GP happy - but of course all down to his meds, right?

[RFS]

So I went to review my results (see sig for potted history).
Postives from today
1) GP is happy that in three months I almost halved my A1C - says he rarely sees that much of a change for a first review in patients
2) No increase to metformin, but we need to review in six months before he would be happy reducing/removing metformin completely. Better still no statins for cholesterol.
3) I must suffer from White Coat syndrome - I took my BP at home this morning and I was pre-high. Got to the surgery (it is a 10 min route march from the house!) and it was high but to my immense surprise he looked at the graphs and readings I brought and was happy to take the highest of the pre-highs for this month as his baseline. So add no BP meds to the equation as well.
4) A moment of hilarity when he said that the hospital had suggested based on previous numbers I attend their DSN clinic and course to learn about diabetes... then he laughed and reckoned I probably knew everything I needed to know so said he would write to them and say he would defer any decision to refer me until we re-assessed in six months.
5) Checked my feet - no nerve issues he could detect at this time.

Cons
1) He is still not a fan of the libre - he thinks if it convinces me I am doing well, then keep using it, but beware the expense and that he firmly believes it is purely the change in diet, exercise and meds that have made the difference. He is not averse to its use, but he still sees it as largely unnecessary to test at all, at any time.
2) He decided to also stick me with my flu jab (as I was gonna get it done at the pharmacy when I picked up my metformin!)

Think it might be prudent to schedule my next bloods BEFORE I go to the US in March. That tournament is the absolute worst for what they give the media. Bring on the cuppa-soups with the low carb counts

 

[Bubbsie]

So I went to review my results (see sig for potted history).
Postives from today
1) GP is happy that in three months I almost halved my A1C - says he rarely sees that much of a change for a first review in patients
2) No increase to metformin, but we need to review in six months before he would be happy reducing/removing metformin completely. Better still no statins for cholesterol.
3) I must suffer from White Coat syndrome - I took my BP at home this morning and I was pre-high. Got to the surgery (it is a 10 min route march from the house!) and it was high but to my immense surprise he looked at the graphs and readings I brought and was happy to take the highest of the pre-highs for this month as his baseline. So add no BP meds to the equation as well.
4) A moment of hilarity when he said that the hospital had suggested based on previous numbers I attend their DSN clinic and course to learn about diabetes... then he laughed and reckoned I probably knew everything I needed to know so said he would write to them and say he would defer any decision to refer me until we re-assessed in six months.
5) Checked my feet - no nerve issues he could detect at this time.

Cons
1) He is still not a fan of the libre - he thinks if it convinces me I am doing well, then keep using it, but beware the expense and that he firmly believes it is purely the change in diet, exercise and meds that have made the difference. He is not averse to its use, but he still sees it as largely unnecessary to test at all, at any time.
2) He decided to also stick me with my flu jab (as I was gonna get it done at the pharmacy when I picked up my metformin!)

Think it might be prudent to schedule my next bloods BEFORE I go to the US in March. That tournament is the absolute worst for what they give the media. Bring on the cuppa-soups with the low carb counts

Great result RFS...perhaps if some GPs didn't tell their patients not to test they might see the kind of results you achieved more often...never a good idea to reduce Metformin at the first review...great getting there but we have to maintain it...BP not surprised at the white coat syndrome...I always do mine before any appointments...as for the DSN referral...why?...he knows you are likely to know more than she does about managing T2 ...she doubtless would advise not to test...however like your GP is happy to accept the benefits/results from it...whether libre or otherwise...god forbid our health care professionals accept it is a vital part of diabetes control...if he did...might have to provide meters & strips on prescription...and that would never do...overall it's attributable to your hard work...adjustments to your diet & lifestyle...and testing...well done.

 

[happydog]

You have done amazingly well RFS. My guess is that it is mostly your own hard work. Let's hope you maintain and even improve on what you have already achieved. Well done, you should be proud of yourself. Personally I am a fan of self-testing and at the moment still get 25 strips a month to do so. I realise that some people don't want to do it and that is their choice. Hope your improvements continue, Good luck! 🙂

 

[Mark Parrott]

It's daft, isn't it. He says no need to test, just keep to your diet. But how would you know that the diet is working without testing. Congrats, BTW.🙂

 

[RFS]

I know... I have perfected the nod and smile technique...

 

[MikeTurin]

It's daft, isn't it. He says no need to test, just keep to your diet. But how would you know that the diet is working without testing. Congrats, BTW.🙂

If you are doing well a continuous test especially if is costly like a Libre isn't necessary.
You could use normal test strips and make a test now and then.

You could think as a thing like Process Monitoring Control, you you look at the outcome, and if you find that the values are staying in rage you could reduce the sampling frequency. Boring things written by engineers http://www.itl.nist.gov/div898/handbook/toolaids/pff/pmc.pdf

I suppose that this was the rationale behind it.

 

[Copepod]

It's your choice about Libre and not as if you're expecting NHS to pay.
I think it's a good idea for GPs to give flu jabs. I used to be prejudiced against, as nurses tend to give far more injections and thus have better technique. However, my current GP has done my last 3 flu jabs and always done BP and foot check at same time. He offered when I couldn't get to flu clinic one year, and situation has continued. Going next Monday.

