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Who has never seen a consultant?

H

hanadr

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I ask this because in 6 years, I have only ever seen a GP and a DSN. I'm doing fine( last HbA1c 5.9%), but wonder if this is usual country wide? I have never seen a training course either and I got 1 short pretty useless discussion with a dietitian, before I was discharged from hospital nearly 6 years ago following my stroke.
Essentially, how did they know I'd cope?
 
Hi hanadr.

I think an awful lot of people have probably never been seen by a Consultant or Endocrinologist judging by the comments around here.

A GP can be good, but when complications set in or the treatment doesn't seem to be working they usually seem to get out of their depth quite quickly. They very quicly turn to the cheapest option, Insulin. there are usually other alternatives. Lack of training in the subject of Diabetes obviously.

I am of the opinion that early intervention by a Specialist is the best way for most people. These guys are trained for over 10 years before they are considered as 'Expert's.'
Most GP's get only a fraction and not in a specialist area.

You mention DSN or DNS. Most patients are really dealt with by a Practice Nurse who again has only ever been on a few courses to become 'skilled' in Diabetes ? A real DSN/DNS usually works in a Hospital in close conjunction with an Endo and is so much more skilled than a Practice Nurse who is covering that area in day to day practice along with many other jobs as well.

My Practice Nurse is a lovely Lady but is quite frankly out of her depth if you try to ask about Diabetes and treatments. She just doesn't know a great deal. My GP admits I know more about the condition than he does. Brave man to admit that. There are a few more who should come clean about their lack of knowledge too.

Ken. :D
 
The sad answer to that ,Hana ,is that they didn't.You are one of the clever ones.For each one like you there are probably hundreds who just don't cope and become more and more ill. I have never seen a consultant either but..I am quite happy with my doctor, so far anyway!!
 
In this extended household, four of the five diabetics (all T2, with one on insulin and a plethora of other medications for related diabetes problems (caused by the combinations of medicines) for heart and thyroid etc problems) see the consultant. The individual n insulin is seen quarterly, three others including myself are checked by the Practice Nurse every 6 months (HBa1c etc) and seen by the consultant annually. The other individual saw the consultant only twice after diagnosis and was told on the second visit that she did not want to see him again (unless something went pear-shaped) because he had obviously taken the diagnosis seriously and with 6 months was almost back to normal blood glucose levels. He now has 6 monthly checks with the Practice Nurse.

There are 3 practices in the local health centre. Of these, only the practice we five attend refers diabetics to the consultant. In fact after initial diagnosis they do not prescribe anything until the consultant has determined what the medication regime should be. Thereafter, they do not change medication or dose without reference to the consultant. The 3 doctors in the practice all have the view that it is a specialist field and patients are better served by a professional who is up to date with the dynamics of diabetes.

None of us have anything adverse to say about the healthcare advice we receive.
 
My doctor booked me in with an endo straight away. I saw him in March and I am due to go again in June. I have only been to the doctor's during diagnosis and the endo has recommended to him that I see the diabetic nurse at the practice and also the dietician but as far as I am aware there are neither at my practice. I received a copy of the letter he sent to the doctor over a month ago and so far no one from my practice has contacted me so I am just getting on with it myself.
 
i saw one twice after diagnosis then put in the care of my gp :)
 
I've never NOT seen a consultant in 27 years, but that may have something to do with my pop being an ex-GP, who knows exactly how to cause trouble when things don't go according to plan or design or his high standard of care.

My GP refers most diagnoses other than very basic, routine or obviously unconnected with diabetes through the hospital team, in the spirit of "too many cooks". He completely acknowledges that they have the specialist expertise to deal with my "interesting" case history. A bit TOO interesting for me sometimes...
 
TheTartanPimpernel said:
None of us have anything adverse to say about the healthcare advice we receive.
Click to expand...
I'm not surprised! What you have described is the gold standard that all GP surgeries should strive to emulate, but sadly very few do. As you said, yours is the only one of the 3 practices that does make referrals. Presumably the GPs in the other practices believe nobody could possibly know more than they do!
 
