Gp refusing the drugs my endo recommended

[rebrascora]

When you have your face to face appointment say you want the c peptide etc tests to rule out type 1 diabetes and if they refuse say you want it written into your records as to why they have refused. You don’t need to be confrontational but do be firm. My experience of getting diagnosis for a non diabetes illness was it only happened when I was firm that I wanted it absolutely ruled out instead of just being fobbed off. Turned out I did have it. The tests for type 1 are cheap and will give you an answer one way or another. From there you can decide on other medical approaches.

Unfortunately a C-pep test is not guaranteed to be conclusive and the urine test which would almost certainly be used at a GP practice is less reliable than the blood test which has to be frozen within 20mis of being drawn and sent off in that state and most GP practices do not have the facilities for quick freezing or transit of frozen samples. A GP is also not really experienced enough to interpret the results, so ideally a referral to a clinic consultant for testing would be what you are aiming for, and a GAD antibody test to give some additional info to help with the diagnosis. My C-pep was borderline and would not in itself have been enough for a Type 1 diagnosis (and that was with blood) but GAD was positive. There are people on this forum who have had the tests and are still in limbo about their diagnosis.

 

[Callista]

Trouble with Nice guidelines is that the cost is to the NHS and the benefits to the patients..........!! Different motivations.....

 

[carmella]

I’m so frustrated right now and this may be equally a question and a rant.

I have been struggling for two years to get my numbers under control and ultimately failed. I’m mid 30sf type 2 and have tried diets and exercise, metformin, jardiance and am now on aloglyptin which is doing very little. I also have a huge trauma response to taking oral meds (long story) which means an injectable med would make my quality of life better.

My bloods have huge spikes ( up to mid twenties) after eating and after being told the wait for an nhs referral to an Endo was 30 weeks at least I went private. The Endo agreed that something like liraglutide would help me massively and also recommended testing for monogenic diabetes.

So I phoned my gp today and they have refused to give me the prescription. They say it’s not something they usually do. I am going in for an appointment on Tuesday to discuss this but it feels so crazy and unfair. The Endo is the expert, and they are refusing his advice.

Is there anything I can do or way at my gp appointment or am I stuck being out of control forever?

I’m so frustrated right now and this may be equally a question and a rant.

I have been struggling for two years to get my numbers under control and ultimately failed. I’m mid 30sf type 2 and have tried diets and exercise, metformin, jardiance and am now on aloglyptin which is doing very little. I also have a huge trauma response to taking oral meds (long story) which means an injectable med would make my quality of life better.

My bloods have huge spikes ( up to mid twenties) after eating and after being told the wait for an nhs referral to an Endo was 30 weeks at least I went private. The Endo agreed that something like liraglutide would help me massively and also recommended testing for monogenic diabetes.

So I phoned my gp today and they have refused to give me the prescription. They say it’s not something they usually do. I am going in for an appointment on Tuesday to discuss this but it feels so crazy and unfair. The Endo is the expert, and they are refusing his advice.

Is there anything I can do or way at my gp appointment or am I stuck being out of control forever?

Hi I think you need a C-Peptide test. You may have severe insulin resistance or you may have insufficient insulin. If you have a C-Peptide test you also need a fasting glucose. The type of diabetes can be informed by using the HOMA-IR assessment for insulin resistance. You don't need to be positive to diabetes auto antibodies to be classified as a Type 1 however it may also be valuable to test for GAD antibodies. Do you have any ketones, do you check for ketones?