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Type 2 & treatment?

Gavinspurs

Newbie
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2
Hi guys, I'm knew to this forum. I'm just wanting to check with other type 2 diabetics what treatment regime they have with their GP? I had to change from my long term GP/diabetic consultant last year due to moving house and outside their postcode responsibility. Before I saw my GP every 3 months and he checked my hba1c from fasting bloods and did weight check etc. I also had to attend eye exam annually and have my feet checked annually. My prescription at time of leaving was 2 metformin tablets 750g a day & sitagliptin & provide with test strips to monitor bloods each day. Since moving to new GP I'm being seen once a year, no fasting blood checks, I'm not allowed test strips on prescription and haven't been contacted regarding any eye exam or feet checks. I'm starting to get a bit worried that I'll just now get worse and end up type 1 because I'm not getting any measurements or support from GP. My dad is a type 1 so he has been able to give me some spare test strips lately so I can now test once a week but it feels a bit pointless. Just wondering if I had a really good GP to start with and now I'm just getting the normal NHS treatment at my new GP or should I be raising any issue with my doctors about standard of treatment now? Any advice would be appreciated! Sorry for the long winded message
 
Firstly you won't change from being Type 2 to Type 1. You may need insulin like T1's at some stage but you will still be T2 (with insulin)

I have the same annual checks as you have mentioned. I was taking metformin but no longer need it as I have reduced the amount of carbs I was eating. A lot of us Type 2s have to buy our own meters and test strips. I'm afraid the NHS consider it too costly to provide us all with them.

So yes I think what you are getting now is pretty standard treatment, but have a read of the forum, there's a lot you can do to help yourself stay well and maybe even reduce the amount of drugs you need to take in the future. :)

I'll tag @daisy1 to give you the info she gives new members, I realise you are not new to diabetes, but there may be something there of use to you.

Come back and ask any questions you may have.

Oh, and welcome to the forum :)
 
Hi guys, I'm knew to this forum. I'm just wanting to check with other type 2 diabetics what treatment regime they have with their GP? I had to change from my long term GP/diabetic consultant last year due to moving house and outside their postcode responsibility. Before I saw my GP every 3 months and he checked my hba1c from fasting bloods and did weight check etc. I also had to attend eye exam annually and have my feet checked annually. My prescription at time of leaving was 2 metformin tablets 750g a day & sitagliptin & provide with test strips to monitor bloods each day. Since moving to new GP I'm being seen once a year, no fasting blood checks, I'm not allowed test strips on prescription and haven't been contacted regarding any eye exam or feet checks. I'm starting to get a bit worried that I'll just now get worse and end up type 1 because I'm not getting any measurements or support from GP. My dad is a type 1 so he has been able to give me some spare test strips lately so I can now test once a week but it feels a bit pointless. Just wondering if I had a really good GP to start with and now I'm just getting the normal NHS treatment at my new GP or should I be raising any issue with my doctors about standard of treatment now? Any advice would be appreciated! Sorry for the long winded message
Welcome @Gavinspurs
You shouldn't "end up T1" as T1 is auto-immune and a completely different disease to T2.(If your islet cells give out , you will be t2, but an insulin dependant one!)
I suspect you had a good GP and have gone to a poor/normal practice now1
Personally, I was under a consultant where I was given good help and my GP has just signed the scripts. Now I am purely seen by my practice and my "box ticking" is fobbed off to the practice nurse (never seen GP for D things in 6 years!)
Rattle your practice's cage about your eye & Feet checks as they should be done annually!
 
@Gavinspurs

Hello Gavin and welcome to the forum :)

Although you are not newly diagnosed, here is the information we give to new members and I hope it will be useful to you. Ask all the questions you want and someone will be able to help.



BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find over 140,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to bloodglucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.
 
Hi. GPs vary a lot with diabetes. If you haven't had a retinopathy appointment for over a year ask the surgery reception to get you on the list; it's a must. Do you know what your HBa1C is? This should be taken and results given to you at least once a year. Don't worry about fasting blood sugar readings as they are of little value and diabetic blood tests now are not fasting.
 
With the medication you are on you are not deemed by the powers that be, not just your GP, to require test strips as the 6 monthly blood tests should be enough. The GP is following laid our guidelines. Having said that, when you joined the practice you should have had a new patient check with the nurse who would then do the referral for the eye screening and diabetic checks.

Book an appointment for the nurse for new patient medical and diabetic check. If youve not moved that far but and are in the same health authority area it may be worth contacting the screening services yourself and advising them of your change of address. If you're under the same lot it could be that theyve sent an appointment to the old address.
 
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