Bit of a shock

[ColinUK]

Thanks Colin.I had such a good giggle at that. You describe it so vividly that I can see it in my head.
Doctors so hate not to be in control! of your treatment!
I can't believe he is continuing to prescribe Metformin, even the slow release version, when your levels are so borderline and you have modified your diet and clearly know more than him about what you need to do to control it. I have every confidence that you will have it well into the pre diabetes range and maybe complete remission by your next blood test... although it may be tight time wise for that .... and I would have been inclined to negotiate a hiatus on medication for at least 3 months to give you an opportunity to prove that you can do it through diet and exercise alone, but look forward to you getting a good HbA1c next month and hopefully coming off Metformin in whatever form after that.
You are doing really great, so keep at it!

He’s primed to medicate like all doctors are I guess. I’m happy to take the meds and carry on with the lifestyle changes to hopefully get this into remission/reversed maybe by the blood test after next. 🙂

 

[Ralph-YK]

Well it seems my HbAC1 has hovered around the upper limit for a while... one test it’d be 0.1 over and the next it’d be 0.1 under. Last two years it’s been 0.1 over each time. So I haven’t been diabetic since 2014. I’ve been borderline since then and really just into the diagnostic range for the last two years.

Are you getting you're results in the old scale? And been around 6.5 (48 in the new scale)?

 

[Neens]

Hi @ColinUK - I was having time away from Forum - but wanted to see how you got on. My D team are a little hesitant about BG monitoring as T2. I think it may have to do with the mental/emotional toll... but had I not tested I would still be eating about 5 bananas a week, whole apples and pears.
It is really difficult to pinpoint when we became diabetic. But I guess as you have had tests before now you can. Happy to hear that you are only just over normal range (unless I have misunderstood) and you have lost over a stone in such a short time that will help with all sorts of health issues or prevent future ones.
Glad you got a print out. When I asked for one they were hesitant about that too. To be fair I don't understand half the jargon.But it is useful to have the HbA1c results.

 

[ColinUK]

Are you getting you're results in the old scale? And been around 6.5 (48 in the new scale)?

Possibly. I’ll look at the report in more detail tomorrow and pull our specific figures 🙂

 

[ColinUK]

Hi @ColinUK - I was having time away from Forum - but wanted to see how you got on. My D team are a little hesitant about BG monitoring as T2. I think it may have to do with the mental/emotional toll... but had I not tested I would still be eating about 5 bananas a week, whole apples and pears.
It is really difficult to pinpoint when we became diabetic. But I guess as you have had tests before now you can. Happy to hear that you are only just over normal range (unless I have misunderstood) and you have lost over a stone in such a short time that will help with all sorts of health issues or prevent future ones.
Glad you got a print out. When I asked for one they were hesitant about that too. To be fair I don't understand half the jargon.But it is useful to have the HbA1c results.

It’s the testing that’s really helped shape my eating so I’m going to keep it up.
I don’t understand the majority of stuff on the report but I’ll go through it with the help of Google tomorrow 🙂

 

[Eddy Edson]

something for high bp

I reckon: keep losing weight and being active, and watch the salt. But if that doesn't work, take the frikkn meds - high BP is much more likely to do you damage than BG at yr levels.

 

[ColinUK]

I reckon: keep losing weight and being active, and watch the salt. But if that doesn't work, take the frikkn meds - high BP is much more likely to do you damage than BG at yr levels.

This month so far it’s averaged 135/87 but it’s clearly coming down. Last measurement was 125/80 but was higher in the GP office. If it’s indicated however then of course I’ll take the meds 🙂

 

[Eddy Edson]

This month so far it’s averaged 135/87 but it’s clearly coming down. Last measurement was 125/80 but was higher in the GP office. If it’s indicated however then of course I’ll take the meds 🙂

Sounds good! Sure you're aware of "white coat syndrome" - ie BP reading higher at surgery vs at home. I'm typically 135/80-ish at surgery vs 115/65-ish at home. This I believe is because I have a subconscious fear that the doc is suddenly going to tell me I have flesh eating bacteria, ebola, etc etc.

