# Just diagnosed - a little frustrated!!



## evilcat (May 23, 2011)

Hi all,

I started feeling ill at the end of March and after checking the NHS Direct site it appeared that I had all the symptoms of diabetes.  Earlier this month I went to the doctor and was diagnosed as I expected.

I am however a little frustrated by the attitude of both the doctor and the diabetic nurse and I was curious to see if this experience has been mirrored for others.

The doctor was completely disinterested and didn't both to ask me a single question, although he did agree to send me for a fasting blood test.  When the results came back I was asked to book an urgent appointment as the results were quite high - 14.7.  On my return appointment however all the doctor advised was 'you have diabetes - it's not good' and he then sent me away with an appointment for the diabetes nurse and 500mg Metformin to be taken twice a day.  [No mention at all of the side effects!] I asked what type I was and his advice was that I could be any of them!

I finally saw the diabetes nurse today and had been expecting to receive some more detailed info as well as a testing kit but I was disappointed by the response I received.  The dietary guidance was to eat lots of fruit, veg and fibre, with some lean meat.  This seems contrary to the low carb diet that most internet sites normally seem to recommend.  One of the specific foods that I was told to eat was canned fruit in juice, which as far as I was aware is like eating a couple of spoonfuls of sugar 

I sat through the discussion on diet without saying too much, but when I asked for a testing monitor I was told I didn't need one as the 3 monthly blood test would suffice.  When I queried how I'd know which foods had good/bad effects, I was told it didn't matter as long as I was following a healthy diet.  The conversation went back and forth for about 5 mins and eventually he agreed I could have one next week, but I would only be allowed to test once a week!!  We then got to the crux of the matter when he confirmed that Cambridgeshire PCT were restricting the number given out as they were over-subscribed!

In the end I went to Boots and bought my own one - I want to get a handle on this as soon as possible.

Is this experience typical?  I'm seriously considering moving to another practice.  Any advice would be much appreciated - sorry, this has turned into a bit of a rant!!

Many thanks!


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## Northerner (May 23, 2011)

Hi evilcat, welcome to the forum  I'm sorry to say that, from the evidence of many other member's stories here, your experience is very typical - both in the lack of interest of your doctor and the restriction of test strips. I'm afraid we hear this story daily and of course it is all related to short term costs, not your best interests as a patient. There are strategies you can adopt to make the strips you buy go further by making each test count and return valuable information over a period of time. Take a look at our Useful links thread - the book  Type 2 Diabetes: The First Year by Gretchen Becker is well worth getting, and Jennifers good advice is a useful guide to efficient testing.

Please feel free to ask any questions you may have and we will do our best to answer them!


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## Steff (May 23, 2011)

Hi there and a warm welcome to the forum evilcat, unfortunetly your situation is all too common, your diagnosed told to eat fruit and are left to it which just aint good enough, the best thing you can do is see about moving practice, you deserve better care then what your getting its terrible.As for being told to eat the juice in fruit well thats just so scary, its like telling you to go off and eat a bag of sugar,so sad that these people are so called professionals when there giving out such dangerous advice..

I can say one positive thing though your on this forum now and whatever we can do to help you we will..x


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## am64 (May 23, 2011)

hi and welcome to the forum ...your experiences seem to be fairly typicical of the way T2 are dealt with now. testing is highly important at this stage as with why you do it and what the results mean. i originaly had no problems getting strips for the meter they gave me but now am serously limited to 100 a year....you need to test to see what it is that is causing your sugars to rise. i was leading what i thought was a 'healthy' diet with masses of muesli for breakfast, fruit and veg and fruit juice all natural organic etc etc ...not really understanding the amount of sugar it all contained which for me as a T2 D wasnt actually that 'healthy' ...stick out for demanding strips till at least you have a good idea whats going on. someone im sure will come on with all the links to the NICE guidelines re T2 and testing , but what i gather if you can prove that you are using the information to improve your levels, testing strips should be provided ...so keep a food diary, test yourself pre food, 1hr later and then 2hrs later ....and keep a record to show your GP/ DSN xxx good luck


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## Northerner (May 23, 2011)

This is Diabetes UK's position statement on self-monitoring:

http://www.diabetes.org.uk/About_us/Our_Views/Position_statements/Self-monitoring_of_blood_glucose/

You might want to test for a while, recording everything and then showing the evidence to your doctor of how it is helping you manage your diabetes - this might help you to persuade them to prescribe some strips.


