Letrozole and T2 Diabetes

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happydog

happydog

Well-Known Member
Relationship to Diabetes
Type 2
In January I was prescribed Letrozole because I have had breast cancer. I have noticed that my BG is increasing and as this is the only change that I have made so I am wondering if this drug is the culprit? The DN at the surgery says this cannot be so. I have read elsewhere on the internet that it can have an effect. I have controlled my BG for almost 10 years with diet and exercise. She says that I will have to go onto Metformin. I tried this last year when affected by the steroids and it gave me diarrhea and nausea plus severe stomach cramps. I am really reluctant to have another go with it as it made me feel awful. The DN's response was that "you have got away with this for years, you have always been told that this is a progressive disease and the day of reckoning has come, so you will just have to do what other people do and go on metformin. The side effects will settle down in time". I am really not happy but at a loss to know what to do. I have been refused a print out of my results. I have tried to access my records online and have been informed that this will take up to two months. Any suggestions? So wish I could speak to a doctor, but apparently it is felt that this is unnecessary.
 
S/he sounds like a charmer! Sorry to hear you aren't being listened to @happydog. Can you use the broken record technique? ie repeat your concerns and repeat that you wish to talk to a doctor, until they cave in? Rubbish advice, I know, but it might work. (((hugs)))
 
You are entitled to see your results so be insistent and it is also your choice as to whether you go onto the medication.
You could delay it by saying you wish to try for 3 months by tightening up on your diet and if you don't have one getting a home blood glucose monitor to identify which meals and food may be causing the problem.
There are other medication other than metformin as you have had issues with that before.

This reference implies there may be increased risk of higher blood glucose but also says that should not be a reason not to take the medication.
www.drugs.com

Does letrozole affect blood sugar levels?

Official answer: Although diabetes and blood sugar level increases are not listed as a side effect of letrozole treatment, treatment...
www.drugs.com www.drugs.com

As it affects hormones which can affect blood glucose as people often find when they hit menopause or menstrual cycles.
 
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I found this from the Patients Association explaining the rules.

www.patients-association.org.uk

Seeing your medical records

This page explains how to get copies of your medical records in England and Wales.
www.patients-association.org.uk www.patients-association.org.uk

In essence you are legally entitled to see your medical records. This includes test results. You can only be refused if :
  • A health professional thinks seeing the records would be seriously harmful to your physical or mental health
  • The records also relate to someone else.
That's the formal position and so it is a bit galling for you to have got the responses that you have. As others have said, the simplest thing is for you to make a polite nuisance of yourself at the surgery. You could print out the leaflet, take it to them and ask for an explanation of why they do not follow national guidelines. If that does not work then the leaflet gives ideas of what to do.

The idea that it takes two months to get set up on line is frankly ridiculous. It can be done in minutes if needed but is likely to take a day or two because there is some paperwork involved.
 
Thank you Bloden. I am trying that technique but they hold the cards. For example I filled in my online form to see my records then took the two proofs of identity to the surgery. They said that they had no record of my sending in the form. I pointed out that I had received an email saying that it had been received, but I had to fill it all out again. I then asked for a passcode as it stated on the internet. The receptionist looked at me as thought I was mad and said that she did not know where I got that idea from as it takes two months to get permission. You have to wait outside until they say you can come in and wear a mask. The receptionist then say "pardon" all the time and say that they cannot understand what you are saying. Really annoying. After a very poor review with the health care assistant I insisted on speaking to the nurse. Several days later she phoned and was very noncommittal. She has booked me for a blood test for cholesterol and offered me the shingles and pneumonia vaccinations. I know that the first is the precursor to statin use and the next two are things that they get paid for. I will not give up. I really appreciate you taking the time to reply. 🙂
 
Thank you Leadinglights for your reply. I have decided that I do not want to have metformin as I did not find it good last time so they will have to come up with something else. I have also decided to test more frequently and to keep careful records about what I eat and the quantities. I have managed for 10 years so I am not going to give up easily. Thank you for your support 🙂
 
Thank you Docb. I know that I have the right to see my medical records so I am not going to give up easily. Difficult to make a nuisance of yourself as you have to stand outside until one of the receptionists says you can come in. Only one person at a time and you must wear a mask. When I told the nurse that I would like to speak to a doctor she said that they are very busy and that she did not feel that it was necessary as all I have to do is to accept the situation and start on the medication. I said that I do not want to do that and she said that I have always been awkward over medication but need to realise that as I have had cancer and am getting older my body can no longer cope without medication. I have worked very hard over the years so I will not give in unless there is no option. Can't understand why one can no longer see a doctor? They did send a little text the other day to say that although they are not endorsing it there is a scheme whereby you can have a doctor's appointment at a cost of £200. Why do I pay tax? Thanks for the information that you sent. 🙂
 