On statins: Highly recommend ignoring most of what you read on message boards and social media: benefit to 1-in-140 at most, will make yr nose fall off, scam by the dead ghost of Ancel Keyes, LDL protects against corinovirus etc etc. Most of it is at best tendentious, and much of it is garbage.

How much good they'll do you depends on yr individual risk level, and yr doc shouldn't be prescribing without taking you thru that. If yr doc is such a pratt that he/she is too incapable/unwilling to do that, find another one.

FWIW, I have a very high risk level, because I have atheroscelrosis resulting in a blocked leg artery. Every credible recommendation I've seen says "Max tolerated statin dose & get LDL cholesterol as low as possible". I had to prod my doc into prescribing that after doing my research on the various expert body reviews and guidelines. If I'd believed in message boards etc I probably would have refused all statins, and my CV event risk would be hugely increased.

 

[ColinUK]

Sounds good! Sure you're aware of "white coat syndrome" - ie BP reading higher at surgery vs at home. I'm typically 135/80-ish at surgery vs 115/65-ish at home. This I believe is because I have a subconscious fear that the doc is suddenly going to tell me I have flesh eating bacteria, ebola, etc etc.

On statins: Highly recommend ignoring most of what you read on message boards and social media: benefit to 1-in-140 at most, will make yr nose fall off, scam by the dead ghost of Ancel Keyes, LDL protects against corinovirus etc etc. Most of it is at best tendentious, and much of it is garbage.

How much good they'll do you depends on yr individual risk level, and yr doc shouldn't be prescribing without taking you thru that. If yr doc is such a pratt that he/she is too incapable/unwilling to do that, find another one.

FWIW, I have a very high risk level, because I have atheroscelrosis resulting in a blocked leg artery. Every credible recommendation I've seen says "Max tolerated statin dose & get LDL cholesterol as low as possible". I had to prod my doc into prescribing that after doing my research on the various expert body reviews and guidelines. If I'd believed in message boards etc I probably would have refused all statins, and my CV event risk would be hugely increased.

But to quote Abraham Lincoln, “Everything you read on the Internet is true”

 

[NotWorriedAtAll]

Crikey!! I hope he didn't keep talking to you about your personal health care while the practice manager was in the room. That is completely against GDPR and all sorts of confidentiality stuff.

My general ponderings about the medication situation -

I am certainly not a person who is against meds.
That said I am against taking meds unnecessarily.

Because every med has side effects and effects on the body generally that are part and parcel of how they work intentionally.
Meds should only be taken if not taking them will be more harmful than taking them.
They shouldn't be taken if the downsides of them are more harmful than not taking them.

Obviously if a person has definite high blood pressure they need them. Obviously if a person has atherosclerosis - they need statins. But I don't think that a person who doesn't have these conditions should take the meds 'just in case.'

Metformin is a great med if someone definitely has diabetes and cannot get their levels (or doesn't want to) down by diet and exercise. But it is completely not needed if they can and do want to take control by those methods.

Moreover taking metformin when carb levels are low is not healthy even if there are no obvious side effects.

All medications put a strain on the liver and kidneys which is why you are supposed to have tests regularly once you are on them to check that no damage is happening. For me personally I prefer not to take meds that could cause me damage if I can achieve the same or better results by simple lifestyle changes. It would be worth the risk of that if I was unable to control my blood sugars and blood pressure by other means but as I can control them by diet and very moderate exercise then I don't see why I would take those risks for no measurable benefit.

Also once someone is on blood pressure meds as a regular thing they are then stuck with having to take them because a missed dose can cause irregular heart beats and even heart attacks (it is in the paper information that comes with them) and if they want to come off blood pressure meds later because they may no longer be needed they have to wean off over a long period of time to make sure they don't get these potentially fatal side effects.