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## Mark T (May 23, 2011)

Welcome to the forums Evilcat


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## Robster65 (May 23, 2011)

Hi evilcat. Welcome 

Sorry to hear of your (typical) poor experience with your GP. Some of them should be recalled to medical school and brought into line with post-mediaeval thinking. 

I hope you can gain plenty of info from the forum and get those BGs down in spite of your GP's poor advice and support. 

Rob


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## KateR (May 23, 2011)

Welcome to the forum. If you don't get any positive information from your GP, I would change practice.


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## evilcat (May 23, 2011)

Hi all,

Many thanks for coming back to me with such good advice so quickly.  

I've started listing my food today - my figures seem pretty high although I've only been on the pills for a week:

11:30 Fasting test as I had more blood taken this morning - 11.7
12:00 Bowl of porridge with 1/2 tsp agave plus a couple of slices of roast beef (brunch!)
14:05 23.4
14:30 2 strip cheese and a pepperami
15:30 6 oatcakes with houmous
18:00 15.5
19:30 Pork fillet, 1/2 boiled sweet potato, dessert spoonful of mash, sugar free jelly 
21:50 14.2

I thought that I'd eaten okay today, but I guess not!


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## Northerner (May 23, 2011)

Bear in mind that it is the relative rise in blood sugar levels after eating that you are trying to determine - if you are, for example, 12.0 before eating and 16.0 an hour or two after eating that's not so bad, but if you were 20 after eating that suggests that what you ate was 'spiking' your levels high. So soon after diagnosis your levels will probably be high generally, but this should improve as the medication takes effect and your body gets used to the dietary changes you are making. Exercise is excellent too if you are able to manage it


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## am64 (May 23, 2011)

watch the porridge .... many of us get spikey highs from it ...take one day at a time xx good luck x


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## evilcat (May 23, 2011)

I read that porridge caused some bad reactions, but I was hoping it wouldn't cause too many issues.  I'll see if I get the same response for the next couple of days.  If so then it looks like porridge is off the menu!!


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## evilcat (May 23, 2011)

Northerner said:


> Bear in mind that it is the relative rise in blood sugar levels after eating that you are trying to determine - if you are, for example, 12.0 before eating and 16.0 an hour or two after eating that's not so bad, but if you were 20 after eating that suggests that what you ate was 'spiking' your levels high. So soon after diagnosis your levels will probably be high generally, but this should improve as the medication takes effect and your body gets used to the dietary changes you are making. Exercise is excellent too if you are able to manage it


Ah, I wasn't thinking in terms of the relative rise, just what seemed like high numbers.  Looks like I'll need to get started on the treadmill!


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## mcdonagh47 (May 23, 2011)

evilcat said:


> Ah, I wasn't thinking in terms of the relative rise, just what seemed like high numbers.  Looks like I'll need to get started on the treadmill!



Hi evilcat,

Here are a couple of pointers to help with T2 testing below.

Basically you need a low GI, Mediterranean style diet. And no they shouldn't have put you straight on metformin without a three or six months trial on diet and exercise. Also ask about courses for new t2s such as DESMOND or X-Pert Patient. Be wary of the nurse, she is probably just the Practice Nurse at your surgery and not qualified beyond taking blood, looking at feet and talking about her holidays to deal with diabetes.

(And yes you have come across the standard reaction to new Ts from many 
medics .... you've got an incurable condition of which the causes are not known and so for which there are no treatments ... so just b***er off. )

Read Jennifer's Smart Advice ....
http://jennifer.flyingrat.net/

and then Alan S's Test Review Adjust blog ...
http://loraldiabetes.blogspot.com/2006/10/test-review-adjust.html


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## margie (May 23, 2011)

Hello evilcat and welcome to the forum.

