Lack of GP support?

L

Lioncub

Member
Relationship to Diabetes
At risk of diabetes
I have recently been trying to be more pro-active about my pre-diabetes, hba1c has climbed steadily up over the years to the top end of pre-diabetes. I bought a blood glucose monitor as I have already cut out sugar/treats etc but hba1c was still rising so I wanted to find out what foods my body was struggling with. However my GP cannot give any support other than the practice nurse saying don’t eat sugar and don’t take blood sugar readings. My previous doctor also put me on metformin but the nurse was dismissive of this and reduced my px down as she didn’t think I should be on it? It seems once I tip over into t2 they will give me loads of support/referrals but for now I’m on my own… is this typical? I’m in Wales if that makes a difference to local NHS practices. Is it worth looking at a private GP appt for better advice? I really want to be proactive but feel I’m fighting against the system, despite all their talk about prevention being better than cure :(
 
Welcome to the forum and yes this is typical , i felt the same when i was diagnosed and was told not to check bloods etc etc and to take the medication oh and see u in a year for next blood test ,this went on for 3 years untill i started to research everything i could about this disease .Have a look in the learning zone there's a lot of good information for you so please take the time to go through it . Also try to keep a diary of what you eat and try find ways to make it a bit more healthy as in more whole foods , greens veg etc and look at low carb meals on the freshwell food app. I test before and after meals and im starting to see descent results just by changing what i eat during the day , im sure that there is a course available through your GP Called desmond course if you mention this to your GP they could refer you for it .Anyway good luck hope you find some answers to your post and your definatly not alone, alot of people feel the same .For me i spent hours and hours learning everything i can and changing my diet etc also being more physically active after eating like taking dog for a walk helps to keep the sugar levels within target .
 
And not only do dogs get healthier by walking more - so do their owners!
 
@CoolShot44 @Lioncub when I was diagnosed with T2, I just got a text on my phone with a link to this site and it basically said "go cure thy self and come back for another blood test in 3 months".

Aint life fun

Alan 😉
 
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totaly agree same here i had no advice from my GP told about carbs and cals book and diabetes uk site 😉
 
Lioncub said:
It seems once I tip over into t2 they will give me loads of support/referrals but for now I’m on my own… is this typical?
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You’re definitely misunderstanding there. Diabetes is mainly something you manage yourself. When a1c is high despite your efforts then GPs can prescribe medication but that’s about it, it’s your diabetes to manage.

Where is it that you’re wanting a referral to?
 
You can learn all you need to know here, so no need to pay for a private doctor who may be no more clued up than your own doctor.

The truth of the matter is that diabetes is quite individual, so you have to figure out what things in your life you can improve on, in order to manage your diabetes well or in your case, reduce your risk of developing diabetes.
 
Doctors and nurses do not train as dietitians. My granddaugher completed her nursing degree recently. I asked how much time on Nutrition. Answer, 'None'.

HbA1c and weight are closely linked. It's possible you need to shed some pounds, and an inch or two from your waist.

Here are some links to help you with your diet:
- https://www.lowcarbfreshwell.com/documents/8/Freshwell_Red_Amber_Green.pdf : Cut back on Red/Amber foods?
- https://phcuk.org/wp-content/uploads/A_5_page_low_carb_diet_leaflet_Unwin_2021-converted.pdf : Good advice from a GP
- What should we eat? https://www.zoeharcombe.com/2021/08/what-should-we-eat/ : Many people have lost weight following this advice.
 
Lucyr said:
You’re definitely misunderstanding there. Diabetes is mainly something you manage yourself. When a1c is high despite your efforts then GPs can prescribe medication but that’s about it, it’s your diabetes to manage.

Where is it that you’re wanting a referral to?
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I was told there’s a dietitian they can refer me to as well as a ‘diabetes support programme’ (possibly the Desmond programme mentioned by CoolShot44?) but only once my hba1c goes over 48. Oh and a free/heavily discounted gym membership I’d qualify for too.
 
JITR said:
Doctors and nurses do not train as dietitians. My granddaugher completed her nursing degree recently. I asked how much time on Nutrition. Answer, 'None'.

HbA1c and weight are closely linked. It's possible you need to shed some pounds, and an inch or two from your waist.

Here are some links to help you with your diet:
- https://www.lowcarbfreshwell.com/documents/8/Freshwell_Red_Amber_Green.pdf : Cut back on Red/Amber foods?
- https://phcuk.org/wp-content/uploads/A_5_page_low_carb_diet_leaflet_Unwin_2021-converted.pdf : Good advice from a GP
- What should we eat? https://www.zoeharcombe.com/2021/08/what-should-we-eat/ : Many people have lost weight following this advice.
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I definitely do need to shift some weight, I eat reasonably sensibly but I know I don’t move enough.
 
