Advice please

[MGR]

Hi. I attended A&E in January, had x rays and told by an AE consultant that I had tendonitis in my wrist. My job involves a lot of keyboard typing and driving. Given pain relief and advice plus splint.

Blood test at GP was okay.other than HBA1C had risen to 63 from 55. Type 1 diabetic for 24 years. No complications and first time apart from when diagnosed that it has been higher than mid fifties. GP wasnt interested with the fact my levels of exercise have fallen to next to nothing due to wrist problems. Have arthritis confirmed in my feet duecto old fracture sites. Main form of daily exercise is couple.of hours at an allotment. No advice offered and GP dismissive of A&E findings. Referred for nerve conduction studies for possible carpal tunnel(understand that has been linked to diabetes) although i have no numbness, no pins and needles and no issues on the underside of my palms.

GP seems to he focused on diabetes and one poor HBA1C result being the reason for pain in my wrist. Always had excellent control of sugars too.

Any one had similar problems. If you have no confidence in GP abilities regarding your diabetic care would you ask to be referred elsewhere for your reviews?

 

[mikeyB]

I’ve had similar problems, because I was using a computer keyboard and mouse in my job when preparing reports. It’s as common problem in such situations, all to do with your seating at the office, and your wrist position at the keyboard. I ended up with carpal tunnel surgery, which is great fun.

As far as the HbA1c went, it went up and down after various steroid injections, and I don’t know what sort of treatment you have been given for this. The nerve conduction studies will give you the answers as to the cause. It’s nothing to do with diabetes directly, for sure it wouldn’t have arisen in me if I hadn’t taken a job where I would be using a computer all day.

And you shouldn’t be under the sole care of your GP as a T1, you should be seen by a diabetic consultant on a fairly regular basis. GPs know very little about T1 diabetes care, because it’s relatively rare in general practice. I didn’t have any patients on my list when I was a GP, I only learned about T1 from my mum, who had been T1 since I was 5yrs old.

 

[trophywench]

I've never been solely in the care of a GP either.

Always remember one GP at our surgery commenting that 'People like you often suffer from ... ' so I challenged this by asking - What? Middle aged slim brunettes who like to go camping? Or do you mean corporate international insurance brokers? and to be fair, he did go red and giggle before sheepishly answering - 'No - PWD' - but on that occasion he was correct anyway and I knew that as it was TSH levels under discussion, and NBG telling PWD that a result of 3 point something was OK, cos we aren't, usually.

 

[JJay]

And you shouldn’t be under the sole care of your GP as a T1, you should be seen by a diabetic consultant on a fairly regular basis. GPs know very little about T1 diabetes care, because it’s relatively rare in general practice. I didn’t have any patients on my list when I was a GP, I only learned about T1 from my mum, who had been T1 since I was 5yrs old.

Really? Every T1? I've been diagnosed 27 years but haven't seen a consultant for more than 20. I've had no particular issues in that time and any that did arise could be dealt with by my (extremely knowledgable) practice nurse and latterly, since I moved to a different area, a referral to the Community Diabetes team (DSNs & dieticians who I presume can refer to a consultant if necessary). I would not be happy about a consultant's valuable time being taken up every so often just to tell me "you're doing OK".

 

[helli]

My understanding is that everyone with Type 1 should "have access to" a dedicated diabetes team. This is often provide by a hospital based clinic but there are also local diabetes clinics and, in I believe some areas, have "travelling" diabetes teams who visit GP surgeries.

For me the benefit of having an endocrinologist is access to new technology and insulins which I would not expect a GP to know about. But, I like to play with new exciting things.
If @JJay you are happy with your diabetes care, you do not have to change.

 

[JJay]

My understanding is that everyone with Type 1 should "have access to" a dedicated diabetes team. This is often provide by a hospital based clinic but there are also local diabetes clinics and, in I believe some areas, have "travelling" diabetes teams who visit GP surgeries.

For me the benefit of having an endocrinologist is access to new technology and insulins which I would not expect a GP to know about. But, I like to play with new exciting things.
If @JJay you are happy with your diabetes care, you do not have to change.

I couldn't agree more. However, in my part of the country at least, the CDT are red-hot on technology and very pro-active in getting Libre for as many of their patients as possible! I'm awaiting an appointment with them myself because Lantus just doesn't seem to be cutting the mustard for me

My issue was more with the assertion that T1s "should" be seen by a diabetic consultant on a regular basis. I just don't believe it's necessary for everyone.

Apologies to @MGR for taking this off-topic.