Is it really this simple?

[Amigo]

Looking through the contents of this post it seems that being seen in a year after diagnosis in not something to be alarmed about ( for T2s)Well, it certainly alarms me. Also I'm not sure that citing other illnesses and how they may/may not get the same treatment in any way makes it right. To me it just highlights the overall deterioration of health care.
As Ds we are all well aware that we are more susceptible to infections, and that stress has direct effect on BG levels. Turfing a newby D out into the world on the back of a 12 month wait is scarily unacceptable. What about all this stuff that is surfacing regarding Ds not being able to get insurance ??

On the one hand they are not ill enough to be seen within a year, on the other they can't get life insurance , whats that about ??

Putting forward that using this forum can plug the gap left by the medical profession is, again seriously scary. I cannot understand why DUK are not screaming this from every available rooftop. There may well be lots of very good advice given in here, is it really acceptable that it's function is in any way to be regarded as taking the place of a GP ??
Are we going to see GP receptionists putting forward the DUK forum because the Dr is busy for the next year ??

I'm struggling to come up with an illness where a patient would be told to take the tablets and come back in a year,, maybe somebody could enlighten me ?

I didn't cite another illness to justify overall bad treatment Bill. It was to highlight the dearth of medical information generally.

Surely the newly diagnosed would elect to see their GP after the first few months to discuss progress and make an appointment. That's what my GP expected me to do. We need guidance for sure but there has to be some personal ownership too. I don't think anyone is forbidden from follow up appointments but I agree a 3 month review for the newly dx is the ideal.

Ironically the subject of this thread seems to have been happy with the advice she was given.We are critical on her behalf!

 

[Bubbsie]

I didn't cite another illness to justify overall bad treatment Bill. It was to highlight the dearth of medical information generally.

Surely the newly diagnosed would elect to see their GP after the first few months to discuss progress and make an appointment. That's what my GP expected me to do. We need guidance for sure but there has to be some personal ownership too. I don't think anyone is forbidden from follow up appointments but I agree a 3 month review for the newly dx is the ideal.

Ironically the subject of this thread seems to have been happy with the advice she was given.We are critical on her behalf!

The problem is not limited solely to the 'subject' here...this is advice given to many type 2 diabetics...it was given to me...and no doubt will be given to others...since it appears to be the only advice given to this person...in the absence of any alternative...she has little choice other than to be happy with it...since she knows no different.

 

[Bill Stewardson]

I didn't cite another illness to justify overall bad treatment Bill. It was to highlight the dearth of medical information generally.

Surely the newly diagnosed would elect to see their GP after the first few months to discuss progress and make an appointment. That's what my GP expected me to do. We need guidance for sure but there has to be some personal ownership too. I don't think anyone is forbidden from follow up appointments but I agree a 3 month review for the newly dx is the ideal.

Ironically the subject of this thread seems to have been happy with the advice she was given.We are critical on her behalf!

I absolutely was not or would not think that you put that forward to in any way justify anything. I was more highlighting it to show that lots of illnesses are sliding in the same direction re treatment. Unfortunately D is finding its place in the pecking order, which is why I put in the bit about it showing the deterioration of health care. If that is the impression you picked up then I apologise totally. Not at all my intent.
Ownership, yes definitely. A new D being sent away for a year is not acceptable. When the D is new to all this is when stuff can seem far more imposing than it actually is. Ownership of getting them through that very definitely belongs with the clinicians, not a forum.
If nothing else this post highlights huge inconsistencies around the UK.
There are probably Ds who would be happy with never being seen by anyone again and have the Meds posted, that does not absolve the NHS of reasonable responsibility to educate and monitor the patient.
Where would that end if applied across the board ??
That person won't exercise-don't treat them, that person eats cake- don't treat them, that person drinks- don't treat them, that person crashed while speeding- don't treat them etc.

How many Ds know that removing carbs too enthusiastically can have quite serious long term effects ?? How many read the other post about trying to be "fat and fit" appears to carry the possibility of damaging the heart ?

Are all the GPs around the UK going to let the insurance companies in on this approach so that they can all get life/travel insurance ??

 

[Bubbsie]

I am not a 'D'...I do not have the 'D'...I have diabetes...thank you.

 

[Lucy Honeychurch]

We're all individuals and need to find our own way, what works, what doesn't. I can't see how 'one size fits all' applies to any human, whether it be education, the body or the mind. We're not a homogenized mass.