The problem is that many people feel they are eating a healthy diet and just by cutting out the sweet stuff it will be sufficient, however it is all carbohydrates which convert to glucose so it is foods like potatoes, bread, pasta, rice, breakfast cereals and some fruits with are the big hitters as well as cakes, biscuits. pastry and sugary drinks including fruit juice.
The Freshwell program (https://lowcarbfreshwell.com/) is one which many have found successful and you could do no better than to have a look at that for some good information about a way forward for losing some weight and reducing blood glucose. It is based on the suggested no more than 130g carbs per day.
As you have a monitor then doing some strategic testing of your meals may reveal some problem foods and meals. Testing before you eat and after 2 hours when you are looking for no more than 8-8.5mmol/l after 2 hours or an increase from the meal of no more than 2-3mmol/l, if it is then your meal is too carb heavy.
The DESMOND course people have mentioned is a diabetes prevention program is subscribed to by some GP practices but it may be not in Wales but there may be an equivalent. Don't let your GP put you off if you feel it would help.
In my opinion Metformin is not appropriate if only prediabetic and dietary changes are much more important.
 
Lioncub said:
I definitely do need to shift some weight, I eat reasonably sensibly but I know I don’t move enough.
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Yes, look at your diet as LeadingLights says. In the links I cited Zoe Harcombe explains how weight loss works - and Freshwell have Time Restricted Eating page which illustrates what she says (try 16:8 and/or 5:2). Dr David Unwin practices what he preaches and that link is about as simple as it gets.

Exercises like streching and squats (if you can do them) take only a few minutes. I sometimes forget to do them, but always feel better when I do.
 
Thank you, I am working my way through all the links. One thing I have already learnt is that this is a super helpful forum so thank you everyone for the replies. I’m feeling a lot better now than I was when I first posted 🙂
 
Welcome to the forum.
I'm also in wales with pre-diabetes. All I got was a printout of a web page (I know this as I later found that exact web page lol).

No need to shell out for a private doctor, if you have the will to change your diet / lifestyle you will find all the information you need from the lovely people here.
I've reduced carbs and lost weight since my diagnosis. I got a 2 point reduction in my HbA1c and my next test is an annual one.
 
Lioncub said:
I have recently been trying to be more pro-active about my pre-diabetes, hba1c has climbed steadily up over the years to the top end of pre-diabetes. I bought a blood glucose monitor as I have already cut out sugar/treats etc but hba1c was still rising so I wanted to find out what foods my body was struggling with. However my GP cannot give any support other than the practice nurse saying don’t eat sugar and don’t take blood sugar readings. My previous doctor also put me on metformin but the nurse was dismissive of this and reduced my px down as she didn’t think I should be on it? It seems once I tip over into t2 they will give me loads of support/referrals but for now I’m on my own… is this typical? I’m in Wales if that makes a difference to local NHS practices. Is it worth looking at a private GP appt for better advice? I really want to be proactive but feel I’m fighting against the system, despite all their talk about prevention being better than cure :(
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You should be eligible for the diabetes prevention program in Wales, AWDPP the info is on the NHS Wales website.
 
Welcome to the forum @Lioncub and I can safely say you're not the only one whose been in this situation regarding a lack of support from a GP regarding any thing diabetes related....I've had the same problems with my old GP when I was diagnosed pre-diabetic.Here hoping you get the support you need.
 
Lioncub said:
Thank you, I am working my way through all the links. One thing I have already learnt is that this is a super helpful forum so thank you everyone for the replies. I’m feeling a lot better now than I was when I first posted 🙂
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Ah that’s great to hear @Lioncub

Sorry you haven’t had the support you would have liked from your GP. It does seem crackers that they hold various things back until after you’ve crossed the diagnosis threshold (rather than throwing all their efforts into preventing that happening), but I wonder whether that may be down to funding for those services not being made available until you have a tick in the box?

Hopefully the members’ shared experiences and suggestions of things you could try in the meantime will help steer your glucose levels away from the diagnosis line.

Good luck, and let us know how you get on 🙂
 
helli said:
It seems DESMOND is more than that - it is a set of programs "for people with or at risk of type 2 diabetes". https://www.desmond.nhs.uk/
It looks as if it covers the whole of the UK including Wales.
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It has come a long way since I first did it about 10 years ago as face to face sessions and then during Covid when it was the on-line version MyDESMOND. Initially it seemed to have a very restricted area it covered and your GP had to subscribe to the scheme.
Good to see how much it has developed and available more widely.
 
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