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Where to get HOMA-IR & c-peptide test in UK

L

Lotties

Well-Known Member
Messages
317
Type of diabetes
Prediabetes
Treatment type
Diet only
Anyone know where i can get these tests done and have them properly interpreted with some additional weightloss guidelines as I'm finding that hard despite, ZC for a month & VLCHF for ~another 6?
Today's visit to my consultant rheumatologist was a bit of a curate's egg.
I mentioned my GP ignored his request to investigate the indications of a fatty liver so he offered an ultrasound - I declined as low carb should be putting that to bed and my regular blood tests should indicate whether the liver is improving. Save the NHS some dosh. Maybe next time if results come through poor again.
I did accept the lung function test as my breathing is getting worse despite the Prednisolone. Declined another chest x-ray- didn't see the point if the only treatment for me is steroids; I can't tolerate the other options. Got quizzed at high speed about why if my lungs were bad at the 7.5mg that they dropped it to and I put it briefly back up to 10mg over Xmas, why was I now only taking 8mg.
I also tried to discuss my low HbA1C but high blood sugars when eating any carbs. He offered anothe HbA1C but said December's was good at 38. No mention of the fact that the 12 hour fasting BG was 6.5 and marked as random and GP even refused to do that only the HbA1C.
I didnt disagree and told him wasn't surprised after nigh 6 months of low-carb but wasn't allowed to get a word in about IR. I did ask for c-peptide as my BG still races up over 12 on a single slice of bread home test and was asked why I wanted it as it was for hyperinsulinemia.
All this in 4 mins, mind.
GAH!
He did ask if I could stick low-carb and when I said yes, he said do that then.
No chance to ask for a blood pressure test. Last time was 165 over something.
 

Lotties, could you confirm where you are please - not necessarily town, but roughly? The reason I ask is at least one of the insulin test providers stopped doing their postal service, with only a clinic option. C-peptide can be done by the usual big boys - Medichecks, Blue Horizon and so on, although their costs vary. My own fasting insulin test was done overseas.

Lotties, why was your appointment only 4 minutes? It's your appointment about you, not his about him.

I always go into these appointments with my list of matters for discussion, and I make sure I see it through. Sometimes, it just happens in the course of the meeting, and other times, I need to check my list and bring stuff up.

My last Endo appointment was 1 hour 20 minutes, albeit in 2 blocks - and hour, then I had to do some paperwork and consents, then another 20 minutes.

My health is important to me, so if necessarily I will dig my heels in.

Curiously, I thought when I emerged from my hour slot there would a queue and baying crowd, but there were neither. Looks like I got lucky that day. Not sure how happy the Endo and 3 students felt though.
 
UK. 50 miles north of London.
Unfortunately, this is the way the consultant conducts things even with his private patients. I don't get a choice who I see in his clinic, occasionally his registrar or, very rarely, the other consultants. His registrars tend to over-prescribe but not seeing the same person each time means you sort of start, not from what was being looked at before but how you feel this week and what last times blood tests looked like. I think I'll leave him with a list next time (after my lung function tests in ?weeks) He's nice enough and is in the Telegraph's top 250 docs in the country.
I broke and ate 6 chips today after a month of Carnivore (with some gin & 4 After Eights in the month) 7.4 1hr PP and 7.3 2hr PP. Not sure if it due to fat adaption, or poor or lazy insulin.
I looked up the London diabetes centre but, apart from the consult time, the only additional things offered were ferritin, fasting test, c-peptide and calcium ultrasound thingy. This site is so full of great posters. I want to make sure treatment for my other condition doesn't progress my carb intolerance
There is a chap at the Brompton, I think, who may be worth contacting privately for my condition; i may ring his secretary to check.
 
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Medichecks will do an HOMA-IR but you have to have the blood taken at their lab in London

https://medichecks.com/products/insulin-resistance-blood-test

it comes with a fairly detailed doctors report.

