Can I self-refer to a diabetes clinic?

Status
Not open for further replies.
F

fatbill

Active Member
Relationship to Diabetes
Type 2
I know I keep asking stupid questions, but I seem to be getting nowhere with the practice nurse.
At risk of boring you all....I'm 75, have Parkinson's, and have had t2 for several years.
I was on Metformin, but eventually had to stop because of the nausea and diarrohea.
I was put on Sitagliptin, but for some time now, probably 3 months or more, my BG levels have been high....around 15 - 18 straight out of bed in the morning, and around 25 going to bed, at least 4 hours after food.
I saw the practice nurse who said she would get me on Glicazide, because the Sitagliptin was doing nothing.
Checked my prescription list, no Glicazide, but something called Empagliflozin, which I have not yet received.
Now, I have just tested, and my BG is 31.4, 4 hours after a very light lunch.
I have asked the practice nurse a few times to refer me to the diabetic clinic, but her approach is 'try this one and come back in 3 months for another blood test'.
My hba1c has doubled to 90 in the last 7 or 8 months.


Any symptoms I have are easily confused with some Parkinson's symptoms.

I'm fed up, and just feel like lonking myself down in a clinic somwhere and saying 'Sort this out'.
 
Hi Bill,
sounds as if you need to contact your GP and not the nurse and insist you are referred to a diabetes specialist. This is your right. There is also no reason what so ever that your own GP can not put you on insulin.

Write everything down and send it via the online form attached to your surgery, if you can not find one then write a letter to your GP.
With numbers as high as you have I would contact the out of hours service who I'm sure will send you to A&E so that way you def will be seen.
 
I agree with @Pumper_Sue go to see your GP instead of the nurse at a minimum but with those numbers out of hours or A&E are entirely appropriate if you don’t want to wait until tomorrow. A&E won’t necessarily get your daily management under control but could get you stable enough to not be in danger. Do you have any way to test your ketones? If so do that ASAP.
 
Good luck @fatbill - let us know how you get on. You must be feeling rotten with your BG in the 30s.
 
Thank you all. BG down to 23.3 just now.
Yes, I feel really rubbish, but a bit better than earlier.
I have no way of ketone testing, but I am about to look for one.
I have messaged the practice, but will demand a face-to-face with a GP
(do they still exist?).
It really needs to be sorted out very soon.
Thanks to all for the responses.
 
Hi bill. I got took to A & E with BG on 31.7 and high ketones, where they stabilised me. I felt horrendous!
my advice certainly would be a trip to A & E…
 
My diabetes nurse told any about 30 should go to hospital could be dangerous that high.
 
Hi. As others have said that BS is far too high and may be dangerous. Gliclazide would help and also possibly the Empagliflozin. Sitagliptin would have only helped a bit to remove BS peaks and not the overall amount. It's possible you are T1 and not T2. If you are not overweight then insist the GP refers you and so you can have GAD and C-Peptide tests to determine the right diagnosis. I'm afraid your nurse doesn't seem to understand the risk of a high BS well into the 20s (neither did my diabetes GP when I was diagnosed and at similar levels!)
 
You could try and find contact details for the diabetes team and contact them direct.

If the surgery keep putting you in with a nurse tell them you will complain direct to the practice manager and CCG.
 
Thanks again for all your responses. I realise now that I should have gone to A&E, which I will do next time.
I have found no diabetic clinic listed under my local area hospital, but I will ring the bigger hospital switchboard.
I do get the feeling that the practice nurse who deals with diabetes doesn't know too much about it.
Thank you all again for your input...it helps enormously that you are all there to call on.

This morning my BG is a bit lower at 17.4.
 
You can see your GP. They can discuss appropriate medications, tests and referrals. The nurse has enough training to do general reviews but should refer back to the GP for anythign more complex anyway. 17.4 is better but you will still feel rough so please don’t delay in getting some help.
 
Well, after chasing around in a circle of answering machines and unmanned email inboxes, and getting nowhere, I found that the local diabetes centre is accessible only via referral from a GP or hospital doctor, but once referred and accepted there's a drop-in clinic, an emergency helpline, and more.
I phoned the GP practice, waited 50 minutes in the queue, and then got passed from pillar to post until I'd had enough and demanded to speak with a GP. All appointments gone. Well, too bad. Upshot was a doctor phoned me, and said to come down for a face-to-face in half an hour.

Result. Medication changed, prescribed and delivered this morning.
Referral made to Diabetes Centre. Ketone test strips delivered too, along with test strips for my test meter......the first time ever!

I start on the new meds...Empagliflozin....tomorrow.
Hopefully will improve, and eventually see the specialists soon.

Bad enough to have to do this normally, but with Parkinson's it's a bit harder. Reading the list of possible side effects of the new meds made me smile. I already have half of them.
 
Well done for persisting, @fatbill, it's shocking that you were pushed around like that - what gets me and Mr Marten is that on the TV they keep saying 'Go and see your GP...', 'Ring your GP about [whatever]....'

