice and try to write a letter and try and get some things sorted
     
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  12. Bladezy

    Bladezy · Member

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    Sorry I only just saw your post, sorry I don't usually use forums or anything. It does go in, honestly I do listen to everyone's experiences and storys but it's just hard for me, I can't even explain it.

    @Kevvb1 I had pretty much the same experience when I was diagnosed, I was 21 and told take this and this and off you go. Since then Iv had minimal contact with docs/nurses. I just order my insulin when iv nearly ran out but that about it. Thats the way it's been for the last 10 years. I'm lucky in a way because my little brother is also type 1, but he has had it since he was about 8, so I knew a fair bit before hand.
     
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  13. Grant_Vicat

    Grant_Vicat Don't have diabetes · Well-Known Member

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    Really don't worry. If you get anything out of these posts that's all that matters. Hope life improves for you.
     
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  14. BeccyB

    BeccyB Type 1 · Well-Known Member

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    I understand, I suffer with anxiety too and think there's quite a few forum members who do too. It's mostly under control for me now but I have had several 'hermit' episodes. My worst was about 2 years ago and in the end hypnotherapy worked for me - I was SO skeptical but a friend suggested it and I was pretty desperate so tried it. 3 sessions and I was back at work and socialising properly again! I've also found Mindfulness helps, try the Headspace app - the basics are free so definitely worth trying

    Also, put in your letter to your GP that you are struggling with your anxiety/leaving the house and ask if there are any online resources you can access, I know my local area has a site you can get access to if you're registered with a local GP. There may also be telephone counselling available, maybe with a waiting list but I think a lot of places are using it these days.

    In terms of your diabetes - if you get an appointment with a hospital team and don't think you will be able to manage it give them a ring and explain. Hopefully they will be willing to arrange a phone appointment too. They may even have a mental health team attached to them as there is a lot more awareness of the interaction with diabetes these days

    Sorry if I'm overloading you with stuff, or it seems like I'm nagging you, I just want to get anything that may be useful onto this thread for you and anyone else that may read it. I'm glad you are popping back here occasionally, as @Grant_Vicat said if you get anything out of these posts then it's great.
     
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  15. Bladezy

    Bladezy · Member

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    No not at all, it's nice to know other people have had similar experiences and have made it through and also want to help others to reach the same place. I'd feel rude not coming back after you guys were nice enough to reply.
     
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  16. Bladezy

    Bladezy · Member

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    I don't understand either to be honest, that's why I came on here originally to ask about dka. As I assumed that something must be up as I didn't ever get ill like my brother.
     
  17. EllieM

    EllieM Type 1 · Moderator
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    Honestly, if you can go a week without insulin after ten years as a T1 I'd be skeptical about the original diagnosis.
     
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  18. Bladezy

    Bladezy · Member

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    Aha well I'm deffo type 1, I can guarantee if I tested my glucose levels they'll be super high. I can tell when they're up or down. My mate always tells me I'm not a real diabetic as i don't crumple at the sight of a chocolate bar lol. After a day or two I get weak and quite thirsty but as long as I keep hydrated I don't feel too bad, but now I think about it maybe I'm just too used to it and don't notice, I'm not really sure
     
  19. porl69

    porl69 Type 1 · Well-Known Member

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    I wish I could tell lol. If you are high a lot of the time then your feelings of low/hypo would be a lot higher that 4mmol. As for control, you need to get your diabetes under control. I totally abused mine in my twenties and am paying for it now...blind in my left eye and stage 4CKD.
     
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  20. EllieM

    EllieM Type 1 · Moderator
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    You know, I'm still wondering about that. Is there a possibility you can be MODY? They don't always need insulin, and as it's rare many get initially misdiagnosed as T1 or T2.
     
  21. Bladezy

    Bladezy · Member

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    MODY? I'll have a Google for that aha

    Hmm maybe... I'm not sure tbh, but I did get diagnosed at 21 but neither of my parents are type 1 though
     
    #100 Bladezy, Mar 5, 2019 at 7:43 PM
    Last edited: Mar 5, 2019
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