# First appointment with diabetic nurse



## MickD (Apr 16, 2018)

Hi
I was diagnosed a number of weeks ago.. im still waiting for an initial appointment with the diabetic nurse currently 1st May but hoping for a cancellation. When i was diagnosed the doctor gave me very little help or advice apart from changing my diet and pointing me in the direction of this forum... so my question is what can i expect from this appointment... will it just be giving me advice on diet/lifestyle change etc... or will there be more to it?
Im doing pretty good i thi k with cutting down the carbs etc.. and the weight appears to be coming off ( i must get some scales lol) but clothes are definitely looser so must be doing something right...
Just feels like im in limbo now until i can get this first appt.
Thanks
Mick.


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## kentish maid (Apr 16, 2018)

Hi Mick.
My appointment with the Diabetic nurse was a 30 minute appointment. I seem to remember she took my blood pressure, examined my feet to check for any lack of sensation and advised me to have flu and pneumonia jabs but gave me very little advice on diet. She booked me a place on a DERIK course, which I think in other areas may be called DESMOND. That was a one day course on diet choices. Unfortunately some DN's are not very up to date with their advice, it is a bit of a lottery


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## Ralph-YK (Apr 16, 2018)

MickD said:


> so my question is what can i expect from this appointment


My experience is not much.


MickD said:


> will it just be giving me advice on diet/lifestyle change etc


I never got that.

My advice is write down what questions you have.  What you expect and require.  Everything.  Get them to tell you results to tests (you may have to list every test, again have them written down).  Ask about an action plan.  (What to do before next appointment & targets.  Insist on diabetes targets that you can actually achieve).  Ask about carbourhydrate awareness sessions & diabetes sessions (Desmond, X-pert and/or local provision.  These things are done regionally).

Diabetes UK has a list, 15 Health Care Essiontials.  Look them up on the website & take a print out.


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## Ralph-YK (Apr 16, 2018)

kentish maid said:


> She booked me a place on a DERIK course, which I think in other areas may be called DESMOND. That was a one day course on diet choices.


I've done Desmond.  It didn't cover diabetics diet choices.  It had a short reminder of the generally (as given for the entire population) healthy eating advice, and spent a lot of time on fat and arteries.  Amongst a couple of other things.


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## Bubbsie (Apr 16, 2018)

Ralph-YK said:


> I've done Desmond.  It didn't cover diabetics diet choices.  It had a short reminder of the generally (as given for the entire population) healthy eating advice, and spent a lot of time on fat and arteries.  Amongst a couple of other things.


I did a DESMOND course too Ralph...|I didn't rate the one I attended very highly at all...if at all.


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## Ralph-YK (Apr 16, 2018)

Bubbsie said:


> I did a DESMOND course too Ralph...|I didn't rate the one I attended very highly at all...if at all.


As an introduction to T2 it was ok.  (Some explanations about diabetes.  Rusty locks and keys.)  Nothing to do with managing it though. And we need lots more info after.


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## Bubbsie (Apr 16, 2018)

Ralph-YK said:


> As an introduction to T2 it was ok.  (Some explanations about diabetes.  Rusty locks and keys.)  Nothing to do with managing it though. And we need lots more info after.


Part of the problem is Ralph me and many of the others had been waiting to go on the course for over six months...so no longer newly diagnosed...they were firmly against self testing...we had the eat well plate...I thought it was archaic...I hear the XPERT courses are better?


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## Ljc (Apr 16, 2018)

Hi Mick.  TBH I think by the time you get to see the nurse it’s highly likely you may know more about your diabetes than she does. The reason I say this is, you not only searched for a diabetic forum , you’ve stuck around, that alone proves you are determined to get to grips with this condition  most diabetics don’t bother.

Some nurses are very good but some are very behind the times esp about carbohydrates and that awful for us eatwell plate or whatever it’s called now .
I agree it’s a good idea to take a list of your questions .
Take a pen to make any notes
Take a bag to put all the leaflets in you’ll probably  be given.
Their are 15 checke you should have done , some only annually. I will  find a link for you .
It’s highly likely you’ll have the statins talk, before you decide yay or nay I advise asking for a breakdown of your different Cholesterol levels then coming on here to let those who know their stuff cast their eyes over the results .


