Unhelpful nurse at 3 month check up

[Mamamoose]

Just had my three month check up with DN and she upset me so much I dont want to go back! She wanted to know why I was checking my blood glucose levels (and this is with a meter provided by the surgery when I was initially diagnosed, as my DN at the time said I was young and it would help me get better control). When I said I was checking three times a day so that I knew what my levels were before meals she said - this is why we dont normally give people meters! I am type 2 and take metformin twice a day. I was diagnosed two years ago and have been head in the sand with regard to food ever since. Some days all I ate was carbs, bread, potatoes, crisps, sweets.

I I have just started a reduced carbohydrate diet to help get my levels down and also lose weight (using my fitness pal set at 1 lb a week and 100g carbs) and she said I was overthinking it, and just needed to know my Hba1c levels every three months to check my progress. She said my recent one was 66 mmol/mol and that was fine. But I thought it was supposed to be below 53? When I tried to explain what good things I was doing - I have reduced my calorie intake to a reasonable level (1500 cal a day) and been going to the gym three times a week since November - she wouldnt listen, just said she wasnt going to argue with me!

I was close to tears at this point as I was proud of myself for finally getting a grip and doing something about my terrible eating and my lack of exercise, plus my BG this morning was the lowest it has ever been at 8.6. I never want to see her again! A lot of people on here seem to think that reduced carbs helps with BG, and I am just in the obese area so definitely need to be in calorie deficit. Am I doing the right thing? Or should I throw away my meter and rely on Hba1c instead?

 

[Brunneria]

My goodness.
I wish I could give you a big reassuring hug.

How can these health professionals bear to live with themselves when they do so much damage with a few carelessly heartless words.
The good thing is that you KNOW she is wrong.
And you have your own meter readings as evidence.

Well done on that lowest ever reading, by the way.
You should celebrate:

And please use her nastiness as a motive to carry on your good work, and prove the w*tch wrong!

 

[Paul59]

If your DN is at your GP practice maybe an idea to tell your GP about her attitude.

 

[Phlogiston]

So what was her version of the diet for health?
I guess the conversation didn't get round to that.

Try and stay cool - the frequency of testing is not going to raise your BG.
Low carbs are probably the key to both your versions of the diet - just your's are lower than hers.

I don't think you can overthink this problem. Use the meter to find out what agrees with you and what doesn't. Keep the carbs and energy intake low and work to give her a nice surprise in June.
Best wishes

Adam

 

[AndBreathe]

Well done of getting to grips with things, and making the excellent progress you have. Surely, that alone shouts loudly, and clearly that you are doing all the right things?

Close to diagnosis, I had a conversation with my nurse about testing (the usual she said no, and I disagreed), but when I point blank asked her what she would do in my shoes, and if she would just wait for the lucky dip every three months, she got very quiet. The deafening silence was enough for me to know I was right.

Unfortunately, I think your former state is all too common with T2s. The debate around why that might be could take the rest of our lives, but I think it must be dispiriting for the healthcare folks to do review after review where they feel they're not being taken seriously. Isn't it ironic what happens when the tables are turned though?

Stick with what you're doing, and use this experience to further firm your resolve to succeed.

Good luck with it all.

 

[jackie_oates_123]

Keep up the good work , I have a bad experience with a doctor terrible bed side manner, it's difficult enough living with it without all these doctors and nurses that talk to you like your stupid, these hand full of people just don't have people skills .

So what was her version of the diet for health?
I guess the conversation didn't get round to that.

Try and stay cool - the frequency of testing is not going to raise your BG.
Low carbs are probably the key to both your versions of the diet - just your's are lower than hers.

I don't think you can overthink this problem. Use the meter to find out what agrees with you and what doesn't. Keep the carbs and energy intake low and work to give her a nice surprise in June.
Best wishes

Adam

 

[Gabe86]

Hi mamamoose forget your dn and go to find a new one she does not care .I think your doing a great job .keep doing what your doing.to reach our goal it takes a lot of work to succeed good luck .

 

[Lenny3]

My 1st DN told me after 6 months of following her advice and not improving, that i shoukd 'just get a gastric band', i never see her anymore.

Your doing a great job keep at it and ignore her. Ask for a different nurse next time.

 

[Mamamoose]

Thank you so much for your supportive replies. It was when I mentioned reduced carbohydrate she flipped. I think it is because the NHS dont recommend BG testing for Type 2s, just 'healthy eating', which is all well and done but if I could manage 'healthy eating' with no help, then I wouldn't be diabetic and obese! She actually looked to see if she could up my dose of metformin, but I'm on the highest dose already. So she disapproves of trying to reduce my BG by testing and eating less carbs, and would have actually encouraged me to eat the way I have been doing by increasing my medication! There is another DN I can see at the surgery - she is the one who gave me the meter - so I think I will ask to see her next time.