They also do a C-peptide

https://medichecks.com/products/c-peptide-blood-test

The lab is just off Euston Road.. I think @Goonergal has been there
 
Consultants will often only stick to opinions on their own speciality, which you obviously have over lapping treatment/conditions. The steriods will effect your blood sugars, and if you are unwell or stressed that will raise them to. As your Hba1c is a normal range, it will not flag anything up, the low carb will mask the symptoms, I have had the same conversation, my bloods are good because I low carb. If I want to test it to distruction, I can eat cake and go back in three months.
I think you will not get all things covered in one speciality, and yes you hardly ever see the consultant, the norm now seems to deligate to minions, who seem never to read your notes.
I would start with what problem that worries you the most, and work on that.
Its a good idea to have a look at the NICE guidelines, for your conditions, because that is what they should be working to, which can be good way to work out why they are or are not doing things and what they could have missed.
https://www.nice.org.uk/guidance
I have decided that I will pay for a consultation and any tests, because I know through the GP I am not going to tick the box. The underlying condition that caused my diabetes is ongoing so it could get worse at any time. The last GP I saw yesterday, which was not about my diabetes, his level of knowledge was appalling and information given completely incorrect.
 

If I'm honest, if,you haven't finished, how does he get you out of the consultation room?

It's no good leaving him with a list. When will you expect to hear any response? Surely, if something is important enough to warrant discussion, it needs to be discussed, not left on a piece of paper, like leftovers or afterthoughts?
 
You sit there, and don't allow them to rush you. Go in with a list, and calmly keep asking questions until you get replies. Firm but polite. Works for me. They can't force you to leave if you do this. What sort of consultant was it? And 4 mins is ridiculous. Why was it only 4 mins?
 
He works extremely fast and always has. Gets in early and starts his clinic sometimes an hour early as it is a specialist clinic and and only runs between 8.30 and 12pm on Fridays. He's very good at making you make the choice on treatment offered and disarming (manipulating) one out the door. I've tried lots of tactics -none have yet worked but happy to revisit any in line with your suggestions.
 
He generally ends it by handing you the appointment/ further action ticklist to take to reception whilst saying he see you in x time and questions are reflected by questions.
 
Then he is not doing his job properly. Unless he or one of his staff physically manhandles you out, he can't make you move. It sounds like intimidation by a combination of charm and force of character to me. How often do you see him and why isn't he telling you what you need? He is supposed to be the specialist, not you. It a cop out on his part. Shameful. These sort bring out my stubborn streak.
 
I think you're right on the charm and character bit. I'll be writing everything down for use next time to leave with him for a response -I'm not good with getting things down though. I'm better 1:1 although not in this circumstance.
Most people love him but I think he's a bit like Marmite. Brain the size of a planet, serious specialist in his field and a workaholic.
 
I have found that having a checklist, and making a point of ticking off each question or topic, and jotting down a note or two slows people down and focusses them on doing their job thoroughly.

They also know I mean business and won't budge until my list is done. When they make a suggestion of a test I ask why. If they ask me what I want them to do, I ask what my options are, and what they recommend, as they are the expert, not me.

I didn't used to be like this, but I think it's my responsibility to ensure I get the most out of each consultation. I am as important as any other patient. Their lack of adequate time allowance is not my problem.
 
Lotties said:
He generally ends it by handing you the appointment/ further action ticklist to take to reception whilst saying he see you in x time and questions are reflected by questions.
Click to expand...

Personally, in that circumstance, I would take the slip of paper, or whatever it is, and put it behind my own list in my hand, showing him, politely, discreetly, but unmistakably where you prioritise his action.

It's your appointment. You need to develop strategies, and where necessary challenge his strategies for rationale.

At my recent mega appointment, the Endo wanted to defer action until a bone scan was done, which would take "a few weeks". I asked if he expected to see a worrying outcome from the scan. Answer: "No". I then asked what rate of degradation of bone density was usually exhibited on the proposed deferred meds. Answer: "Very slow". So my response was, "what exactly is the clinically material and significant impact of deferring prescribing? What material harm could be done in 6-8 weeks?" His answer: "None".

I then looked him in the eye and asked what advantage there was, to me, in deferring prescribing. He gave in.

i usually come out of these meetings tired. But it's important. A 4 minute consultation isn't a consultation in my view, never mind covering multiple topics.
 
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Hi -

did you ever get to the bottom of this? I have been diagnosed as insulin resistant but like you am incredibly carb intolerant...I spike and stay spiked for hours with a single piece of bread. I'm wondering about the possibility of being LADA or type 1.5 given I am not overweight, and definitely not now and am still losing weight that I can ill afford to do. I was going to see if GP will do a c-peptide test but if not then I'll do it privately. Did you end up going private? Also, I'd advise buying a cheap BP monitor for home use. I found my BP correlates significantly, and positively, with blood sugar. Day before my first endo visit I ate a McDonalds breakfast - egg muffin and one hash brown - I knew it would be my last ever - BP was 180/150!

D
 
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