I have white coat BP and before my GP prescribed blood pressure meds for me they gave me a 24 hour monitor to ensure that they were not prescribing them needlessly. I wore it and then they used that information. At the time it was borderline even with that info but I took them for a year and now I am off them (which took ages to achieve) except for taking a low dose now and then if I am in a stressful situation. I came off metformin and the blood pressure meds because there was no good change in my readings using them - my blood sugar levels were not improved on metformin (in fact they got more likely to have high peaks) and my blood pressure was not better on my bp meds. When I came off them both readings became more consistently good.

My last BP was 128/80 in the surgery and with me being a bit stressed (without BP meds) and the GP agreed with me that taking meds for that was overkill.

A person should do whatever they personally feel is sensible but they should be working together with their medical professionals to make joint decisions based on being properly informed about the positives and negatives of what the options are and then they can make informed choices and decisions that best suit their specific needs and requirements.

 

[ColinUK]

I made a decision to carry on talking about things whilst the practice manager was in the room and said it was OK to talk in front of her. After all she has access to everything anyway.
I’ll see what happens over time but this GP was very quick to praise the efficacy of metformin and when I went through the dietary changes I’ve made and the BG monitoring results he put all of them down as a result of the drugs. Which was a touch frustrating as it made my efforts seem worthless.
I’m expecting better from the nurse.

 

[NotWorriedAtAll]

I hope so too.
I am very lucky with my GP practice - they have a Diabetes expert who saw me about three months into my journey and who was over the moon with my progress and put it down to my handling of the condition. I'm getting my first anniversary blood test results back today and I'm a bit nervous because so far it has all seemed too good to be true. Fingers crossed for both of us.

 

[Northerner]

So... the GP gave me a print out of all my figures and I’ll look over them in the morning but he was astonished that I’d bought a BG monitor and was quite dismissive of the steps I’ve taken so far.
“Most type 2’s just take the medication and that’s all”
“I’m not most type 2’s”
“Evidently.”

So putting aside that realisation that my GP is a prat, what else did I learn?

Well it seems my HbAC1 has hovered around the upper limit for a while... one test it’d be 0.1 over and the next it’d be 0.1 under. Last two years it’s been 0.1 over each time. So I haven’t been diabetic since 2014. I’ve been borderline since then and really just into the diagnostic range for the last two years.

“It’s really borderline so that’s why you weren’t probably told.”

He’s changed my metformin to the slow release after my detailing the side effects. Which elicited a response of “Haven’t you gotten used to them by now?”
“No”
“So have you cut the dosage down?”
“No”
“Why not?”
“Because it’s what you prescribed me!”
“And you’ve not become used to the side effects?”
“Yes I’m very used to the side effects. I can set my watch by the side effects. But if they can be stopped I’d like to get used to not having them!”
“I’ll change your medication.”

We spoke about diet a little and I mentioned I’d significantly cut down on carbs, was weaning myself off sugars, eating more fish, olive oil and other healthy fats, veg etc...
“Well I can give you a diet sheet if you’d like. It just says to follow a Mediterranean low carb diet. Do you know what that is?”
“Yes. It’s what I’ve said I’m following! Low carb, natural fats, good quality protein.”
“I won’t print off the diet sheet then.”

During the consultation the printer toner needed changing so the practice manager came in to do that. The GP himself was pacing around the room at one point. It was like a comedy sketch. Especially when he bumped into a shelf and knocked a pot plant flying.

Anyway.... I’m more relaxed. He’s happy with my monitoring everything but thinks it’s unnecessary of course. He’s given me the form for prescription charge exemption. I’m going to see the practice nurse on 10/2 which is a week after a repeat of the blood tests. Immediately after the nurse appointment I’m in with the same GP to get the blood test results.

He’s quite keen to put me on statins and something for high bp. I’m quite keen that he doesn’t have the need to do that so I’ll do everything I can do between now and then to make sure he doesn’t need to.