It was lovely to have your reassurance that I am doing the right thing. I need to see those BG readings to keep me focussed on the diet, which is not easy for me for lots of reasons, and seeing those levels drop is my reward for giving up crisps, chocolate and bread! I will ignore her and, hopefully, prove her wrong come June!

 

[rowan]

Well done Mamamoose, sounds to me that you're doing just fine without her dubious 'help'. Keep on with the testing, it's the only way to know that you're eating the right foods or not

 

[IanD]

Just had my three month check up with DN and she upset me so much I dont want to go back! She wanted to know why I was checking my blood glucose levels (and this is with a meter provided by the surgery when I was initially diagnosed, as my DN at the time said I was young and it would help me get better control). When I said I was checking three times a day so that I knew what my levels were before meals she said - this is why we dont normally give people meters! I am type 2 and take metformin twice a day. I was diagnosed two years ago and have been head in the sand with regard to food ever since. Some days all I ate was carbs, bread, potatoes, crisps, sweets.

I I have just started a reduced carbohydrate diet to help get my levels down and also lose weight (using my fitness pal set at 1 lb a week and 100g carbs) and she said I was overthinking it, and just needed to know my Hba1c levels every three months to check my progress. She said my recent one was 66 mmol/mol and that was fine. But I thought it was supposed to be below 53? When I tried to explain what good things I was doing - I have reduced my calorie intake to a reasonable level (1500 cal a day) and been going to the gym three times a week since November - she wouldnt listen, just said she wasnt going to argue with me!

I was close to tears at this point as I was proud of myself for finally getting a grip and doing something about my terrible eating and my lack of exercise, plus my BG this morning was the lowest it has ever been at 8.6. I never want to see her again! A lot of people on here seem to think that reduced carbs helps with BG, and I am just in the obese area so definitely need to be in calorie deficit. Am I doing the right thing? Or should I throw away my meter and rely on Hba1c instead?

You are doing the right thing by reducing carbs & checking BG readings. You have to become your own expert in control of YOUR health. And if you are young, it means you have longer to get & maintain good control. The problem with professionals is that they do their learning while they are young, with no personal experience of type 2 diabetes. They know what they are taught, but don't live with it like we do.

I was young when diagnosed - 61, & followed the recommended high starchy carb, low fat diet carefully. My HbA1c readings were around 50, so supposedly good control BUT by about 7 years, serious complications were setting in. At that point I came on the forum & learned about low carb. After discussion - & because I was becoming crippled with muscle pain, I cut all the obvious carbs from my diet. Within 3 months all the complications had gone. 7 years on I am fit & well & at 76 last week I am fit & well, & still feel young. 7 years ago I was feeling very old.

HbA1c is still around 47, so not a big change. The big difference in BG readings is that after a low carb meal, my BG stays below about 8.5 & may drop to above 5 before meals. With the high carb diet, BG would spike to mid teens, & fall to below 5 towards hypo. The average would seem OK, but its an average of very high & low, rather than a steady state average. That is what HbA1c doesn't tell you. It's the high BGs that cause the damage.

The point is you need a lifestyle change that you can maintain, & that controls your diabetes. A low carb diet is beneficial. A possible problem is reduced energy, as normally carbs are the main energy source. Increased fat in your diet will correct that - fat as it comes in meet, cheese, nuts, etc, & butter rather than marg.

Don't be bullied - you know by your results what works, as all sorts of measurements show your progress.

 

[Daibell]

The fact that your DN said an HBa1C of 66 (8.2%) was fine tells me she hasn't a clue. You are right to be testing and well done for starting to change the diet and get weight down. I think you need to set yourself a weight target for the next time you see her so you can say Ya Boo. You mention calories. As diabetics we need to think carbs not calories so set yourself a carb limit 150gm/day is a good start point and forget calories. As you know you need to be aiming for an HBa1C of less than 7% and as near to 6% as you can get it. Don't bother to discuss it with the DN; just get there thru diet and determination. The Metformin may be the only tablet you need but others can be added if needed.

 

[sanguine]

Hi @Mamamoose welcome - you're doing the right thing, keep it up!

 

[Ruth B]

I'll add to the list of people who are saying you are doing the right thing. Keep on the reduced carbs and keep testing and you will reduce your HBA1C in spite of her not because of her, and it is true that the HBA1C is an important measure as it tells us how we are doing overall, however by the time we get one every 3, 6 or 12 months its too late to do anything about that reading and then the downward slide of meds begins. Keep testing and make the changes daily as needed.

Have a big hug from me, and I hope you are feeling better in yourself this morning. Next time try and keep from telling her that you are self testing and reducing carbs until after she has done all her checks and told you how well you are doing and how much your BS levels have dropped, it fun to watch them trying to be disapproving after they have just been telling you how well you have done.

