Cuts to basic care.

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EllaRose71

EllaRose71

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My husband has been diagnosed with T2 Diabetes & high BP as the cause of his stroke, 6 weeks ago. After spending 10 days in hospital, he came home, although his eyes and short-term memory and walking have been affected and i am now his carer. Which i am not complaining, it is the least i can do for him.
He attended his first ever appointment for Diabetes a few days ago and i am annoyed at the lack of information he is receiving in terms any Diabetic leaflets re diet or recognition of hypo's or even attending a Diabetic eye screening, etc. She didn't advise him to lose weight or even ask for a water sample to be sent off with the bloods she took, he was asked to take it in later.
He cannot walk too good now and i suspect one of the reasons is because his nails have thickened and grown too long, we cannot cut them because of this. He complained of his toes feeling numb, yet the nurse said his feet were fine as she can feel a pulse in his ankles. She also said she could not refer him for nail cutting because he didn't have any other symptoms!
The whole appointment lasted just 15 mins, whereas i was under the impression the first appointment should last at least 30mins with diabetic advice given as standard.
So, do T2 Diabetics have to wait until there is an ulcer or worse before they get nail treatment? Is this standard practice now, whatever happened to the idea of preventative care?
I am now in the process of trying to find a Podiatrist with an appointment asap, but most are booked up weeks and months in advance.
 
I went online during lockdown, when my regular podiatrist became unavailable, and found a podiatrist that actually specialised in home visits for the elderly. He had identified a need in our area. Ideal for people with mobility issues, so might be worth exploring.
I Googled "diabetes type 2 leaflet" and got the information leaflet for Scotland, which you could download and print. Also
https://patient.info/diabetes/diabetes-mellitus-leaflet I've used patient.info and patient.info/forums in the past and found them helpful. Of course this diabetes.org.uk has a wealth of information as well. It will explain what tests diabetics should have, and their frequency. There can be a wait for eye screening, but keep pushing.
Best wishes
 
Hi @EllaRose71. Now you have become a carer can I suggest you investigate carer support services in your area?

Googling carer support and your county council should give you a start. What you will get is a bit of a post code lottery I am afraid but if you are lucky you will be able to get access to somebody who knows their way around how services work in your area and can help you to find what you need. It might take a little time to get you into the system with a formal carers assessment but once there all sorts of avenues might be opened for you to find help with your caring duties.
 
Do you have Type 2 yourself @EllaRose71 ? Looking back at your previous posts, it seems you do? Is your husband on medication for his diabetes? If he’s on a different regime to yourself, I can understand why you’d expect more support. I notice you say he hasn’t been told about hypos - is he on something like Gliclazide that can cause hypos?

I hope the podiatrist can sort his nails once you’re able to get him seen. If the numbness still persists, it might be connected to high blood sugar. Do you know what his HbA1C was at diagnosis?
 
Here in South Pembrokeshire there's a NHS self-referral podiatry service - you can drop in (limited to a 2-hour time slot, once a week) or phone up. I went over there, filled out a form and received an appointment about 6 weeks later (it wasn't an emergency). I had absolutely no idea that this was available until I spoke to a receptionist at my surgery. Maybe there's something similar in your area - I hope so!
 
I had to deal with swelling of lower legs and feet after Covid jab, which I did using the shower spray and cold/hot/cold water up and down my legs and then massage with moisturising cream after drying. I was doing it twice a day at first, but still do the massage now a couple of times a week as it made such a difference to my feet, particularly the nails.
The diabetes care for type twos is not exactly top notch. The dietary advice I got was rubbish and possibly dangerous, as in potato and beans being a good choice for lunch - I mean - no - better not express my feelings about that.
Anyway - type 2 diabetics typically can lower blood glucose and get back to near normal Hba1c, or even lower, by eating a diet low in carbs, replacing them with protein and natural fats. Unless being treated with glucose reducing medication hypos are unlikely to occur.
 
It was about 4 months before my son got a letter for a diabetes eye test
 
I guess i was a bit overwhelmed yesterday.
Thankyou all for your valued replies. I will take a look at the info on here and see if there is a self-referral for a Podiatrist at my Dr's. In the meantime, i am trying to arrange a private one to come out as he finds walking difficult.
Yes, i am T2 myself, but mine is under control because i eat salad-based meals, hubby wants starchy winter food and his memory problems means he forgets he has eaten and wants another meal or to snack! (which i try to persuade him he has eaten). What do you give someone at 10pm at night?
He is on 1 500gm Metformin, which i have never been on, which frightened me thinking he could have hypo's.
I am trying my best to give him healthier meals, but he won't eat salads.
To be honest i feel food is a mine field for diabetics. It does not help that certain products have the colour coded energy values in white, giving the impression that it's healthy at first glance. (Have you noticed that lately?)
I have no idea of what his HbA1C was at diagnosis at all. There wasn't any information given to me at his discharge where he was dumped with a carrier bag of 7 types of medication in the discharge suite. There was a letter stating his medication to take in the mornings, with a Statin at night. When i asked for it to be explained, i was told there wasn't anyone available and it was all in the discharge letter. I had to ring the hospital Pharmacy to ask if it was safe to take them all together or to space them out and what meal to take his Metformin with.
 