If you've met one person with diabetes, then you've met one person with diabetes. I have 2 autistic children and the same theory applies. The amount of times I've heard "my sister has a friend whose got an autistic child and does x y z" expecting my children to be exactly the same, or how teachers generalise and categorise children with special needs. Sorry for the rant but am doing battle with the LEA regarding my children's education 😡

 

[Ralph-YK]

I thought it was hba1c every three months for diabetics. I believe this is what my friend has.

This is one of those "it depends" things. Started at 3 months for me. Within a year was at 6 six months. I've been making a fuss, otherwise I'd only be seen yearly, and that was at less than two years in. And I've never been down to see a doctor about my diabetes. It's all been with nurse (except when I actually complained and saw a Dr.).

 

[Bubbsie]

We're all individuals and need to find our own way, what works, what doesn't. I can't see how 'one size fits all' applies to any human, whether it be education, the body or the mind. We're not a homogenized mass.

If you've met one person with diabetes, then you've met one person with diabetes. I have 2 autistic children and the same theory applies. The amount of times I've heard "my sister has a friend whose got an autistic child and does x y z" expecting my children to be exactly the same, or how teachers generalise and categorise children with special needs. Sorry for the rant but am doing battle with the LEA regarding my children's education 😡

Good luck Lucy...hope you give them hell...we cannot afford to let cost cutting interfere with our children's education...or their future...I wish you every success...be interested to hear how you progress with this.

 

[mikeyB]

I am not a 'D'...I do not have the 'D'...I have diabetes...thank you.

Mind you, Bubbsie, everyone on the Parkinson's disease forum refers to PD. Hope you don't get it, it would drive you spare

 

[Amigo]

The problem is not limited solely to the 'subject' here...this is advice given to many type 2 diabetics...it was given to me...and no doubt will be given to others...since it appears to be the only advice given to this person...in the absence of any alternative...she has little choice other than to be happy with it...since she knows no different.

I'm honestly lost now as to what advice was wrong Bubbsie. Any new person diagnosed with type 2 posting here gets exactly the same advice. Diagnosis, limit carb and sugar intake, exercise and lose weight if possible and take prescribed meds. This is exactly what she was told by her GP. The issue is about follow up monitoring and being offered a course (even though we don't really know whether it was actually offered).
I'm certainly not defending diabetic care but I'm not sure this is the best example of doctor's behaving badly!

We're all individuals and need to find our own way, what works, what doesn't. I can't see how 'one size fits all' applies to any human, whether it be education, the body or the mind. We're not a homogenized mass.

If you've met one person with diabetes, then you've met one person with diabetes. I have 2 autistic children and the same theory applies. The amount of times I've heard "my sister has a friend whose got an autistic child and does x y z" expecting my children to be exactly the same, or how teachers generalise and categorise children with special needs. Sorry for the rant but am doing battle with the LEA regarding my children's education 😡

I'm absolutely with you on this Lucy. My autistic son is 32 now and I'm still having these battles. Now that is the mother of all battles! Hope it goes well for you because it's as stressful as hell.

 

[Bubbsie]

I'm honestly lost now as to what advice was wrong Bubbsie. Any new person diagnosed with type 2 posting here gets exactly the same advice. Diagnosis, limit carb and sugar intake, exercise and lose weight if possible and take prescribed meds. This is exactly what she was told by her GP. The issue is about follow up monitoring and being offered a course (even though we don't really know whether it was actually offered).
I'm certainly not defending diabetic care but I'm not sure this is the best example of doctor's behaving badly!

You may be lost Amigo...I'm not...it's not right to advise anyone managing diabetes that it is 'simple'...it is not simple it is manageable providing the right support is given...it's not right to give medication...dispatch them for twelve months before their management/control is reviewed...we do 'know' that according to happydog 'No there has not been any other information etc.'...the issue is not about 'follow up'''...it's about being given the right start...providing the right resources from the onset ...the issue is about the shabby care meted out to type 2 diabetics time after time...I find these comments at odds with your previous view of 'I'd like to see an information pack given to all patients at diagnosis with nutrition advice, offer of an Education Course, testing advice, contact numbers including this site and the usual health warnings around non compliance. Along with this would be a testing meter, instructions on how to use it and a diary of what then to expect in terms of eye and foot checks.' I concur wholeheartedly with that view...that is what's needed...that's what should be provided with...it's not just about the subject of this thread...it's about the 90% of the UKs diabetic population (type 2s) who have to struggle to get even the basics to manage/control their diabetes.