 

[hankjam]

Hi you'll see from the responses that most of the contributors have been here for sometime and gained a lot of experience, which they are great at sharing. Follow their advice, with small steps, and you'll see a positive change, which will help you.
You've done the right thing posting that message. wish you well.
My two bits would be to do some 2 hours after eating tests just to see what effect the food you ate had on your BG's.

 

[pavlovsdog]

Just had my three month check up with DN and she upset me so much I dont want to go back! She wanted to know why I was checking my blood glucose levels (and this is with a meter provided by the surgery when I was initially diagnosed, as my DN at the time said I was young and it would help me get better control). When I said I was checking three times a day so that I knew what my levels were before meals she said - this is why we dont normally give people meters! I am type 2 and take metformin twice a day. I was diagnosed two years ago and have been head in the sand with regard to food ever since. Some days all I ate was carbs, bread, potatoes, crisps, sweets.

I I have just started a reduced carbohydrate diet to help get my levels down and also lose weight (using my fitness pal set at 1 lb a week and 100g carbs) and she said I was overthinking it, and just needed to know my Hba1c levels every three months to check my progress. She said my recent one was 66 mmol/mol and that was fine. But I thought it was supposed to be below 53? When I tried to explain what good things I was doing - I have reduced my calorie intake to a reasonable level (1500 cal a day) and been going to the gym three times a week since November - she wouldnt listen, just said she wasnt going to argue with me!

I was close to tears at this point as I was proud of myself for finally getting a grip and doing something about my terrible eating and my lack of exercise, plus my BG this morning was the lowest it has ever been at 8.6. I never want to see her again! A lot of people on here seem to think that reduced carbs helps with BG, and I am just in the obese area so definitely need to be in calorie deficit. Am I doing the right thing? Or should I throw away my meter and rely on Hba1c instead?

Of course you are doing all the right things, that nurse sounds like an idiot! If you feel up to it you could always make a complaint, either try customer services or PALS . If you don't want to do that you could always ask to see someone else. You don't have to put up with being treated like that. Well done for all your hard work, your on the right track so keep it up. Don't let jumped up 'professionals' - who actually bring the profession into disrepute because of their poor attitude - get you down.

 

[Erin]

I wonder what kind of nurse care was practiced before Banting and Best. I think diabetics were hospital patients. Chances are diabetic life was limited to possibly a year. I know that we presently have medications and meters and visits to your dr.,, but as for hospital care I don't think we do, unless it is an emergency.

 

[Mamamoose]

Wow! Thank you all for taking the time to reply with your reassurance and good advice! I am so heartened by your replies. If I wanted any more confirmation that I am doing the right thing, today's pre meal BGs of 7.5 (lunch and dinner) were proof - I'm usually hovering around 10. I have decided to ask for the other nurse next time as she has always been much more positive (she was the one who gave me the meter).

IanD - your point about the HbA1c not picking up the difference between a level BG or one that is spiking high but averaging the same, is exactly what I was trying to say to her - I had been having spikes of 14.5, even up to 22 after a roast dinner. She said these didnt matter as my average BG was 'obviously fine'! (Except you and I know that 66 isnt fine really.) Thanks again everyone.

 

[Ruth B]

My mother was a nurse and she can remember when the only options were a tablet that helped the pancreas create insulin (which might have helped kill off any remaining beta cells by overworking them) or insulin injections. It was also referred to as sugar diabetes (makes me wonder if they thought there was more than one type) and only sugar was thought to be the problem, carbs were never considered. Insulin injections were still new enough to be thought fairly miraculous.

We also were loaned a copy of a diary by someone who lived in the 1800 (I can't remember the exact dates), one of his relatives was diagnosed diabetic at 24 I think, life expectancy for a diabetic then was 18 months, he was dead by age 26.

I am so glad I live in this day and age, even if some of the nurses seem behind the times.

 

[Natalie1974]

I always find that getting my HBA1C results is one of the things in life that I dread most...my last was 65 (8%).

My HBA1c has crept up considerably over the last few years because I kind of gave up on it all but this was actually quite a good result for me considering how high it had been. I received the most incredible verbal ***** slap from the DN for this one though...which I found very upsetting.

Don't get me wrong I know this result still needs to be improved upon...but surely...credit where due...and a little encouragement wouldn't go amiss. It's all too easy to judge someone by a number but what they don't see is the day to day blood sweat and tears that go into achieving any kind of reduction to this result, the constant testing and hypo's and mental anguish etc...so much so it's hard not to take this kind of criticism to heart.

Having recently joined this site I have done a lot of research into LCHF...I have books coming out of my ears because I want to ensure that I learn all I can about it before embarking on it completely...but already some of the information and advice on this site has proved invaluable and given me lots to think and learn about and the success stories are truly motivational.

Don't let this DN get to you...you're doing a great job...stick with it...and good luck.