My son is T1, but at diagnosis they didn't give use results of any of the follow up tests, just the initial ones indicating diabetes. By follow up I mean same day but later. We were only told tests upon admission.
 
I was put on Atorvastatin at diagnosis and became forgetful and confused - I did all the Christmas shopping twice and lost the car in carparks. It took some time to recover from just 5 weeks taking the tablets. It frightened me as I thought I was headed for a care home and dementia.
Metformin is not a glucose lowering medication, you need not be concerned about hypos, it doesn't work like that.
I find food choices very easy - I eat twice a day, no snacks as I am never hungry.
If you want 'filling' foods then cauliflower cheese, made with just cauliflower and cheese, stir fries - I get frozen ones from Lidl which are very low carb and different flavours, stews, a pressure cooker, a few slices of onion, a pack of frozen beef, some frozen mixed veges and mushrooms make it an easy option coming in after a day out in the cold.
Don't worry about saturated fats - the brain is made up of various fats, so for repairing itself - if that is possible, a diet with low fat and seed oils makes for poor choices.
 
It is difficult when you have to juggle multiple conditions. Metformin helps the body use the insulin it is producing more efficiently and depending on what somebody's HbA1C is, the dose may be increased over a period of weeks to allow the body to adjust. However dietary changes are important as you probably appreciate being type 2 yourself.
Soups are a good winter option and there are quite a few substitutions that can be made for high carb foods, butternut squash, celeriac, swede and all be used as a topping for shepherds pie instead of potato.
This link may help you with some ideas for menus which may suit both of you. https://lowcarbfreshwell.co.uk/
 
Hi @EllaRose71

I hope your area offers NHS podiatry in a reasonable time frame. Where I live my high risk foot clinic has been reduced to two clinics per year and nail cutting & skin care is now classed as personal care & I'm told to go to a private podiatrist for it. I have contacted Diabetes UK who told me that shouldn't be happening - my leg is in a cast with ongoing diabetes related complications - but I can't get any extra appointments or nail and skin care included in the NHS appointment. My private podiatrist can't believe I've been told to go privately for foot care but in my area it is how it is. Ive tried my gp who managed to get me one appointment but no nail/skin care just pulse and sensation in my feet. When I asked for further help I was told to go privately.

I hope your area has some podiatry appointments available and nail & skin care is available and not categorised as personal care. A system that used to work well where I live is no longer available to provide safety and reassurance and prevent problems from getting worse.

I hope things settle for your husband and you can find appropriate care. Best Wishes.
 
Thankyou all so much for your very valued replies and for the dietary advice also. I had a look in Lidl but didn't see the stir fry packs, i'll look again next time i am in.
If i had been told by the hospital on his discharge about his medicines and the Metformin, i would have been saved a lot of worry (thankyou for the reassurance re Metformin). As for the Podiatrist, i have now made a private appointment for him to visit.
I have cut his sugar intake, so at least that's 6-8 teaspoons of sugar per day he doesn't have in his tea anymore and also no biscuits allowed.
I am now planning meals that don't include potatoes and have introduced more fresh vegetables. There hasn't been a slice of white bread in the house since he was discharged form hospital, i found a good Warburton's brown loaf with multigrain which is very tasty.
Only now do i feel i am on the right track.
 
EllaRose71 said:
Thankyou all so much for your very valued replies and for the dietary advice also. I had a look in Lidl but didn't see the stir fry packs, i'll look again next time i am in.
If i had been told by the hospital on his discharge about his medicines and the Metformin, i would have been saved a lot of worry (thankyou for the reassurance re Metformin). As for the Podiatrist, i have now made a private appointment for him to visit.
I have cut his sugar intake, so at least that's 6-8 teaspoons of sugar per day he doesn't have in his tea anymore and also no biscuits allowed.
I am now planning meals that don't include potatoes and have introduced more fresh vegetables. There hasn't been a slice of white bread in the house since he was discharged form hospital, i found a good Warburton's brown loaf with multigrain which is very tasty.
Only now do i feel i am on the right track.
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I should think it will make cooking easier as you can be having the same meals.
The recipes on the website sugarfreelondoner have low carb cakes and biscuits which might ease the transition as they are about a quarter the carbs of an actual biscuit.
 
Leadinglights said:
I should think it will make cooking easier as you can be having the same meals.
The recipes on the website sugarfreelondoner have low carb cakes and biscuits which might ease the transition as they are about a quarter the carbs of an actual biscuit.
Click to expand...
Thank you, yes it does make a difference and it is easier now we have similar food. Thank you also for the link to the website sugarfreelondoner, i will certainly look that up.
 
SunflowerMama said:
It was about 4 months before my son got a letter for a diabetes eye test
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I think that is better than my experience although maybe my experience was too long ago to be relevant.
But on the point of the eye tests, I believe this is one of the areas where an early eye test is less relevant for Type 1 than it is for type 2 as issues are typically caused by prolonged high blood sugars. As Type 1 (but not necessarily LADA) is more sudden we are diagnosed sooner so an early eye test is less necessary.
 
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