 

[scottishlass]

Just read Bill Stewardson's latest post in this thread & alarm bells are ringing regarding being too enthusiastic about removing carbs and possible longterm consequences. Yikes! I was only diagnosed ("probably T2") in June and am getting my BG levels into single figures but only by drastically reducing carbs. of all sorts. On Metformin 2 x 500g. Can someone point me in the right direction please regarding a sensible carb intake? I am sure there is advice somewhere on this website!

 

[everydayupsanddowns]

Of all the dreadful examples of T2 care that we have heard about on the forum I think this one must surely count as 'pretty good, but could be improved' from the way I see it.

I think it is important to recognise when discussing the bleaguered GP community what was done well as well as what perhaps was not quite what we'd have hoped in an ideal world. And then recognise that this appointment (like all GP appointments) would have taken place under significant time and resource pressure. Almost everyone on the thread is posting that 12 months is too long for follow-up, and I'd cerrtainly agree with that. Aside from that... strips and carb reduction advice was given, along with encouragement to exercise and lose weight.

As to whether it is right for someone to be told that managing a long term condition is 'easy' (or whatever form or words was actually used) I'm not sure I think that's altogether a bad thing. Maybe it depends on your own personality?? To present a lifelong task as impossibly difficult would make me think 'what's the point in trying'.

As long as the gravity of the situation was suitably communicated, I'm all for a "You will be able to do this long-term. This will be manageable for you" type pep-talk.

But absolutely agree with others that there were parts of the care-plan/follow up that seem to have gone missing.

 

[Bubbsie]

Just read Bill Stewardson's latest post in this thread & alarm bells are ringing regarding being too enthusiastic about removing carbs and possible longterm consequences. Yikes! I was only diagnosed ("probably T2") in June and am getting my BG levels into single figures but only by drastically reducing carbs. of all sorts. On Metformin 2 x 500g. Can someone point me in the right direction please regarding a sensible carb intake? I am sure there is advice somewhere on this website!

Scottishlass... I wouldn't worry about your levels being in single figures...you've been managing your condition for over four months...not unusual for some of our members to bring those levels down to single digits in that time period...some do it faster without any ill effect...we all have our individual approaches to managing our diabetes...like you.I have reduced my carb intake considerably...many of us here do...some at a steady pace...other take the plunge straight away...reduce those BG levels swiftly...if you were feeling unwell...or concerned about your management in any way...then discuss it with your GP...doubt you have anything to worry about...as @Lucy Honeychurch says...we are all individual and need to find our own way...none of us here are medically qualified to give such an opinion...I'm sure it wasn't said to alarm anyone...no doubt you've made that decision after careful consideration of how you should manage your diabetes...as said please don't be alarmed by the comments...if you have any concerns at all discuss it with your health care team...I'm sure they will be happy to allay your concerns.

 

[Bubbsie]

Of all the dreadful examples of T2 care that we have heard about on the forum I think this one must surely count as 'pretty good, but could be improved' from the way I see it.

I think it is important to recognise when discussing the bleaguered GP community what was done well as well as what perhaps was not quite what we'd have hoped in an ideal world. And then recognise that this appointment (like all GP appointments) would have taken place under significant time and resource pressure. Almost everyone on the thread is posting that 12 months is too long for follow-up, and I'd cerrtainly agree with that. Aside from that... strips and carb reduction advice was given, along with encouragement to exercise and lose weight.

As to whether it is right for someone to be told that managing a long term condition is 'easy' (or whatever form or words was actually used) I'm not sure I think that's altogether a bad thing. Maybe it depends on your own personality?? To present a lifelong task as impossibly difficult would make me think 'what's the point in trying'.

As long as the gravity of the situation was suitably communicated, I'm all for a "You will be able to do this long-term. This will be manageable for you" type pep-talk.

But absolutely agree with others that there were parts of the care-plan/follow up that seem to have gone missing.

I'm sorry were we reading the same thread here Mike...what was reported was a GP saying managing diabetes was 'simple'...to give encouragement by saying diabetes is perfectly manageable if you reduce carbs...exercise...find the right regime is one thing...to be told it is simple...take the pills...comes back in twelve months is not acceptable...whether GPs are under pressure or not...would you be happy with that advice at your diagnosis...I very much doubt that.

