What Powers does the Diabetic Nurse Have?

[bulkbiker]

They are specialists

Some are... others might have just drawn the short straw and been labelled as the DN in my experience.
Few have the knowledge of this forum.

 

[zand]

If they try to persuade you to take Metformin ask about having regularly vitB12 tests. Metformin us known to deplete B12 levels. It did with me

 

[Lenny249]

Nope. afraid not , its within the margin of error for that test
The HbA1c is an average over 3 months, weighted more to the recent weeks, so in essence it was just a confirmation blood test that the original HbA1c was correct that you are diabetic. Basically 2 days of changes wouldn't really change it because of how it works

Thanks

I did say it is my reckoning (with a typo)!

 

[brianb]

Following my recent two HbA1c blood tests of 50 (26 Sep) and 49 (14 Oct) the Dr phoned me on 17 Oct and suggested I go on medication (Metformin).

Maybe im misreading what you said above but HBA1c tests are normally done every 3 months, If you had one on 26th September and another on 14th October that's less than a month apart so that's not a good indication of what's going on

Ultimately you always have a right to say no to any medication or advice offered you just have to see what works best for you.

 

[catinahat]

that's less than a month apart

I think Lenny249 is recently diagnosed, Dr's often confirm the diagnosis by doing a second HbA1c test a few weeks after the first

 

[brianb]

I think Lenny249 is recently diagnosed, Dr's often confirm the diagnosis by doing a second HbA1c test a few weeks after the first

Ok I see, just seemed odd.

 

[catinahat]

just seemed odd.

It's not unknown for laboratories to make mistakes, mixed up samples for example. Imagine the chaos that could cause, it would odd if they didn't double check.

 

[HSSS]

Ideally I’d like another HbA1c test 3 months from when the Dr phoned me (17 Dec).

Nice guidelines say to test hba1c 3 monthly til sat le and then 6 monthly. Not that many surgeries do this. They do the annual full check including an hba1c and toe tickle etc and some do a 6 monthly one. If you want it remind them of this guidance. It worked for me early on in diagnosis even after I was stable for a while. Post covid and steroids I’ve gone haywire and will be doing likewise in a couple of months as I’m no longer stable.

 

[Lenny249]

They do the annual full check including an hba1c and toe tickle etc and some do a 6 monthly one.

My first meeting with the DN is due on 17 Nov; now I've read that some sufferers develop sores around their private parts. If that's true, and she does a tickle test in that region, I'm hoping she has warm hands and goes easy on the tickling stick. Thus far I don’t seem to have developed any sores and perhaps she will take my word for it?

 

[lovefuchsias]

They DN told me the wee test was for cholesterol, so what's the wee test for then...

I was told it was to check that my kidneys are filtering properly.

 

[Koalajane]

They DN told me the wee test was for cholesterol, so what's the wee test for then...

I believe it is to see if there is protein in your urine

 

[jjraak]

Following my recent two HbA1c blood tests of 50 (26 Sep) and 49 (14 Oct) the Dr phoned me on 17 Oct and suggested I go on medication (Metformin).

I asked her for a stay of execution for six months to try and sort myself out with diet and exercise.

She kindly agreed but said I’d benefit from an assessment with the Diabetic Nurse (DN) and has arranged for an appointment on 17 Nov.

Does it vary from practice to practice what powers the DN has? Ideally I’d like another HbA1c test 3 months from when the Dr phoned me (17 Dec).

If the DN talked me into having Metformin (unlikely) is she (in this case) the person who would up/lower the doses or does one have to go back and see the Dr on each occasion. My friend (I have one honestly) has been on Metformin for some years and told me, albeit it before I was diagnosed, that he’d had problems with it but the Dr had changed the medication to slow release and he was suiting him better.

Can the nurse prescribe monitors/strips etc (a bottle of Chivas Regal would be better!)?

Please, any pointers what I should expect from the assessment? Another blood test? Feet inspection? The Dr told me on the phone the assessment would take approximately 40 minutes.