Have these TV people ever *tried* to see their GP lately? Our surgery is still done up like Fort Knox 🙄
 
Pine Marten said:
Well done for persisting, @fatbill, it's shocking that you were pushed around like that - what gets me and Mr Marten is that on the TV they keep saying 'Go and see your GP...', 'Ring your GP about [whatever]....'

Have these TV people ever *tried* to see their GP lately? Our surgery is still done up like Fort Knox 🙄
Click to expand...
It's just a shame that I have to lose my temper and make threats before the impossible becomes possible. I was even angrier when the doctor I spoke to on the phone said ' Come down in half an hour....I don't have anybody else to see today'......that was at 3.15pm . I'd already been told that there were no possible appointments left for the day.

When will things ever be 'normal' again?
 
fatbill said:
It's just a shame that I have to lose my temper and make threats before the impossible becomes possible. I was even angrier when the doctor I spoke to on the phone said ' Come down in half an hour....I don't have anybody else to see today'......that was at 3.15pm . I'd already been told that there were no possible appointments left for the day.

When will things ever be 'normal' again?
Click to expand...
Good grief! I wish I knew when things will be normal... Actually seeing a GP wasn't very easy in 'normal' times as I recall. Our surgery once had the utterly stupid method of telling us to ring at 9am to book an appointment. I remember being at work, ringing at 9am to find it was engaged, trying to ring again on and off but finding it was still engaged until about 11am by which time there were no appointments left. I'm glad to say they got rid of that system at least.
 
Pine Marten said:
Good grief! I wish I knew when things will be normal... Actually seeing a GP wasn't very easy in 'normal' times as I recall. Our surgery once had the utterly stupid method of telling us to ring at 9am to book an appointment. I remember being at work, ringing at 9am to find it was engaged, trying to ring again on and off but finding it was still engaged until about 11am by which time there were no appointments left. I'm glad to say they got rid of that system at least.
Click to expand...
Yes our surgery has that system, ring at 8am, if you are lucky you get through.
We had a situation recently when late in the afternoon, we consulted the online 111 which said contact your GP, who said contact the Community nursing team but they had not received the referral so they said go to A & E, fortunately they sent us straight to the urology ward rather than having to queue there.
 
Leadinglights said:
Yes our surgery has that system, ring at 8am, if you are lucky you get through.
We had a situation recently when late in the afternoon, we consulted the online 111 which said contact your GP, who said contact the Community nursing team but they had not received the referral so they said go to A & E, fortunately they sent us straight to the urology ward rather than having to queue there.
Click to expand...
Pine Marten said:
Good grief! I wish I knew when things will be normal... Actually seeing a GP wasn't very easy in 'normal' times as I recall. Our surgery once had the utterly stupid method of telling us to ring at 9am to book an appointment. I remember being at work, ringing at 9am to find it was engaged, trying to ring again on and off but finding it was still engaged until about 11am by which time there were no appointments left. I'm glad to say they got rid of that system at least.
Click to expand...
Our surgery still has that system too.
Ring at 8 am, find you're 11th in the queue, on hold for up to an hour, then find all appointments for the day gone. Then told to ring back at 8 am the next day....and so on.
Actually getting a face-to-face at 30 minutes notice probably indicates just how angry I was. Not abusive, but not holding back.
BG 19.1 again first thing this morning, but no more Sitagliptin, first day on Empagliflozin.
Thanks to all who replied...I love the support shown on here.
 
I’m so glad you were seen and have a way forward. While your numbers are so high try to keep your fluids up as it will help flush out your system. And if you can go for a decent walk that will also help as moving your larger muscles helps bring your BG down. I hope the new meds bring about a swift change in your numbers. I dread to think what might have happened if you weren’t self testing.
 
Thanks. I'm drinking lots and peeing lots. Trouble is my Parkinson's often gives very little notice...☺
I walk with a 4-wheeled rollator, so I don't get very far, but so far I've kept my mobility scooter parked!
I had been just randomly self-testing until I had to stop taking the liquid Metformin.
Since the latter part of June I've tested morning, first thing out of bed, and just before going to bed. The figures have been high and getting higher. Hopefully now they will start to fall. Always a bit worrying adding another med to my longish list, but we'll hope for the best and see how it goes.
 
Pine Marten said:
Our surgery once had the utterly stupid method of telling us to ring at 9am to book an appointment. I remember being at work, ringing at 9am to find it was engaged, trying to ring again on and off but finding it was still engaged until about 11am by which time there were no appointments left. I'm glad to say they got rid of that system at least.
Click to expand...
That’s my surgery’s current system - except the starter pistol goes off at 8am. It took my 89-year-old neighbour 3 days to get an appointment recently. Shocking!

I’m so glad to hear you’ve been seen at last @fatbill and are now ‘in the system’. I’m sorry to hear what an effort it was tho. I hope your BGs drop into a more comfortable range soon.
 
Status
Not open for further replies.
Back
Top