26. If you are the doctor undertaking an investigation or providing treatment, it is your responsibility to discuss it with the patient. If this is not practical, you can delegate the responsibility to someone else, provided you make sure that the person you delegate to:
a. is suitably trained and qualified
b. has sufficient knowledge of the proposed investigation or treatment, and understands the risks involved
c. understands, and agrees to act in accordance with, the guidance in this booklet.
27. If you delegate, you are still responsible for making sure that the patient has been given enough time and information to make an informed decision, and has given their consent, before you start any investigation or treatment.
43. You must respect a patient’s decision to refuse an investigation or treatment, even if you think their decision is wrong or irrational. You should explain your concerns clearly to the patient and outline the possible consequences of their decision. You must not, however, put pressure on a patient to accept your advice. If you are unsure about the patient’s capacity to make a decision, you must follow the guidance in Part 3.
I was at an X-PERT refresher course where one participant said he had had heart trouble as well as diabetes - the Dr was monitoring his diab by regular HbA1c - ANNUALLY.The nurse actually said " If you are not using insulin, and you get a test result of, say, 8.7 - what are you gonna do about it? You can't DO anything about it"
I said possibly you could look at the food you had eaten to try to understand the result. You could definitely go for a brisk walk or do some exercise. And that was the end of that. She ended the discussion then and there. So it is very obvious that self testing is completely ignored as a help to control type 2.
CathyN said:Unsurprisingly, a month of random urine stick testing had produced few positive results, as these sticks don't read positive until 10 mmol/L. This was greeted with more patronising enthusiasm and I'm sure a slightly confusing message that we were all well under control. So I just had to raise the question - if you're officially diabetic at 7mmo/L or over, you could have been 9.9mmol/L for the entire month, but the sticks would not inform you of this worrying fact. Suddenly the patronising charm was replaced by a more business like attitude. The nurse actually said " If you are not using insulin, and you get a test result of, say, 8.7 - what are you gonna do about it? You can't DO anything about it"
I said possibly you could look at the food you had eaten to try to understand the result. You could definitely go for a brisk walk or do some exercise. And that was the end of that. She ended the discussion then and there. So it is very obvious that self testing is completely ignored as a help to control type 2.
susanmanley said:I have been enrolled on a DESMOND course but am now worried. I have got a s/h meter from this site and have worked hard to find the best information I can [again from this site mainly] I am concerned I will get negative responses to my way even though it is obviously working.
I have a range of problems [CHD, Kidney removed, diverticulitus, pancreatitus,chronic asthma, etc] and need to juggle the needs of each which can be difficult and will not respond well too brainless trotting out of government guidelines. I was hoping it would help/support me as an individual.
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