Also mentioned that I’d looked at the DUK website and joined this forum. He said it’s the gold standard for advice and I agree with him 🙂

Great description of your encounter @ColinUK It sounds to me like he is one of those GPs who doesn't find diabetes 'sexy', so just prescribes and forgets about it - just not interested It does make you worry about the state some of his other, less pro-active patients if they are getting such minimal response Apparently, this attitude is widespread - I once attended a meeting of the top diabetes consultants in Southampton (I was there as a 'Patient Representative' because of my work in the forum, and they said that one of the major reasons for the poor levels of many Type 2s in the area was that the GPs tended to (consciously or sub-consciously) blame the patient for their condition, and believed the only path was progression to increased medication, eventually insulin, and almost inevitable serious complications in the years to come At that time Southampton was one of the worst areas in the country for amputations due to diabetes

At least there were positive words about you joining the forum - at one time GPs dismissed the value or positively discouraged people from online forums because they did not think the advice was trustworthy, probably without ever actually visiting a forum and reading it 🙄

Anyway! It's great news that you have only been borderline all these years, although a shame that they didn't tell you earlier so you could have made some changes before you actually reached diagnosis levels 🙄

 

[ColinUK]

Great description of your encounter @ColinUK It sounds to me like he is one of those GPs who doesn't find diabetes 'sexy', so just prescribes and forgets about it - just not interested It does make you worry about the state some of his other, less pro-active patients if they are getting such minimal response Apparently, this attitude is widespread - I once attended a meeting of the top diabetes consultants in Southampton (I was there as a 'Patient Representative' because of my work in the forum, and they said that one of the major reasons for the poor levels of many Type 2s in the area was that the GPs tended to (consciously or sub-consciously) blame the patient for their condition, and believed the only path was progression to increased medication, eventually insulin, and almost inevitable serious complications in the years to come At that time Southampton was one of the worst areas in the country for amputations due to diabetes

At least there were positive words about you joining the forum - at one time GPs dismissed the value or positively discouraged people from online forums because they did not think the advice was trustworthy, probably without ever actually visiting a forum and reading it 🙄

Anyway! It's great news that you have only been borderline all these years, although a shame that they didn't tell you earlier so you could have made some changes before you actually reached diagnosis levels 🙄

That was my main beef yesterday. But then again I don’t honestly know if I would have made the changes after being told I was pre. I like to think I would but human nature and everything...

 

[Edgar's Raven]

Good grief, @ColinUK - just read through this thread (didn't realise you were a Newbie!) and what it shows is that the care for those with diabetes (I'm focussing on T2 as that's what I have/had) is wildly different, depending on your GP. No wonder you are upset at the way you were treated, but it seems like you have a handle on the way forward. Very wise words in other comments here, especially the 'don't go mad' in regard to plunging into very low carb/keto - it can be too much at first for some. It's a shame your GP wasn't knocked out by the plant pot..... Mine was so laid-back about it he was horizontal: "just see what you can do with diet and exercise". His approach worked for me as I'm a little like that too and he doesn't chuck out meds like sweeties, but it wouldn't work for others. Make sure you have all the diabetic checks available - bang on desks if necessary! I had to fund mine or ask for three-month bloods at first - as soon as the hbA1C came down to 'normal' (still prediabetic though) my practice wasn't interested. With your diagnosed BG levels, what you have now embarked upon re diet and exercise, you'll be on your way down (BG-wise!) very soon. 🙂

 

[Ralph-YK]

Also once someone is on blood pressure meds as a regular thing they are then stuck with having to take them because a missed dose can cause irregular heart beats and even heart attacks (it is in the paper information that comes with them) and if they want to come off blood pressure meds later because they may no longer be needed they have to wean off over a long period of time to make sure they don't get these potentially fatal side effects.

I've not been weaned off most every meds I've taken, including BP/heart tablets I've taken.
Interestingly high BP tablets are also use for other things. Which is a pain for people like me who have low BP. Ironically, 10 years ago I was put on some because of high BP. Got diagnosed for other things, and kept on the tablets for that. Even though my BP came down.

