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What to expect?

I

I shoot Nikons

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Location
Glasgow
Just had my second appointment with the nurse this morning.

Following on from the initial appointment when I was diagnosed a fortnight ago I have been staggering my dosage of Metformin up one each week until a reaching 3 per day (tomorrow).

She asked me to allow a week on one a day to let any side effects take place before trying to start taking some weight off from day 7 onwards. I have been following the NHS guidelines on diet for diabetics needing to lose weight and have lost 9.4 lbs this week and my blood pressure is coming down.

I am delighted with the standard and depth of care provided by my GPs clinic. However I do have a couple of areas of concern. Due to my age (27) I was told that before my handheld record is started being filled in I have to attend a hospital appointment with a specialist. I was wondering if anyone could enlighten me as to what this would involve. I'm worried about being poked and prodded to excess. I've never been a big one for medical treatment so it's all a bit daunting.

I'm also having concerns over the dietary guidelines put forward by the NHS. The arguments for low carbing make very compelling reading! That's not a criticism of my local GP and nurse, after all they have to toe the party line on such matters!

Ross
 
Hi Ross, firstly congratulations on your initial weight loss, well done
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I wouldnt worry in the least about a specialist diabetic appointment you will no doubt find it useful and whoever you talk to are likely to be far more knowledgeable than your practice nurse or GP.

Most T2's find that a reduction in the carbs they eat will help with their control, to what extent you need to reduce your carb intake by you will only know by testing your blood glucose levels regularly, before and two hours after meals seem to be the optimum times, if your bg is not returning to close to your pre meal levels after two hours then you will find that by reducing the carb content of your meal it will start to come down, trial and error, just keep chipping away at your carbs till your bg levels are within your targets. You may also find as many do that once you have your diabetes under control you will be able to increase the carbs you eat and keep your control but this will depend on the level of insulin resistance you start off with and the condition of your insulin production/pancreatic function.
 
Thank you very much! Start of a very long road, but I'll get there in the end.

That's a fair point. I have been looking upon it with dread but that is the perspective I should be taking. So long as the prodding is kept to bare minimum of course!!

The subject of self-testing hasn't come up yet. I'm assuming that they are waiting until after the hospital appointment to make a decision on that. Unless of course I'm in one of the local authorities where they have cut out such things. I'll bring it up at my next consultation.
 
It seems less and less likely nowadays to be offered test trips to help with your control but if you go and say you want to be proactive in controlling your diabetes you may have a chance, but I cant stress how important I believe testing is for T2's a view sadly not held by most health trusts today :(

I doubt if there will be any poking or prodding involved at your specialist diabetic appointment, unless you really upset the nurse/consultant :lol:

In my experience you will just have a chat with a specialist who will tell you about your condition make a few suggestions re meds, diet and lifestyle changes and answer any questions you may have.

Some useful info here Questions To Ask At The Diabetic Clinic and here Tips For Strips


Good luck
 
I wouldn't worry at all about the clinic; it should be fine. Most annual/bi-annual check-ups for diabetes consist of a blood test beforehand to check BS, kidney function etc and at the appointment you will have a blood pressure check, weight check and normally a foot check for pulse and nerve sensation with a tuning fork or whatever. The rest will be a chat and review of medication and any other worries. Ref low carb be aware that the NHS may suggest high levels of starchy carbs. What they really mean is high levels of fibrous carbs which aren't too bad but this gets translated to bread, pasta etc which can be very bad for BS, so go for low-GI carbs where you can and not too many. As others have said a meter is essential whatever the NHS says and you can get one for free from one of the manufacturers and strips off the web.
 
As well as the results of blood test & the foot check, I also got weighed, height and waist measured, and blood pressure too
 
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