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## Drummer (Apr 16, 2018)

I went on a three session education course and it was dreadful - bad advice on diet, little understanding of the problems, and some very concerned very ill people being told to eat baked potatoes and beans, wholemeal carbs etc.
They were completely baffled as to how I had reduced my Hba1c to 47 in the 80 days since diagnosis, but sidetracked all comments I made.


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## Ljc (Apr 16, 2018)

Here’s a link to the 15 Health checks 
https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/15-healthcare-essentials


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## Bubbsie (Apr 16, 2018)

Ljc said:


> Hi Mick.  TBH I think by the time you get to see the nurse it’s highly likely you may know more about your diabetes than she does. The reason I say this is, you not only searched for a diabetic forum , you’ve stuck around, that alone proves you are determined to get to grips with this condition  most diabetics don’t bother.
> 
> Some nurses are very good but some are very behind the times esp about carbohydrates and that awful for us eatwell plate or whatever it’s called now .
> I agree it’s a good idea to take a list of your questions .
> ...


Agree unequivocally Lin with the DSN appointment comments...also so important to consider the ratios in respect of our cholesterol...that's often forgotten by our HCP's...my GP knew little about the different LDL's or the breakdown of LDL/ HDL/Trigs...always worth exploring...there seems to be some consensus of opinion that all diabetics should be taking statins.


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## MickD (Apr 16, 2018)

Thanks for all you replies I appreciate it. 
Sounds like i shouldn't take everything too literally.
Regards
Mick.


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## trophywench (Apr 16, 2018)

Dr Malhotra has recently given a talk to the European Parliament explaining why the 'Eat Well' advice is rubbish and the benefit of good fats - in terms of heart and general health.  There's a You Tube video, and Malcolm Kendrick (another Cardiologist and Author of 'The Great Cholesterol Con' etc) has put it up on his Blog.  I haven't actually watched it (no text version) as yet - but I shouldn't think I'll disagree with him for a minute!


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## MickD (Apr 17, 2018)

Well just been for an appointment with a nurse practitioner for some extra pain relief as i have arthritis in my hip. . It turns out the nurse is the same one that will be conducting first diabetes appointment... so had a chat and I should have been put on metformin before now!!! So Ive been prescribed this today .. ive read about the side effects regarding upset stomach etc..  are there alternatives? Ive heard slow release does this make much difference? I mentioned about me using a test meter and she was very dismissive which I've heard people mention before... but why thought they would be happy im interested in trying to figure out which foods are good/bad..?


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## Ljc (Apr 17, 2018)

MickD said:


> Well just been for an appointment with a nurse practitioner for some extra pain relief as i have arthritis in my hip. . It turns out the nurse is the same one that will be conducting first diabetes appointment... so had a chat and I should have been put on metformin before now!!! So Ive been prescribed this today .. ive read about the side effects regarding upset stomach etc..  are there alternatives? Ive heard slow release does this make much difference? I mentioned about me using a test meter and she was very dismissive which I've heard people mention before... but why thought they would be happy im interested in trying to figure out which foods are good/bad..?



What dose of Metfartin have you been put on ? To help lessen side effects They should start you on a low dose and gradually build it up. I know their are slow release versions but don’t know any names, I believe the have SR after the name

I remember reading on here some time ago about a trial done on T2s self testing, I can’t remember the details but it looked as though it had been set up to prove that T2s self testing would not make any difference  . One of the things T2s on the trial were told was to test but not change their diet in any way.
When we on here test to see how the various carbohydrates affect us so we can make informed changes to our diet and also so we don’t cut out something that we enjoy and our body handles very well, you see Diabetes can’t read, so it doesn’t know the rules The nhs says it should follow 




.