Thanks

If I remember rightly, my then DN, took a lot of details, height, weight, etc..then the tickle test for feet .

Then told me I'd need statins & began talking about how many carbs I should eat, etc etc.

Taken aback I chose no statins (had found here by that time, and had done due diligence in my research)
Didn't seem I appreciated how necessary that were to me (2018)
Tone became a more hectoring one. Once it was clear I wasn't a stepford type 2

As said, it's guidance/advice.

Should we blindly just take it as read, or should we investigate the pros & cons, just a little for our own good ?

I had read up on here, decided not needed at that point.

Came in 6 months later with a hba1c of 40, and all the main lipid values at optimal or good.
Oddly. No one curious why or how...ho hum.


A little knowledge goes a long way,

Best wishes on your journey,

 

[PlushPuppy]

Should we blindly just take it as read, or should we investigate the pros & cons, just a little for our own good ?

This is about where I am at the moment. Had blood tests taken beginning of AUG because GP thought I may have DVT (not) and he was concerned that my HbA1C was elevated more than he would like. As was my cholesterol.
I countered with I know pain and stress can elevate both, to which he agreed. I said the pain I was having in the back of my knee (to which he had not a clue what the cause was) that had now completely engulfed the leg, ankle, and now my back was crippling. And just for fun, let's throw in that we had just buried my mother-in-law, who I adored and was like my Mom to me, as well as my father-in-law four months earlier... Not to mention the stress which went on from the end of last year when they suddenly went downhill within days of one another.
So, we agreed to test in 3 months time.

A month forward, I had another issue crop up and was back to the GP seeing a locum who ran bloods again.
This time another GP called frantic saying my HbA1C level was higher than in AUG, she wants me on Metformin - that day!
Also, cholesterol was higher then in AUG so she wants me on statins stat - but that will happen middle of NOV.
My kidney numbers were low, however, she will give me that if I was in week 8 or 9 of rampant diarrhea that they could not find a reason for. I was probably dehydrated. No probably about it, I was. Couldn't eat or drink.

I called my older sister in tears. She's been T2 for 15 years and has managed quite well, in fact coming off Metformin, but now back on it after the kidney stone bout.
She wanted my numbers - which I was so flustered I didn't get. I finally got them and I wasn't higher in SEP then in AUG, I down by 3 on the HbA1C. Still high, but not as dire as she projected.
My sister keeps saying she feels they jumped the gun and should not have prescribed yet - and it was too early to retest. My sister keeps saying, "Stress and pain, and you've got them both."
Neither has been eliminated, but now ramped up by all this kerfuffle.

I have set upon researching how to lower my numbers. I feel I've taken positive steps. Tomorrow I have my first appointment with the DN and I've a few questions lined up.
I do have the benefit of my sister's and two older brothers' experiences, not to mention my nephew who has now got, according to him. "...a whiz bang diabetes doctor who thinks outside the box..." and has reversed everything my nephew was originally advised to great success.
But yes, I am making my own decisions and shall see if I am correct - and am really undecided about the statins at the moment. Heart disease is in my family.

 

[jjraak]

But yes, I am making my own decisions and shall see if I am correct - and am really undecided about the statins at the moment. Heart disease is in my family.

Oh poor you, what an awful time of it you have had.

Stress, that well known enemy of BG Levels.
And the bonus rise of pain...how can any test be representative at this moment ?

A little too much ME, but I hope it makes sense and shows my intent.

"I had great bgs, a decent HBA1c (40 down from 58 over 6 months)

But awful accident a year ago left me in a dreadful state.
Meds, pain, immobility..
And high bgs....

But were THOSE BG's my 'normal' ?

Of course not, so why add stress to the medley of issues ?

One battle at a time, I say.

No good having a panic over good or bad BG's if I meant my injuries didn't heal...right .

So I Focused on getting better or as close as possible...THEN Attack & play BG Roulette.

To the point I gave up testing for almost 8 months, far too depressing on top of trying to keep my proverbial together."


