What do new doctors need to know about Type 1?

[Robinredbreast]

Good morning and very pleased to meet you.I'm female, Type 1 in my 26 th year.
Guidelines on eating carbs. I find that by reducing my carb intake, (but not low carb) readings, over all are better, for me.
Type 1's are all different, what works for me wont necessarily work for another Type 1.
Stress, upset, worry, shock, illness, operations can affect our blood sugars dramatically, sometimes for weeks. sending them soaring.
Teaching hospital medical staff that there is a Type 1 diabetes, as I found out last year,( when I was asked in A &E about medical conditions, I said I had diabetes and the nurse said ' Type 2)' after an accident. No, I said ,Type 1, I should of been asked 'which type'? I was taken aback.
Definitely awareness and understanding of type 1. It ain't easy at times( especially young adults we have seen on the forum how hard they find it) and I'm sure the majority of Type 1's do there utmost to get good over all control.
Thank you for bringing Type 1 to the surface ( as at times it feels we are overlooked) and I wish you all the best on your upcoming teaching session, I hope it has a positive affect in the NHS.

Best wishes RRB

 

[himtoo]

interesting that you only have 25 minutes on this -- considering that 10% of the total NHS budget is spent on Diabetes and its treatment and dealing with complications -- you would think a module of 6 months to 1 year of the average 10 years it takes to become a GP would be more appropriate.

 

[Spiker]

100% bang on analysis smidge
Exactly what all gp's should know

Not that simple. It's not just auto immune vs non auto immune and then age of onset. You also have all kinds of other pancreatic failure / absence. You have some genetic faults. You have conditions like reactive hypoglycaemia. So type 1 vs type 2, based on autoimmunity - which PS doctors rarely ever actually test for when making a diagnosis - isn't enough.

But hey, why confuse the medical students with the facts. :-/

 

[Spiker]

I have actually never met a GP who didn't understand the basic distinction between type 1 and type 2. Other HCPs yes, but not a doctor.

 

[noblehead]

I have a teaching session with medical students in a couple of weeks. I have 25 minutes to talk to them about type 1 and living with it. What would you like your Dr's to know? What should I cover?
Many confuse Type 1 and 2 so I thought I'd cover the difference and awareness of hypos but any ideas otherwise?

Just talk to them about your own experiences of living with type 1 and how this has effected your life over the years, time allowing also talk to them about your insulin pump as some HCP's only have a basic understanding on what they are and how they work.

 

[yingtong]

One simple thing no two type 1's are the same in their medical requirements.

 

[iHs]

I once gave a talk to some medical students at my GP surgery about diabetes. They were fairly knowledgeable and asked me how long I had been diabetic for and then looked at my insulin pump and knew more or less that I was type 1 because of the number of years.

 

[DunePlodder]

Please tell them not to assume that they know more about the patient's diabetes than she/he does.
For those of us who work hard at their control it's very irritating.

 

[Flowerpot]

I would tell them never to underestimate the severity and speed complications can happen. Don't ever dismiss something because the patient is young or doesn't exhibit all the classic signs.

From bitter experience I was sent away from A & E by a young medic after being diagnosed with a sprained ankle, I had Charcot foot and have had 15 years of fractures and currently have both legs in casts battling to save my one leg from amputation all due to being sent away without the young Doctor consulting with an experienced diabetes specialist. Unfortunately I'd never heard of Charcot foot, nor had the Doctor who saw me. I'm the one dealing with the ongoing, hideous consequences.of that mis diagnosis, all for the sake of being dismissed as too young for complications..

 

[Robinredbreast]

Please tell them not to assume that they know more about the patient's diabetes than she/he does.
For those of us who work hard at their control it's very irritating.