 

[everydayupsanddowns]

Just read Bill Stewardson's latest post in this thread & alarm bells are ringing regarding being too enthusiastic about removing carbs and possible longterm consequences. Yikes! I was only diagnosed ("probably T2") in June and am getting my BG levels into single figures but only by drastically reducing carbs. of all sorts. On Metformin 2 x 500g. Can someone point me in the right direction please regarding a sensible carb intake? I am sure there is advice somewhere on this website!

This is a blog post we often use as a suggestion of how to improve BG management with a meter and carb reduction: http://loraldiabetes.blogspot.co.uk/2006/10/test-review-adjust.html

Congratulations on the progress you have made so far - as to advice for mow many carbs are right for you, there are widely different viewpoints both here on the forum and across the healthcare community... So in a sense you have to make up your own mind. I do note though that AlanS's post includes suggestion about looking at your diet as a whole and making sure it is nutrtionally balanced and includes sufficient minerals/vitamins/trace elements etc.

 

[everydayupsanddowns]

I'm sorry were we reading the same thread here Mike...what was reported was a GP saying managing diabetes was 'simple'...to give encouragement by saying diabetes is perfectly manageable if you reduce carbs...exercise...find the right regime is one thing...to be told it is simple...take the pills...comes back in twelve months is not acceptable...whether GPs are under pressure or not...would you be happy with that advice at your diagnosis...I very much doubt that.

Are you sure you read my post Bubbsie?

How do we know 'perfectly manageable' was not the phrase used? And then translated and reported (third hand) as 'simple'.

And I said that 12 months follow-up was too long. Go back and have another look. It's right there.

 

[Bubbsie]

Are you sure you read my post Amigo?

Are you sure you read mine Mike...I'm bubbsie...not Amigo!

 

[everydayupsanddowns]

LOL! Like you Bubbsie, I seem too intent on posting quickly.

 

[Amigo]

To me, this is the key and most valid point made on this thread by Lucy;

'We're all individuals and need to find our own way, what works, what doesn't. I can't see how 'one size fits all' applies to any human, whether it be education, the body or the mind. We're not a homogenized mass'.

I wouldn't feel able to dictate to anyone as to the prescribed frequency of their reviews or tell them they they are accepting things because they don't know any better. Frankly I'd have taken great encouragement if my GP had told me I could crack this with simple, sensible means but that doesn't mean I don't recognise that certain elements of the care plan were then missing in this particular case (allegedly). This newly diagnosed person was given a meter and strips and that's a huge positive. As for the eye and foot checks...they are then generated automatically so there's no certainty they were missed. It may indeed be simple for this person based on the information she has so far. How do we know and why do we have the right to dictate the same process and level of oversight for everyone? I don't want 3 monthly Hba1c's and my GP doesn't believe that they are clinically necessary. I didn't want an Education course or my GP to give me nutritional advice he's ill-equipped to provide. But I absolutely agree that is should be available for those who do.

I'm not qualified to say whether 90% of the diabetic population receive inadequate care or struggle to receive the basics to manage their condition because only a very small percentage of them post on here and my story, my needs and expectations may not be theirs.

I feel desperately sorry for those who do struggle and have inadequate information and would fight as hard as the next person to ensure that they receive it. However I'm not prepared to insist that everyone must follow the same format, same level of monitoring frequency or indeed test if they don't choose to. It's about choice and that has to be a two way street. The subject of this thread seems quite reassured by the advice she's received and I'm certainly not going to patronise her by saying she doesn't know any better. I hope she does brilliantly well and does in fact find it 'simple' to achieve control. Surprisingly, many do.

My final post on this subject thankfully!

 

[scottishlass]

Hi, thanks for the reading advice re. sensible carb intake - tonight's reading matter! Bubbsie - it's kind of you to think that my decision to cut carbs was a considered one but ..... 'fraid I just went into a blind panic after the out-of-the-blue diagnosis and having looked at this website thought I would try carb cutting and see what happened. So far seems to be giving some positive results but first post diagnosis HbA1C in a couple of weeks should give more of an indication. This website has been my saviour, felt rather thrown onto my own resources with zilch knowledge by my GP surgery - no diabetes nurse up here in the far flung frozen peat bogs of the north!