Update from DSN phone appointment

[Eternal422]

As some of you may know, I had a worrying time just before Christmas where a consultant was suggesting I come off insulin, despite the fact I started on Metformin and Glibenclamide for 5 years whilst my HbA1c continued up from the 70s to 144 at peak before coming off both oral meds and starting on insulin. My appointment with the consultant felt like she wasn’t listening to me at all and had already decided beforehand that I should come off insulin and start oral meds.

I saw a letter from the consultant to my GP (I wasn’t copied in but it was loaded onto the GP health record in the NHS app) saying that I would come off insulin and start on Metformin and Dapagliflozin, without any consultation with me. I saw my DSN at the time and she agreed that it would be best for me to stay on insulin as everything was stable and there are no side effects.

Anyway, I had a really good hospital DSN appointment this morning. My DSN agreed that the consultant’s letter about coming off insulin and onto oral meds without any consultation with me was wrong and apologised saying it should never have been written. She said that any change in treatment plan / meds must be done in consultation and agreement with the patient. They would give their professional views and advice but the final decision must always be that of the patient.

I have my next consultant appointment in April but my DSN said it would be a good idea to change consultant as trust was already broken with this one. She said that it should be a partnership and there must be trust there between the patient, consultant and all other health care professionals.

So, great outcome for me. No problem staying just on insulin and the Libre plus I will remain under continuing care with my hospital DSN plus a new consultant who she thought would be a better match for me - fingers crossed for that.

Hopefully this may help any others who feel as though they are being pushed down a particular treatment plan route that they don’t want to take. I have found that the DSNs I have spoken with at the hospital have been fantastic in being pragmatic, extremely helpful and truly empathetic.

 

[rebrascora]

What an absolutely brilliant result! So pleased for you. I really hope it puts your mind at rest and perhaps gives some hope and support to others who are struggling with a consultant trying to force a change of medication/ regime onto them when what they already have is tried and tested and working extremely well.

 

[Eternal422]

Thanks @rebrascora - it certainly does help me and I am so grateful for my DSN, she is brilliant! Hopefully this will help anyone else going through similar drama.

 

[gail2]

Eternal422 sounds like you have a DSN whos on your side a keeper Glad you got the result you wanted
gail

 

[Eternal422]

Eternal422 sounds like you have a DSN whos on your side a keeper Glad you got the result you wanted
gail

Thank you! Yes, my DSN is so good, I feel so grateful that I have her.

 

[Pam123]

As some of you may know, I had a worrying time just before Christmas where a consultant was suggesting I come off insulin, despite the fact I started on Metformin and Glibenclamide for 5 years whilst my HbA1c continued up from the 70s to 144 at peak before coming off both oral meds and starting on insulin. My appointment with the consultant felt like she wasn’t listening to me at all and had already decided beforehand that I should come off insulin and start oral meds.

I saw a letter from the consultant to my GP (I wasn’t copied in but it was loaded onto the GP health record in the NHS app) saying that I would come off insulin and start on Metformin and Dapagliflozin, without any consultation with me. I saw my DSN at the time and she agreed that it would be best for me to stay on insulin as everything was stable and there are no side effects.

Anyway, I had a really good hospital DSN appointment this morning. My DSN agreed that the consultant’s letter about coming off insulin and onto oral meds without any consultation with me was wrong and apologised saying it should never have been written. She said that any change in treatment plan / meds must be done in consultation and agreement with the patient. They would give their professional views and advice but the final decision must always be that of the patient.

I have my next consultant appointment in April but my DSN said it would be a good idea to change consultant as trust was already broken with this one. She said that it should be a partnership and there must be trust there between the patient, consultant and all other health care professionals.

So, great outcome for me. No problem staying just on insulin and the Libre plus I will remain under continuing care with my hospital DSN plus a new consultant who she thought would be a better match for me - fingers crossed for that.

Hopefully this may help any others who feel as though they are being pushed down a particular treatment plan route that they don’t want to take. I have found that the DSNs I have spoken with at the hospital have been fantastic in being pragmatic, extremely helpful and truly empathetic.

I spoke to my GP when I went to try and sort out my eye appointment, and based on your experience I decided to tell him that I wanted to stay on insulin, having never had oral meds but didn't want to go down that road. He said my control was very good and although he was aware some T2 who start on insulin are moved to oral meds once under control, I was up to me and he wouldn't even suggest changing anything.

 

[Eternal422]

@Pam123 - so glad you had a good result from your GP and glad that my experience had a small part in helping.

My DSN said that if I did try oral meds I would fairly quickly end up back on insulin. She also said that insulin has no side effects, other than potentially getting hypos if you give yourself too much, whereas oral meds will all have some side effects which may or may not be bothersome. Like your GP her view was if it is working and I’m stable on it and have no desire to come off insulin then it makes total sense to stay on insulin.

 

[everydayupsanddowns]

Anyway, I had a really good hospital DSN appointment this morning. My DSN agreed that the consultant’s letter about coming off insulin and onto oral meds without any consultation with me was wrong and apologised saying it should never have been written. She said that any change in treatment plan / meds must be done in consultation and agreement with the patient. They would give their professional views and advice but the final decision must always be that of the patient.

I have my next consultant appointment in April but my DSN said it would be a good idea to change consultant as trust was already broken with this one. She said that it should be a partnership and there must be trust there between the patient, consultant and all other health care professionals.

So, great outcome for me. No problem staying just on insulin and the Libre plus I will remain under continuing care with my hospital DSN plus a new consultant who she thought would be a better match for me - fingers crossed for that.

So glad to here you’ve had such a positive outcome in the end @Eternal422 - and great to have such a supportive DSN behind you, who recognises the importance of a positive relationship between consultant and person with diabetes.

 

[goodybags]

Great to see you were again well supported by your DSN, so all your HCT can agree with the best plans for you to manage your Diabetes is with Insulin

 

[Eternal422]

Great to see you were again well supported by your DSN, so all your HCT can agree with the best plans for you to manage your Diabetes is with Insulin

Yes, I’m so pleased everyone is on the same plan now and the stress and anxiety have thankfully reduced for me!

Interestingly it sounded as if the DSN team have had similar “issues” with this consultant and my DSN had someone whom she thought would be a much better match for me so I’m hoping when I see the new consultant next month that will be the case. I’m sure it will be as I trust my DSN.