Advice please

[Emmaathome]

I have read tonnes of stuff over the last few days / weeks since diagnosis, and am still getting my head round everything - I think its going to take me some time.

The main thing I have picked up is how important testing my bg levels are. However, my diabetes nurse has advised she isnt going to give me a bg monitor until after i have attended the 6 week Xpert programme so then i know what i'm doing and what the levels mean.

I just get the feeling I'm going to be "starting from scratch" in 6 weeks, whereas i could have learnt an awful lot in that time, and got some of the problems under control or at least be making a decent effort!!!

I have an appointment with the doc this afternoon not connected (i dont think) to my diabetes, i'm also seeing my nurse (again not connected to diabetes). Do you think its worth asking today if I can have a monitor so I can start testing? If not, is it worth buying one, or waiting 6 weeks.

I know its only 6 weeks, but I do really want to get on with trying to help myself - seems daft to put off what I know is round the corner!!

What do you think? Help / advice much appreciated!

 

[trophywench]

A resounding YES Emma!

If your doc doesn't know you are interested and WANT to be pro-active he won't know, will he? - so many people sit there and expect the GP/Nurse to 'solve it for them' and don't do anything to help themselves he'll fully expect you to be the same.

You could draw a blank, but OTOH you may well not!

 

[Northerner]

Hi Emma, What your nurse has advised is partly true - testing without knowing what the results mean or what to do with them is pretty much a waste of time, and there's always the possibility that you may be disheartened by some of the results you get if you have not had things properly explained to you, as will happen on the course (great news that you are getting onto an XPert course so quickly, by the way! 🙂).

However, it's not rocket science. There's a very easy to understand guide you can use called Jennifer's Advice. I'd suggest having a read of it and if you have any questions then do get back to us. I would also suggest starting a food diary and recording everything you eat and drink, noting the carbs in each meal separately - this will give you a good idea of the quantities and types of food you are eating and can be used in conjunction with your blood test results to determine what can and what shouldn't be a part of your diet.

Meters are cheap, but the test strips are expensive. You can get a free meter from Abbott at http://www.abbottdiabetescare.co.uk/free-meter-signup

It's worth asking your doctor or nurse, but it's likely that they will turn you down because of the reasons I mentioned earlier - but you may be lucky, especially if you can explain that you know what you need to do after reading Jennifer's advice 🙂

 

[Emmaathome]

As a long term member of weight watchers I'm pretty good at writing down my food / drink intake, and the size of the portion dictates the number of "points" i'm having (I think the above is one of the reasons I'm so frustrated by my diagnosis!!!)

I read Jennifers advice yesterday, which has set me off thinking I need to get on with it. Reading the "open letter" made me realise the sooner I start the better!

I'll ask, they can always say no! The nurse knows I want to do it as I asked, but she said not till after the course. I'll ask again and sound desperate!!!

 

[Northerner]

I'd try to sound motivated and knowledgeable 😉

 

[Andy HB]

Hello Emma,

When I was diagnosed (over 2 years ago now .... strewth doesn't time fly when you are enjoying yourself), I was given a meter straight away with some simple guidelines.

1) Test once a day at different times (saves on the strips!).
2) Before meals aim for 4-7mmol/L
3) 2hrs after meals aim for 7-9mmol/L
4) Try and avoid <4mmol/L (hypo)
5) Try and avoid >10mmol/L (hyper)

I also started exercising (mainly just walking) immediately and kept that up ever since.

Sticking to all that I was soon able to work out which food to avoid and more importantly which I could still tolerate. It took a little while for everything to settle down and I am now burbling along quite nicely (off all medication and have been so for nearly two years now ... but I'm losing track!).

Andy 🙂

 

[Andy HB]

Oh, by the way, I think you'll find the Xpert course very useful. I managed to get on it just a month after diagnosis and it was key in helping me get control (as well as this forum, of course!).

Andy 🙂

 

[Emmaathome]

Well, I saw the nurse (as i said not my diabetes nurse).

I explained how i had read as much as I could since diagnosis, and all pointers seem to suggest I need to be testing to see what foods are best avoided - I explained I'm an avid weight watcher, so do stick to mostly healthy foods, but I was following weight watchers diet when I produced a fasting result of over 18!!!

She basically poo-poo'd what i said, and told me testing was not necessary, and that was that. Epic fail on my part then!!

Feel confused, disappointed and a bit let down now. She isn't my diabetes nurse, but I know she was the diabetes specialist nurse at another practice so "should" know what shes talking about.

By the time I got to the doctor I felt like I was being stupid in asking so just sorted out the other problems and got out of there!!!

I start the Xpert course next week so will see what they recommend and might venture back to the nurse before my next proper appointment, which isnt for another 6 weeeks.

 

[Northerner]

...She basically poo-poo'd what i said, and told me testing was not necessary, and that was that. Epic fail on my part then!!

Feel confused, disappointed and a bit let down now. She isn't my diabetes nurse, but I know she was the diabetes specialist nurse at another practice so "should" know what shes talking about.
...

Stupid nurse, does she have diabetes? I wonder if she would take her own advice if she was? I very much doubt it, much as I woulds also doubt that she could have ever described herself as a diabetes specialist nurse - more like a practice nurse who dealt with the diabetic patients for foot checks, blood pressure etc. after attending a 1-day or 1-week course. A real DSN does a full degree and lots of specialist training and would most certainly not have poo-poohed your request.

Don't be disheartened, it is her fail not yours. Motivated individuals should be encouraged to self-monitor, not discouraged - have a read of Diabetes UK's position statement on self-monitoring. Not everyone wants to test, some are told to test but not educated, but you want to test and know what to do, so you should be given the means to do it. 99% of your diabetes management is done by YOU, not the healthcare professionals, so you should be put in the best possible position to do just that! Grrr!!! Makes me so angry! 😡

Don't give up on the idea, if you can, see your diabetes nurse or approach your doctor again (as you said, you haven't told them so they don't know how motivated you are!) and hopefully they will support you. Perhaps you'll get more confidence after you've started the course 🙂

 

[Andy HB]

I am with Northerner on this one. Information is key to controlling Diabetes. Simply waiting for a 6 monthly HBA1c check isn't enough if you want to get on top of things quickly and permanently.

On the other hand it is too easy to then start testing too much merely as a type of 'crutch'. It's a natural response and needs to be resisted!

What you could do is try and get a free meter. These usually come with an initial supply of test strips. Then just start testing yourself and build up a record of how different foods affect you. Then, when you next see your GP (or specific DSN) use that evidence to press for the strips to be prescribed.

If you need any further advice on the best way to do this .... well, just ask here and weigh up the replies (we have differing views, probably, but at the end of the day you need to find out what works for you!).

Good luck,

Andy 🙂

p.s. You could also tell them that when I was diagnosed in October, 2009 I was given a meter by the DSN and told how to use it. I'm still prescribed a pot of strips, but that lasts me a year now rather than the month or two at the beginning.

 

[Emmaathome]

Yep, going to give the Xpert course a couple of weeks, hopefully increase my knowledge a bit more (and grab a word with the DSN and dietician running it and see what they think).

Then armed with my extra confidence I'll go back and try again.