Although your Dr said you could be any type the treatment prescribed and the attitude towards testing implies they have decided you are type 2. It doesn't mean you are as we have members on here who have been diagnosed with type 1 in their 50s and 60s. That is quite rare and it can confuse GPs.  

Its terrible that when people are feeling confused and worried that they get left to fend for themselves.

I am wondering when they told you to eat tinned fruit in juice whether they were trying to tell you to avoid tinned fruit in syrup and if you had tinned fruit to ensure it was in natural unsweetened juice. 

In terms of porridge - the coarser the oats the less the effects on blood sugar - well that is the general rule and it does not seem to work for everyone.

Have a good look around and ask as many questions as you can think of.


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## evilcat (May 23, 2011)

Many thanks for the links - there's some really useful info there!


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## evilcat (May 23, 2011)

margie said:


> Hello evilcat and welcome to the forum.
> 
> Although your Dr said you could be any type the treatment prescribed and the attitude towards testing implies they have decided you are type 2. It doesn't mean you are as we have members on here who have been diagnosed with type 1 in their 50s and 60s. That is quite rare and it can confuse GPs.
> 
> ...


Hi Margie,

Many thanks for your comments.  I'm 36 years old, but a bit overweight so I presume that's why I was diagnosed as type 2. The only thing I was a bit unclear on was the normal timeline for a type 2 diagnosis.  The dehydration, weight loss and blurred vision all started around the end of March and got worse very quickly but I thought type 2 was a more gradual process?


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## Blythespirit (May 24, 2011)

Hi Evilcat and welcome to the forums. I'm sorry you've had to find out so quickly that T2's have an uphill struggle as far as health care goes. 
I was diagnosed in 2003 and had to buy my own meter and strips til I was put on Byetta injections last month. Like you though, my symptoms came on very quickly. Got the all clear in the June and my fasting HbA1c was 18.5 in the November. The symptoms came on over the span of  couple of weeks and my eyes went funny in the space of an hour! I was still diagnosed as T2 though. Take care. XXXXX


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## Mark T (May 24, 2011)

evilcat said:


> Hi Margie,
> Many thanks for your comments.  I'm 36 years old, but a bit overweight so I presume that's why I was diagnosed as type 2. The only thing I was a bit unclear on was the normal timeline for a type 2 diagnosis.  The dehydration, weight loss and blurred vision all started around the end of March and got worse very quickly but I thought type 2 was a more gradual process?


Welcome to the diagnosed in your mid-30's club - there are a lot more of us then I was initially led to believe 

I think how quick it jumps on you is one of those YMMV things - I didn't even notice it coming.  Do you have any diabetes in your family?

It's a bit poor that your GP thought to label you as a Type 2 right away.  Mine refereed me to the hospital and my anti-bodies were tested to check if I was LADA/Type 1.5 or not (although from the link Northener posted today, my negative result doesn't necessarily mean that I'm not).


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## evilcat (May 25, 2011)

Hi Blythespirit/Mark,

Many thanks for your comments.  The doctor actually said he didn't know what type I was - it was the diabetic nurse who advised.  As he didn't ask me any questions, I presume he made an assumption.

My Dad has Type 2 so I guess I'm the same, but as neither the doctor or the nurse asked, they weren't aware of the family history...


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## Mark T (May 25, 2011)

evilcat said:


> Hi Blythespirit/Mark,
> 
> Many thanks for your comments.  The doctor actually said he didn't know what type I was - it was the diabetic nurse who advised.  As he didn't ask me any questions, I presume he made an assumption.
> 
> My Dad has Type 2 so I guess I'm the same, but as neither the doctor or the nurse asked, they weren't aware of the family history...


Type 2 can have strong genetic connections, my father is diabetic (type 2 we think, but he is insulin dependent), my uncle is type 2 and my grandfather was diabetic (type unknown, he died in the 1960's).  I have suspicions about my great grandparents as well, but that can't be proven.