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## MickD (Apr 17, 2018)

Hi Lin. She pht me on 500mg... first week 1 with breakfast... week 2 1 with breakfast and 1 with evening meal.. week 3 2 with breakfast and 1 with evening meal.. and week 4 2 with breakfast and 2 with evening meal...
But she said any problems go back and look at it again...
I just cant believe that if i hadn't gone for pain relief for my hip i wouldn't be on it until my appt on 1st May!!! I was diagnosed about a month ago... 
Mick.


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## trophywench (Apr 17, 2018)

See what side effects you get before starting to add another tablet - very often if you are one of the people who get the gastric effects, it actually wears off again after about 2-3 weeks for a lot of people, but they have to give every increased dose the same amount of time to settle again.  It's good because it takes up to 3 weeks for the full benefit of any amount of Metformin to be 100% anyway.

Of course if you don't get any problems then you can do it quicker!

'Glucophage SR' is one of the slow release ones, think there's another brand called Bolamyn?


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## Ljc (Apr 17, 2018)

MickD said:


> Hi Lin. She pht me on 500mg... first week 1 with breakfast... week 2 1 with breakfast and 1 with evening meal.. week 3 2 with breakfast and 1 with evening meal.. and week 4 2 with breakfast and 2 with evening meal...
> But she said any problems go back and look at it again...
> I just cant believe that if i hadn't gone for pain relief for my hip i wouldn't be on it until my appt on 1st May!!! I was diagnosed about a month ago...
> Mick.


Ah that’s good to hear. 
I never had any ummm side effects  from Metformin hopefully you won’t either. 
Jenny has given you good advise re Metformin .


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## MickD (Apr 18, 2018)

Thanks Jenny & Lin.
See how it goes... first tablet soon to be consumed lol.
Mick.


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## grovesy (Apr 18, 2018)

There are many different brands of Metformin Slow release, I think I have have had at least 6 different ones over the years. Though my prescription over the last few has been for a specific brand. I think the CCG has done a deal with different manufactures.


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## MickD (Apr 19, 2018)

Day 2 on Metformin... thought I did well yesterday, no side effects.. although I would think it would take longer than one day to be honest.... but today... stomach is doing cartwheels, feeling sick also... see how it goes will try and persevere.. 

Mick.


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## Northerner (Apr 19, 2018)

MickD said:


> Day 2 on Metformin... thought I did well yesterday, no side effects.. although I would think it would take longer than one day to be honest.... but today... stomach is doing cartwheels, feeling sick also... see how it goes will try and persevere..
> 
> Mick.


Hope things settle for you Mick


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## Ljc (Apr 19, 2018)

Hopefully the symptoms will subside soon.  Try taking Metfartin while your eating or directly afterwards, that’s what I was told to do when I was first prescribed it.  
TBH I would not go up to the next dose increase untill your symptoms have eased.
If the symptoms get bad, I would stop taking them and contact your nurse ASAP.


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## MickD (Apr 19, 2018)

Lin,
Yes that's what I did, part way through breakfast, the nausea has subsided a bit now.
Can the drug start to work in 2 days? I doubt it... but I've has the best numbers since I started testing... 2 hrs after eating an apple I got 6.9..!! ( I didn't test before so not sure what the numbers were then ) I've been getting mid 8's and the odd 7.9... I'll test again  2 hrs after lunch.
Hope it wasn't a duff test..
Mick.


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## trophywench (Apr 19, 2018)

LOL - no good really only testing after food.  Say you ate something and it shot your BG after up to 14? - you'd assume you couldn't eat that - however if it was 12.5 before you started eating - it's brilliant!


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## MickD (Apr 19, 2018)

Well lunchtime.... pre lunch was 6.1 and 2 hrs after was 7.2.. had chicken salad and an apple..
Happy with that.  moving in the right direction. hopefully have a better Hba1c result on the next test.
Mick.


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## Ljc (Apr 19, 2018)

Good numbrs .
 Atm I think it’s more likely to be the changes you’ve made to your diet working rather than the Metfartin, as it takes a while to build up in the system.


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