 

[NotWorriedAtAll]

I've not been weaned off most every meds I've taken, including BP/heart tablets I've taken.
Interestingly high BP tablets are also use for other things. Which is a pain for people like me who have low BP. Ironically, 10 years ago I was put on some because of high BP. Got diagnosed for other things, and kept on the tablets for that. Even though my BP came down.

Just got back from getting my yearly check up results and told them I'd come off my bp meds. They were initially worried about that until I explained I'd weaned off them and not just stopped abruptly. I've come off the prescription now except for the low dose ones for me to take as and when needed for social anxiety. That is only now and then so no need to worry about getting dependent.

 

[Sharron1]

So... the GP gave me a print out of all my figures and I’ll look over them in the morning but he was astonished that I’d bought a BG monitor and was quite dismissive of the steps I’ve taken so far.
“Most type 2’s just take the medication and that’s all”
“I’m not most type 2’s”
“Evidently.”

So putting aside that realisation that my GP is a prat, what else did I learn?

Well it seems my HbAC1 has hovered around the upper limit for a while... one test it’d be 0.1 over and the next it’d be 0.1 under. Last two years it’s been 0.1 over each time. So I haven’t been diabetic since 2014. I’ve been borderline since then and really just into the diagnostic range for the last two years.

“It’s really borderline so that’s why you weren’t probably told.”

He’s changed my metformin to the slow release after my detailing the side effects. Which elicited a response of “Haven’t you gotten used to them by now?”
“No”
“So have you cut the dosage down?”
“No”
“Why not?”
“Because it’s what you prescribed me!”
“And you’ve not become used to the side effects?”
“Yes I’m very used to the side effects. I can set my watch by the side effects. But if they can be stopped I’d like to get used to not having them!”
“I’ll change your medication.”

We spoke about diet a little and I mentioned I’d significantly cut down on carbs, was weaning myself off sugars, eating more fish, olive oil and other healthy fats, veg etc...
“Well I can give you a diet sheet if you’d like. It just says to follow a Mediterranean low carb diet. Do you know what that is?”
“Yes. It’s what I’ve said I’m following! Low carb, natural fats, good quality protein.”
“I won’t print off the diet sheet then.”

During the consultation the printer toner needed changing so the practice manager came in to do that. The GP himself was pacing around the room at one point. It was like a comedy sketch. Especially when he bumped into a shelf and knocked a pot plant flying.

Anyway.... I’m more relaxed. He’s happy with my monitoring everything but thinks it’s unnecessary of course. He’s given me the form for prescription charge exemption. I’m going to see the practice nurse on 10/2 which is a week after a repeat of the blood tests. Immediately after the nurse appointment I’m in with the same GP to get the blood test results.

He’s quite keen to put me on statins and something for high bp. I’m quite keen that he doesn’t have the need to do that so I’ll do everything I can do between now and then to make sure he doesn’t need to.

Also mentioned that I’d looked at the DUK website and joined this forum. He said it’s the gold standard for advice and I agree with him 🙂

God, what a story. Bet you can't wait to see him again

 

[Lucylemonpip]

Lol! I loved your description of your last GP consultation. I could visualise it all. I am so sorry that you’ve had such a rubbish time of it. I would say though, that if it were me, I’d change my GP or even the practice. You might find a much better one and have a totally different experience.

My diabetes nurse said there was no need for a BG monitor at this stage, as my HbA1c is 50, so just concentrate on losing weight. However, I had already got one and have now started to monitor what I’m eating low carb-wise and how my meals affect my BG. Besides, it’s actually interesting to monitor what foods do what. 🙂

 

[ColinUK]

God, what a story. Bet you can't wait to see him again

Actually I don’t dread it. I think he’s certainly different from my last GP but I like the practice. I’ve been under their care for 20 years pretty much.