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## donnarob (May 26, 2011)

Hi Evilcat, 

I wasn't surprised to hear your story as the medical profession seem to be failing miserably at good diet advice. 

You sound as if you're on the ball and you were right to counter argue the reasons for getting test strips and a meter.  It's all down to cost and the sooner the doctors and nurses stop treating us like inferior beings, the better.  I think you'll find that by testing, you'll learn to avoid certain carbs like the plague. In my case, porridge, baked potatoes, rice will all spike me. 

In my personal opinion, I think we should all be given test strips and meters.  How else are we to know how are levels are doing on a daily basis?  Getting checked every 3 months and following a healthy diet is so stupid, especially when you're advised to eat tinned fruit in juice.  By the way, fruit juices are notoriously high in hidden sugars as are low fat versions of mayonnaise. Like me, you live and learn, but by joining this site, you'll get far better advice than you're getting from your blundering doctor. 

Welcome aboard. 

Donna


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## rubik101 (Jun 5, 2011)

*Testing time*

My Doctor here in Thailand gets me to test 3 hrs after a meal. I am only testing about twice a week now as my numbers seem to be good and stable. (here we use the US system so my numbers of 85-110 won't mean much to you!) The reason he suggests 3 hrs is that after just 1 hour the numbers might be high and so cause alarm. As we spend more of our time more than 1 hour away from a meal I tend to agree with him, the 3 hour number is a better reflection of the conditions in my body. 
Any opinions?


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## Copepod (Jun 5, 2011)

Example of a conversion chart between blood glucose units (UK mmol/L; US mg/dl) here: http://www.diabetesforum.com/diabetes/74-blood-glucose-conversion-chart.html

Many people find they have to test fairly often when newly diagnosed with type 2 diabetes, then not so often, if their levels become stable like rubik101. Opinions about the significance of "spikes" (high readings 1 hour after meals) varies.


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## Northerner (Jun 5, 2011)

rubik101 said:


> My Doctor here in Thailand gets me to test 3 hrs after a meal. I am only testing about twice a week now as my numbers seem to be good and stable. (here we use the US system so my numbers of 85-110 won't mean much to you!) The reason he suggests 3 hrs is that after just 1 hour the numbers might be high and so cause alarm. As we spend more of our time more than 1 hour away from a meal I tend to agree with him, the 3 hour number is a better reflection of the conditions in my body.
> Any opinions?



What needs to be borne in mind is that a non-diabetic person will generally maintain fairly stable levels after eating, with no 'spikes' or extremes, and this is the ideal we are aiming for by selecting food that we know, through testing, does not elevate our levels too much. Ignoring the fact that you might be high an hour after eating doesn't mean it doesn't matter - you need to know so that you can modify your diet appropriately. There's little point to testing if you only do it when you know that the reading is likely to be in range, so I'd have to disagree with your doctor's logic.


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## mcdonagh47 (Jun 5, 2011)

rubik101 said:


> My Doctor here in Thailand gets me to test 3 hrs after a meal. I am only testing about twice a week now as my numbers seem to be good and stable. (here we use the US system so my numbers of 85-110 won't mean much to you!) The reason he suggests 3 hrs is that after just 1 hour the numbers might be high and so cause alarm. As we spend more of our time more than 1 hour away from a meal I tend to agree with him, the 3 hour number is a better reflection of the conditions in my body.
> Any opinions?



Hi Rubik,

There is a great deal of evidence that post prandial spikes in glucose are just as damaging as high A1cs. So its the levels at 1 hour and 2 hours you need to know about in order to correct - if you weren't at 85-110 (4.7 - 6.0) 3 hours after a meal you would be in a pickle ! 

Here are some links on the matter ....
http://diabetes.diabetesjournals.org/content/54/1/1.short

http://care.diabetesjournals.org/content/23/12/1830.short

You might also be interested Alan S's Test Review Adjust page ...
http://loraldiabetes.blogspot.com/2006/10/test-review-adjust.html


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