Hi all

God am gettin a bit worried now lol, erm, ive seen the consultant every month since january when i started on byetta.

Got referred to specialist wen i signed up with a new practice, but i must say he is good. I have 15 mins with the DSN to get weight bp etc done, then i have 30 mins with the consultant.

Maybe if i play ball and stop bein naughty i might go on longer checks!!!! (only jokin)

This is supposed to be a new way of stabilising diabetes and wont be referred back to gp till am stable, but still get my meds from gp though

Juliexx
 
Looks like Berkshire is out on its own again. here I think only insulin users see the consultant ever.
Adn I'm not going that far.
Whilst I can manage on just the Metformin, I'll settle for the nurse. My lovely one has retired, but someone told me she's helping out part-time.
She was keeping me sane and didn't mind how mucch I rambled on about my dietary theories In fact I think she is coming round to them
 
I've only seen my G.P. and practice nurse, never even been offered the chance of going to the hospital Diabetic clinic.
I'm not moaning, because my recollections of Diabetic clinics were HUGE queues of people kept hanging around for hours and dropping like flies!
It does concern me that I haven't seen a "specialist" though, as much of what my G.P. and nurse says is quite different to what I've read and been told by others.
It's the usual thing of not knowing who to believe!
 
Ho hum.
I was diagnosed T2 a month a month a go.
Past 20 years my blood pressure was borderline.
About 10 years ago i went and had a health MOT on the NHS and was ok.
Have Scuba Dived so have had to pass a medical to do that.
Had my weight down in the past to 14 stone now 18 stone 6 foot 2 inches, and ran 2 glasgow half Marathons.
Was in Hospital 3 years ago so i must of been ok then.
No Diabetes mith my mother, father or grand parents.
Father had heart probs and Angina.

Around a month ago i was asked for to go for a yearly blood pressure test.
So i phoned and asked for a cholestrol check as i was 18 stone and did not want heart problems, when i had my health MOT test 10 years ago it was fine but a lot can hapen in ten years.

Went and got my blood pressure test and got my fasting blood samples taken, asked practice nurse what i could do about my weight, she looked at the leaflet that i had lifted about five a day said that was good and said i would not see her unless something happend with the results.

A week later i got a call to see the doctor about my results.

Took my partner with me for moral support who hapens to be a midwife.

Appointment 5:30, i was seen at 6:30 by an young indian doctor who was only in the practice for a week, when i was leaving the roller shutters were coming down and the practice was closing.

She asked what i was in for and i said i had a high blood pressure test and a cholestrol test.

She went on about the results but it was my partner who pointed out that my Blood Glucose was 16 and some of my other results had a star next to them as well on the computer.

She then said i was a diabetic, i said no, did not want to be put on medication and was in denial and wanted to do a runner, my partner then told me to sit down around 3 times or i would of been off.

Young doctor then went for a more experienced doctor who took another blood sample as a second oppinion as i did not beleive it.

This blood sample was abnormal as well when i lreceived the results.

Doctor said sugar was my enemy stay off sugar and Beans from what i can remember.

I was put on Metformin 1000mg for 1 week and 2000mg for rest of my life going by the doctor.

Then i had young indian doctor phoneing me a couple of times to see how i was i said i should of ben refered to a Dietician.

I had already phoned the next available day and got an appointment with the practice nurse.

Then i had the practice nurse phoning me up to say i had a appointment with her i asked her about a meter and was told that would be sortrd out when she saw me.

Took Partner with me to see the nurse and low and behold they knew each other and had worked together.

I got a meter accucheck aviva and 10 strips lancets and an appointment for retinaopathy.

Got a lecture on plate portion size and told i would be seeing a dietician but not heard of that.

Got a card now that says i do not have to pay for prescriptions but was told to test with my meter once a wek so i will have to watch and not abuse that.
Now got 200 lancwts and 50 test strips. but to test once a week.

This week i went to see the nurse my self.
When i got home 4 weeks a go i went right on the net searched google that came up with Diabetes Daily which is an American site and then came here eventually.
Phoned NHS24.com and got leaflets and explanation from them about type 2 from them next day.
Partner asked Dietician at her hospital to send me info which had Diabetics uk in it.
Basically i learned 100% more than i learned from the health service on the net.