@happydog can you email the practice manager? outline your concerns and the manner in which you have been treated including asking why you have received a text saying you can see a doctor for £200. I have an adult daughter with learning disabilities who was treated poorly by a nurse at my previous practice some years ago and having had a poor response from receptionists and nurses I emailed the practice manager and the situation was resolved. I would also look at your areas Clinical Commissioning group's (CCG) and see what its complaint procedure is. Good luck
 
@happydog , if the nurse had said that to me, my response would not have been polite! You need to go into writing with this. Two months to gain access to your medical records? Nonsense. It is a setting they control.

In terms of your curiosity about Letrozole, it seems it is pretty well recognised it can cause increased insulin resistance and raised blood glucose levels.

There are many, many medications available to help treat T2. If Metformin is not for you (and by the sounds of it, it isn't), then if you are to take meds, they need to try harder. You have enough to contend with without gastric upsets over a period of time.

On an aside, I thought my surgery was the last to make a gap in their fortress, although now when one enters there are so many posters informing of the various symptoms one should not bring into the building. It now includes monkeypox. I mean, how many folks know the full range of monkeypox symptoms?
 
@happydog I would definitely be calling and asking to speak to the practice manager. Another option to get to speak to a doctor might be an eConsult if your surgery does them? One question is whether there's someone specific you want to respond, and if you click yes it's then an open text to type and you can put "a doctor" if you don't have a specific GP you would like to speak to. Part of the idea of them is that you can contact the surgery when it suits you, but my surgery switches them off outside of surgery hours...
 
WOW @42istheanswer - your surgery is far ahead of ours. We really really ought to change our doc .... however the only real candidate don't get a good review for their ongoing treatment of longterm medical conditions - obviously I have T1 D plus I am hypothroid, have intermittent claudication and high BP, Pete has COPD, an AAA for which the hospital do do a regular 3 monthly ultrasound scan - which the surgery didn't arrange despite the hospital telling them to instigate until Pete actually got to see a random out of hours GP once, and having had prostate cancer needs an annual PSA test. Incidentally my D consultant sent me a the GP a letter about my thyroid pills last time I saw him to which I have yet to receive any sign of acknowledgment of from the surgery. (Maybe just as well really, since it made no sense to me anyway!)
 
My surgery has improved massively in technological terms since the covid pandemic started, but many other surgeries were offering eConsult long before mine did. I'm not sure if they had actually sent a text out to everyone to say it was an option, or if I just checked and discovered it was now last time I needed to contact them (about a month ago). My sister has been talking about how useful they are (because she doesn't have to talk to people until GP contacts her!) for months
 
42istheanswer said:
My surgery has improved massively in technological terms since the covid pandemic started, but many other surgeries were offering eConsult long before mine did. I'm not sure if they had actually sent a text out to everyone to say it was an option, or if I just checked and discovered it was now last time I needed to contact them (about a month ago). My sister has been talking about how useful they are (because she doesn't have to talk to people until GP contacts her!) for months
Click to expand...
Our surgery has the option to write and e-consult, but literally, nobody looks at them. I tried to use it (for something not too time sensitive) and was told off when I called to chase it up.

If it wasn't potentially awful, it'd be funny!

(Theoretically, there is a safety net in there in that the opening steps for the e-consult is confirming one is not suffering chest pains or other red flag symptoms.)
 
Im shocked about the 2 months thing as well as its basically a SAR which I know has to be responded to within 28 days (If you are looking to make a Subject Access Request it must comply with the Data Protection Act 2018 (DPA) and can take up 28 days to process.) where is she getting the 2 months from. I am so sorry for the way you have been treated and am angry on your behalf. I didnt realise that everyone didnt have online access to their records, my own surgery joined up and I see my test results often before my doctor does

x
 
Thank you for your reply Wannie. There is no email contact with the surgery or the practice manager. Only contact is by telephone and one gets quizzed as to what you want etc. I missed a call from the nurse a couple of days ago. When I phoned back I was told that she would telephone again when she had time. I am hoping that there may be a resolution without being really difficult. I appreciate your advice and will use it if I need to. 🙂
 
Thank you Jenny85. These are all useful bits of information. I will keep trying. 🙂
 
Thank you for your reply Andbreathe. I was irritated by the nurse's attitude, but did not show it. I am sure that i have read that Letrozole can cause a rise in BG but the nurse dismissed this and said "I don't know where you got that from it is not true". I have asked Macmillan and Docb sent me a link that says that it can. May have to stop taking it and see what happens. 🙂
 
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