am I or am I not?

[trevor123]

Hi everyone. I was diagnosed with T2 4 years ago after an accident sent me to hospital where I was put on insulin injections. After leaving hospital I was put on metformin and I was so scared by diabetes (after having a friend die from it years earlier) I dieted down to half my body weight (I was a big boy!) and read all I could on how to take care of myself.I gradually reduced the metformin dose and for the last 2 years have only used diet to control my diabetes.
My diabetes nurse (a new one to our clinic) is now saying that because I have such good control that if this test comes back ok she is going to recommend the doctor take me off of the register.
I do not want to be a malingerer but I thought diabetes was for life and I really do not want to be taken off the register in case it all goes wrong again.
shall I refuse to be taken off or thank my lucky stars that they now see me as "cured"
I do wonder if this is just another way to slant figures by the NHS but what would you do?
Thanks in advance
Trevor

 

[LeeLee]

Hello Trevor, welcome! Congratulations for achieving such excellent control. I don't know the answer you your question. I was told that D is for life, and that better control during a long downward spiral was all I could expect. Well, I also set out to prove 'em wrong and so far so good! 🙂

I suspect the reason for wanting to take you off the register is at least partly financial. When you're on the register, they have to do all the follow-up checks and referrals. On the other hand, having a well-controlled diabetic on the books makes the practice's figures look good.

If I were you, I would want a discussion with the doctor to talk about all the implications before agreeing to anything.

 

[Copepod]

Welcome to the forum, trevor123.

Congratulations on your excellent response to your diagnosis 🙂

Interesting question. Is the nurse at the GP surgery or hospital clinic? By being taken off the register, does nurse mean that you won't be called into so many appointments or completely cut off? What blood test? HbA1c is diabetes specific, but other checks eg blood cholesterol, blood pressure etc are more general for people over about 40 years.

Don't worry about NHS statistics - it's what's right for you that matters. If you are not taking any medication for diabetes, then you aren't entitled to free prescriptions (in England) for that reason alone, although there may be other reasons you may qualify.

 

[yorksman]

Roy Taylor's work on diabetes reversal at the Magnetic Resonance Centre in Newcastle suggests that a substantial weight loss in obese patients will halt the decline in beta cell function. In some patients the required loss may be as high as 30%. Patients who started dieting within 4 years of diagnosis have a 75% chance of success. He has a Frequently Asked Questions page which states:

"The essential point is that substantial weight loss must be achieved. The time course of weight loss is much less important.

It is a simple fact that the fat stored in the wrong parts of the body (inside the liver and pancreas)
is used up first when the body has to rely upon its own stores of fat to burn. Any pattern of eating
which brings about substantial weight loss over a period of time will be effective. Different approaches suit different individual is best."

I posted some more info frm an article of his entitled Type 2 Diabetes: Etiology and Reversibility

Of particular importance is the lack of knowledge of the extent of damage to the beta cells. If you had a high tipping point, from non diabetic to diabetic before, because you will have lost some beta cells, your tipping point is now likely lower so, even if you are working properly again, it is more important to guard against poor nutrition and lack of exercise else you can get it again.

"β-Cell number following reversal of type 2 diabetes remains to be examined, but overall, it is clear that at least a critical mass of β-cells is not permanently damaged but merely metabolically inhibited."

One advantage of staying on the register is that it will keep you on your toes. You get your bloods tested and your eyes and feet too. If you do happen to lapse and become diabetic again, would you know if you were on your own? I think not being on the register is more for the GP Practice's benefit that your own.

 

[trophywench]

I don't see how it benefits them? Yes. less time spent on you but No - they then won't get the extra payment the surgery gets for having a diabetic on their books that ticks all the right boxes which demonstrate (on paper LOL) good diabetes control !

Still Mrs Nurse isn't a bean counter is she? All the GPs are as interested in income as their accountants, these days.

And in any coase - you want to keep having the eye checks and all the rest of it - it keeps you on the straight and narrow.

I would defo discuss it with your GP before agreeing to it and see what his/her 'take' on it is.

 

[Northerner]

I would say you are still diabetic, but with excellent control. As I m sure you are aware, should you lapse then your blood glucose control will begin to suffer again, so the word 'cured' cannot be applied. I would want to remain registered as a person with diabetes, well controlled.

Well done on your efforts! 🙂 If you have any tips on how you achieved it, please share as I am sure others would be interested 🙂

 

[yorksman]

As I m sure you are aware, should you lapse then your blood glucose control will begin to suffer again, so the word 'cured' cannot be applied.

Yes, it seems to be easily overlooked. If you revert to the same poor nutrition and low level of activity that caused diabetes in the first place, you'll get it again, except this time, sooner.

But what Taylor means by reversal is that the progressive decline in beta cell function is halted and a critical number of beta cells are 'reactivated'. So, if you continue the lifestyle which brought about these beneficial changes, there is no need to fear the 'inevitable and progressive' failure of the beta cells function.

But stay away from iced jam filled doughnuts.

I sometimes wonder what a condemned man's last meal would be if he were a diabetic.

 

[trophywench]

Well it sure as hell wouldn't be doughnuts if I was that man.

Beef Wellington, maybe or Lobster - oooh yes, Lobster Thermidore, that's it. Coffee ice cream for pudding.

 

[yorksman]

Lobster - oooh yes, Lobster

In Germany there is a fast food chain called Nordsee, to buy in or take out. They do a good lobster:

I went to this one on the Victuals Market in Munich. It's a diabetics dream of where to get a safe lunch. Full of places selling cooked, smoked, cured meats, game and sausages, slicing and spreading sausages, chicken, turkey, duck, goose, many places selling cheeses of every shape, smell and description, masses of fruit and veg and exotic salad oils and dressing, stuff from northern europe, stuff from southern europe plus lots of tables and chairs for you to eat it.

Beats the hell out of Greggs and Subway.

 

[PattiEvans]

Time we had a chain like that in the UK methinks!