On Low carbing the practice nurse does not encourage that and comes back to the plate size portion control and i wont get low carbs on diabetics uk.
Was asked if i had joined diabetics uk i said no as i am unemployed i have still to send a tenner but i have enough learning on here and Diabetes Daily.

She then asked was there anything i thought was not explained to me properly.

1. If i had not asked for a dholestrol check would they of found out if i had been diabetic in the first place, she said it would of been checked and i told he when i came about my blood pressure test that i had a 5 a day leaflet when i asked could i do anything about my weight, she said i already knew about my weight.

2. I asked her about Endocologists and said they were better than doctors and knew more about doctors than them. Who told me that was the reply.
3. Asked her about low carbing and that some people were on 50 grams of carbs a day, she said is that healthy, i said no, she then said i wonder what the dietician will say about that.
She said i would not get that information on that on Diabetics UIK.
She also said that people encouraging low carbs had hiden agenda, i said it was information from other diabetics.
4. Told her that this April this year NHS are screening people over 40 like me who have high blood pressure a lot of the population are obese and there are millions of people who are diabetic and do not know it.

As things were getting touchy i backed down and left it at that, i do not think she was happy.

I have to see her again in another month and take another urine sample as the one i took was not the first one when i woke up but the third before i had anything to eat.

Well looks like i will be a regular on here and Diabetics Daily.

Davey.

P.S Sorry if this is off topic but been stewing about this for 4 weeks.

When i test around once a week my blood glucose is around 6 or 7when i wake up in the morning Do not check before and 2 hours after a meal as i dont want to upset the NHS when i have to ask for more strips.

Oh!!!! and i have never seen a consultant or a Endocologist LOL.
 
Im still quite a newbie in relative terms

On dx I saw Consultant in Oct for first A1c then Jan and again this month. They consider me well controlled and I suspect that after May, i will be on six monthly for next check, then annual

I am invited to call DNS if I need info but until I change regimes for insulin I reckon it will be like this. In my understanding, its type 1's mainly, and t2's on insulin who get seen by clinic at hospital. My doc is the Type 2 Doc but advised she knows nothing about insulin :shock: so I can only assume she sends them to the hosp clinic for 'proper' care.

L
 
I only got to see one after I joined this forum and was advised that I'm entitled to see one if I wish, so took the bull by the horns and just told my DN I wanted to be referred to a specialist. Had I not done that,I'd never have known I was actually Type 1 and the not Type 2 I'd been treated as for the previous 5 years.
 
hanadr said:
Looks like Berkshire is out on its own again. here I think only insulin users see the consultant ever.
Click to expand...

Not really, that's actually very common. Type 1s generally get referred to an Endo, Type 2s are left to the GP at best or the least trained nurse at worst. Probably depends how many endos are in the area as to whether anyone else gets referred, they are not as widespread as they ought to be.
 
Sounds like a numbers game again to me - am I right in thinking there are many more T2s than T1s? Of course add that to the (incorrect) perception that T2 is "not as serious" as T1, so the former get palmed off to GPs unless specifically requested?
 
kegstore said:
Sounds like a numbers game again to me - am I right in thinking there are many more T2s than T1s? Of course add that to the (incorrect) perception that T2 is "not as serious" as T1, so the former get palmed off to GPs unless specifically requested?
Click to expand...

Best I could find about statistics was back in 2007. This was just for England alone.

Diabetes is a chronic and progressive disease that has an impact upon almost every aspect of life. Diabetes is the leading cause of blindness in people of working age in the UK. It affects infants, children, young people and adults of all ages, and is becoming more common. There are an estimated 2.35 million people with diabetes in England. This is predicted to grow to more than 2.5 million by 2010 - 9% of which will be due to an increase in obesity.
Life expectancy is reduced by at least fifteen years for someone with Type 1 diabetes. In Type 2 diabetes, which is preventable in two thirds of people who have it, life expectancy is reduced by up to 10 years. It is estimated that around 90% of people with diabetes have type 2 diabetes.
 
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