Very true, thumbs up on that one

 

[Robinredbreast]

Thumbs up for this thread, so many interesting and thought provoking posts

 

[LucySW]

If I had a group of medical students in front of me I would impress this on them as strongly as possible:

- the orthodox medical approach to diabetics of all types is not working, and is making the problem worse.
- even the classification of diabetics into type 1 and 2 is crude and out of date
- that as physicians they should educate themselves on the facts and the research, stay up to date, and not rest on orthodox recommendations. Almost by definition these will always be decades out of date
- in the case of T1 to read the work of Dr Richard Bernstein
- in the case of T2 to read the work or Prof Roy Taylor
- to understand how orthodox medicine can deviate very badly from the scientific data and scientific method, on diabetes and on metabolic syndrome / CVD, read The Diet Delusion by Gary Taubes.

Spiker I second every word.

Lucy

 

[LucySW]

Also to add: diabetics deserve to be protected from the risk of complications, and those who wish to work for normal-ish blood sugars should be supported, not castigated.

And one last thing: they should understand what HbA1c is, and what it isn't. It is not a mean. It is a cumulative aggregate which accumulates above a particular level of BG that is probably specific to each individual.

 

[Daibell]

Hi. I agree with Spiker and. Smidge. T1 can come on at any age and many HCPs don't know this and just assume T2 if older. The latest NICE Draft DEC 2014 Diabetes Guidelines now, sensibly, suggest the GP assumes T1 as a possibility if the patient presents as slim and having had weight loss as I did. It also says that the two tests GAD and c-peptide need to be used with care (if used) as GAD is only reliable at or near the time of diagnosis and c-peptide becomes more relibale as the condtion progresses. Note that GAD antibodies are not the only cause of T1 things like viruses, pancreatitis and so on can cause iselt cell damage. To me one of the important differences between a typical T2 and a typical T1 is that aT2 will have too much insulin whereas a T1 will have too little. This means the tablets and insulin if needed need to be chsoen with that in mind.

 

[Auckland Canary]

Not to forget about the mental difficulties. Many diabetics self harm, suffer from depression or experience burn out. It is certainly not just a physical condition.

 

[donnellysdogs]

Please stress that every diabetic is individual: eating; lifestyles and insulin needs.
Any medical professional should be open to treating patients as individuals as one size does not fit all.

 

[serenity 24]

Please stress that every diabetic is individual: eating; lifestyles and insulin needs.
Any medical professional should be open to treating patients as individuals as one size does not fit all.

Just adding to this my lovely daughter was diagnosed. Type 1at 15years of age but GP missed the signs for 10 months. Nearly lost her. She is 23 now suffers with depression, self harm, and has also been diagnosed as celiac 5 months ago. Consultant 're celiac told her she didn't need any follow up 're celiac condition. Shocking rally as obviously this has a big affect on what carbs she can eat. She is permanently tired out. Trying to keep working but picks up the slightest illness an is knackered and has to rest. She is trying to keep positive but a daily struggle

 

[Flowerpot]

I'd collate these great posts and give them as a handout to go with your talk @Unique pixie.

 

[Daphne917]

Just adding to this my lovely daughter was diagnosed. Type 1at 15years of age but GP missed the signs for 10 months. Nearly lost her. She is 23 now suffers with depression, self harm, and has also been diagnosed as celiac 5 months ago. Consultant 're celiac told her she didn't need any follow up 're celiac condition. Shocking rally as obviously this has a big affect on what carbs she can eat. She is permanently tired out. Trying to keep working but picks up the slightest illness an is knackered and has to rest. She is trying to keep positive but a daily struggle

My brother was diagnosed with Coeliacs Disease about 10 years ago when he was in his 40s - although it is in the family as both my aunt and cousin also have it. However he has a check-up with his consultant every year even in Spain where he now lives. Perhaps she can request that her GP refers her again.

 

[serenity 24]

My brother was diagnosed with Coeliacs Disease about 10 years ago when he was in his 40s - although it is in the family as both my aunt and cousin also have it. However he has a check-up with his consultant every year even in Spain where he now lives. Perhaps she can request that her GP refers her again.

Thanks. She is going to call on Monday