 

[RFS]

If you are doing well a continuous test especially if is costly like a Libre isn't necessary.
You could use normal test strips and make a test now and then.

You could think as a thing like Process Monitoring Control, you you look at the outcome, and if you find that the values are staying in rage you could reduce the sampling frequency. Boring things written by engineers http://www.itl.nist.gov/div898/handbook/toolaids/pff/pmc.pdf

I suppose that this was the rationale behind it.

I use the Libre because as a writer for a living, testing via fingerprick is really not terribly helpful! also I suppose at diagnosis everything was so high, it was probably a reasonable track to follow that things needed to be monitored.

If I had a 9-5, and was able to guarantee healthier food, and cooking all the time at home I might even agree with you. But I don't have that luxury. I have two tournaments to close out the year, and then will be away pretty much every month from January and throughout the clay and grass court swing I will have about 3 weeks at home. Media centres vary a lot on what they provide journalists. Some are good with plenty of choice and a generous provision on your credential. Others are... not.

So for as long as I choose to continue to pursue this itinerant career... (and as it is my second career, I am not throwing it away any time soon) then I can't see me NOT testing regularly to try and keep things in control, because I can pretty much guarantee that the long days, late nights and irregular eating habits of 4 years on the sports writing circuit certainly contributed to those numbers.

It has been a great achievement thus far but the real test for me will be where I sit a year from now and how I manage that with... Australia, Indian Wells, Stuttgart, Madrid, Roland Garros, Birmingham Eastbourne, Wimbledon, Montreal, Cincinnati, Singapore and London as my minimum tournament spread next year.

If I survive that... then I think that would be true justification to mothball the Libre!!!

 

[trophywench]

I rather think DSNs who work WITH hundreds of different diabetics all day every day, know more about all sorts of things diabetes-wise than I do Bubbsie. I mean for starters I've never worked in a hospital and I've certainly not attained a University Degree in it, although it's been my specialist subject for over 35 years! LOL

I know I was pleased with the amount of anatomy I learned when attending the carb-counting course I went on. But of course such courses don't distinguish between the participants to know upfront whether they are going to get a roomful of thickos who know nuffin and don't grasp the necessity of learning about their bodies - or a roomful of engaged people with active brain cells. I don't actually envy them their task, myself.

 

[MikeTurin]

It's your choice about Libre and not as if you're expecting NHS to pay.
I think it's a good idea for GPs to give flu jabs.

Agree. Because the last time I had a flu I stayed at bed with a 40 C fever and vomiting all except some rice "porridge" without even a drop of oil for two days..

I use the Libre because as a writer for a living, testing via fingerprick is really not terribly helpful! also I suppose at diagnosis everything was so high, it was probably a reasonable track to follow that things needed to be monitored.

If I had a 9-5, and was able to guarantee healthier food, and cooking all the time at home I might even agree with you.

Ok, if one has problems and a hapazard schedule and also living in hotels I suppose that fingerpricking isn't a comfortable option. I'm agreeing with you.
But in my opion makes sense if all is under control to use cheaper means to check the blood sugars.
I measure my blood pressure twice a day because having found that I have idiopathic hypertension like my dad, the cost is 30 second of remaining still . If something goes awry I take corrective actions like switching back to potassium chloride for the salad or cut the wine.

 

[Bubbsie]

It's daft, isn't it. He says no need to test, just keep to your diet. But how would you know that the diet is working without testing. Congrats, BTW.🙂

Exactly Mark...exactly.

 

[RFS]

It's daft, isn't it. He says no need to test, just keep to your diet. But how would you know that the diet is working without testing. Congrats, BTW.🙂

I was sat next to someone at a shift on a sportsdesk yesterday - one of the interns, and we were chatting about it as I had to decline the floor's weekly BakeOff challenge and free cake, and told him how much the sensors are and god love him, he squeaked "that's like a whole day's work for you"... and I suppose that's now how I equate it now... at least one shift a month keeps me in that month's Libres..!

 

[RFS]

Agree. Because the last time I had a flu I stayed at bed with a 40 C fever and vomiting all except some rice "porridge" without even a drop of oil for two days..

Ok, if one has problems and a hapazard schedule and also living in hotels I suppose that fingerpricking isn't a comfortable option. I'm agreeing with you.
But in my opion makes sense if all is under control to use cheaper means to check the blood sugars.
I measure my blood pressure twice a day because having found that I have idiopathic hypertension like my dad, the cost is 30 second of remaining still . If something goes awry I take corrective actions like switching back to potassium chloride for the salad or cut the wine.

That is my next thing to try and fix... get that BP down to normal. It's getting there (IF i don't have my BP taken at the surgery!)

 

[RFS]

It's your choice about Libre and not as if you're expecting NHS to pay.
I think it's a good idea for GPs to give flu jabs. I used to be prejudiced against, as nurses tend to give far more injections and thus have better technique. However, my current GP has done my last 3 flu jabs and always done BP and foot check at same time. He offered when I couldn't get to flu clinic one year, and situation has continued. Going next Monday.

Exactly. I know that any NHS funded libres will go to people in far worse a position than me, and that is fine by me.

And... it is absolutely my money, so I will spend it on what I want. Right now.. I'd rather spend what I probably would have in a month of weekend takeaways on a Libre sensor. Fair swap, I think!