Sound like you weren't too far off that, IF I may be so bold...<Hug>


Absolutely agree, we have to take into account our own background, do our own research and come to a decision WE are happy to accept & live with.

For some, quite rightly that is to take statins or whatever drug or advice the doctors offer

For others it's a 'hold on' let me think about it, moment .


After all it is a shock to us all at that first DX.

While forum ethos, quite rightly is we can't diagnose.

The least we DO deserve IS to have the HCP, actually see us as individuals.

And resist the tendency to see type 2's as a group that needs xyz drugs and a dogmatic retort that strikes me as meaning ALL type 2's are incapable of

A. Thinking for ourselves.
B. Of making clear decisions.
C. Sticking to a course of action
D. And Undeserving of being given the choice of treatments that have shown to be very effective.

THAT ain't ME , Thank you very much.

I know others have a good rapport with their doctors, DN & HCP's, but sadly from what I have read from far too many on here, those lucky enough to have such support are too few & far between for me.

TL;Dr.

Research, we ARE worth it .
THEN make informed choices.

Best wishes.
Look forward as I'm sure many will, to seeing more positives scores, once life settles down.

 

[Nicknackwack]

Personally I’ve found that my Specialist Diabetic Nurse knowledge is invaluable. Not only is her understanding of meds and their impact wide ranging but even interpreting such things as a home monitoring diary record very insightful.

For other reasons, I’m currently on a very aggressive program to reduce my BG & HbA1c which involves combination therapy of Tresiba insulin, Rosuvastatin & Metformin and I’m seeing very quick results that are well within my tolerances.

Does she have the ”power” ? Well that’s a very odd question IMO. But my DN certainly has the ability !

 

[Daphne917]

Personally I’ve found that my Specialist Diabetic Nurse knowledge is invaluable. Not only is her understanding of meds and their impact wide ranging but even interpreting such things as a home monitoring diary record very insightful.

For other reasons, I’m currently on a very aggressive program to reduce my BG & HbA1c which involves combination therapy of Tresiba insulin, Rosuvastatin & Metformin and I’m seeing very quick results that are well within my tolerances.

Does she have the ”power” ? Well that’s a very odd question IMO. But my DN certainly has the ability !

@Nicknackwack Rosuvastatin is a statin and will do nothing for reducing your blood sugar however statins have been known to increase blood sugar

 

[Deleted member 475901]

I just had a cholesterol test done with a finger prick and a meter similar to my BS one. Results in a few minutes, total, HDL, LDL and triglycerides. I asked about it and it is fairly new so not all surgeries have the meter yet.
The main difference is that it seemed to need more blood (at least the way this nurse did it) and my finger was cold so that took longer!

 

[Nicknackwack]

@Nicknackwack Rosuvastatin is a statin and will do nothing for reducing your blood sugar however statins have been known to increase blood sugar

Agree totally. But it does reduce LDL cholesterol significantly which is why I’m taking it

 

[JohnEGreen]

My DN can leap over tall buildings stop a speeding train with one hand and bullets just bounce off her or is that superman any way neither of them can cure Diabetes.

 

[jjraak]

Personally I’ve found that my Specialist Diabetic Nurse knowledge is invaluable. Not only is her understanding of meds and their impact wide ranging but even interpreting such things as a home monitoring diary record very insightful.

For other reasons, I’m currently on a very aggressive program to reduce my BG & HbA1c which involves combination therapy of Tresiba insulin, Rosuvastatin & Metformin and I’m seeing very quick results that are well within my tolerances.

Does she have the ”power” ? Well that’s a very odd question IMO. But my DN certainly has the ability !

Hi @Nicknackwack .

Interesting background story of your DX .

I hope things are moving in the right direction .

Marvelous stuff on your specialist.....well needed I suspect.

Just wondered if they are the GP designated one or from the hospital team ?

Very glad however they appeared for you.

Just trying to clarify if they are perhaps more highly trained then those more generally seeing gp patients, in light of your journey ?

And if not...,
.....how do I transfer to your GP....