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Shouldn't my GP know a bit more?

K

katie

Well-Known Member
Relationship to Diabetes
Type 1
I went to see my GP today. He is an old guy who was my doctor when I was a kid and he was my mum's doctor before I was born!

The thing is... He asked How much insulin I take. So I said i'm on 20 Lantus and 2units of Novorapid per 10gs of carbs.

He looked confused and said "They expect you to work all that out?" and then "They still do that? My goodness".

I know he isn't a Diabetes Specialist or anything but shouldn't he know that Carb counting is the most widely used method and that it's second best to the pump?

:eek:
 
I think it's bad that Gp's do have such a lack of knowledge. They don't tend to deal with many type 1's though, as are usually looked after by hospital clinics and DSN's. So won't be as up to date if they don't choose to update themselves. GP's have their own specialist areas of interest- obviously diabetes isn't his! Although I would say that carb counting is not the most widely used method, most people take set doses of insulin, that are only changed by a Dr or nurse. It is of course the best method, but in reality not enough people do it.

One of my most shocking expereinces was at my last Gp practice, I saw the 'diabetes nurse' , she told me that most of the diabetes patients didn't go to the hospital clinic because she was there. When I said that I adjusted my novorapid by carb counting, she didn't understand. She understood using a sliding scale to adjust insulin but not carb counting. Was scary her lack of knowledge.
 
Surely it's better that a GP asks someone about the method they use to manage their diabetes, rather than telling them how to do it, without really understanding? Probably most diabetes specialist GPs and diabetes specialist practice nurses deal more with type 1 diabetes than type 2, as the majority of type 1s are dealt with by hospital clinics and their only contact with GP practices is to obtain repeat prescriptions.
Carb counting has a history - it was popularm using CHO exchanges, then went out of fashion, and is now used by some people, including myself - that's probably why an older GP said "They still do that? My goodness".
 
OK, the method that should be used the most :p

I would have thought because diabetes is so common and because it's written about all the time that doctors would keep a bit more up to date with it.

sofaraway said:
One of my most shocking expereinces was at my last Gp practice, I saw the 'diabetes nurse' , she told me that most of the diabetes patients didn't go to the hospital clinic because she was there. When I said that I adjusted my novorapid by carb counting, she didn't understand. She understood using a sliding scale to adjust insulin but not carb counting. Was scary her lack of knowledge.
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That is pretty shocking. And exactly why I don't go to the GP practice for my diabetes care. I just had a feeling it could be bad! They keep sending me letters telling me to go and I have to keep telling them I already go to the hospital. It would be very interesting to see how much they know though ;)
 
My GP is lovely, but I suspect that she knows that I already know more than her about how to treat my condition, because I live with it on a daily basis - also, I am the type of person who likes to understand what is happening to me and why.

It's logical that the GPs know less about Type 1s, because there aren't actually that many of us - I think about 300,000 out of a population of 60 million - and illustrated by the fact that so many people coming here have never met another Type 1 face to face even if they've been diagnosed for decades!

They ought to be pretty much up to speed on Type 2 though, yet it seems that from many of the messages posted here there are many who are not.
 
I wouldn't expect a GP to know very much about diabetes. They aren't specialists and one person's brain can't hold very much detail about a vast number of different conditions.

I have had some bad experiences with GPs. One did not know the difference between blood and ketone strips. Another berated me until I was in tears and then told me I had exceeded the appointment time. And recently I found out I was down as a type 2 not type 1! I am generally anti-GP - I think they earn far too much since they only work 9-5 - and would never trust them to look after my diabetic care. I see them as an admin person dispensing my medications and dealing with minor non diabetic issues.

Having said all that they aren't all bad. I recently went to the surgery with ketones due to the flu. The doctor just told me I knew much more about my own condition than she did, and put me through to the surgery on the phone, who reminded me of the sick day rules.
 
I've heard a few tales of GPs not recognising symptoms of diabetes and testing appropriately - I think that's pretty poor, as I think they should be at least aware of these basic principles, which affect all types of diabetes, but wouldn't expect them to know the ins and outs of all the various treatment options. It's very much a 'hot topic' at the moment though, so maybe some GPs are like those judges we hear about that have never heard of Girls Aloud or the X-Factor, and live in their own little narrow worlds.

And Lizzie, absolutely appalling that a doctor should dismiss you in such a distressed state just because the alloted time was 'up' - shame on him/her! My GP does give you the time you need, which is why I often have to wait way beyond appointment time, but I'd rather that than treated like I was nothing.
 
From experiences GPs are what their name implies General Practitioners. That is why we need specialists.

As a general rule of thumb I do things like attend health awareness events at work and then go to my GP with the results, he then gives me medicinre or not as necessary.

These days I think NHS GPs are rare and overworkd and spread rather thin on the ground. I am not happy with my GP, but if I feel like the pits he is at least not too far to walk. The next nearest surgeries are all a bus ride away and reluctant to take on too many new patients from over walking distance away!
 
Northerner said:
And Lizzie, absolutely appalling that a doctor should dismiss you in such a distressed state just because the alloted time was 'up' - shame on him/her! My GP does give you the time you need, which is why I often have to wait way beyond appointment time, but I'd rather that than treated like I was nothing.
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Yeah that is awfull Lizzy. I have been rushed out before by a GP who seemed in a rush the whole time and barely looked at me. I hate those kind of GPs. Luckily know I usually quite like them though, I just choose the ones that I know are ok now :)
 
My GP seemed to be on the ball when he asked if I thought I had diabetes. Turns out I did! :D But I do agree that its very likely that with Type 1 Diabetes being a very, very elite group of people, GPs might not recognise the symptoms. :cool:

Northerner said:
It's very much a 'hot topic' at the moment though, so maybe some GPs are like those judges we hear about that have never heard of Girls Aloud or the X-Factor, and live in their own little narrow worlds.
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There was a judge who asked who the Beatles were. Conversely I would have thought most judges were well aware who Girls Aloud and of course The Saturdays are. ;)
 
My GP is very good, but as I am on insulin I am looked after by the hospital diabetic unit.. I asked my GP something last time I saw her regarding my diabetes and she told me what she thought, but said it would be better to contact my DSN as she would know more and also be more up to date with my care. The advice she gave what what the DSN gave me as well.

When I was doing my nurse training 26 years ago, regarding meals for diabetic patients it was all to do with carb exchanges and what you could have in place of something else.
 
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I'm just on Amazon looking at some diabetes books to see if I want to wishlist them etc and one of them has a look inside feature. A page of this book has some helpful hints from a Swedish professor; he says that if you want to manage well with diabetes you need to:

1) Become your own expert on diabetes
2) Have more knowledge about diabetes than the average doctor.
3) Accept your diabetes and learn to live with it.

Guess why number 2 is in bold? :D
 
I had an interesting experience at my GPs recently. I went to get a medical form signed for my skydive which she said she couldn't do but would ask her boss (she was new) and call me back. Two minutes after leaving the surgery she called to ask: 1) was I type 1 or type 2, 2) was I on insulin (I'd have hoped the answer to 1) would have told her, and 3) did I ever have hypos...

Now normally I'm not one to complain about doctors, I don't expect my GP to know too much about my diabetes care as that's mianly managed by the hospital but I really think she should have been able to find that information on my file, or at least ask it while I was in there!
 
sofaraway said:
now thats a question I hate. It always seems like a bad thing to answer yes to it. But find me a diabetic that has any kind of control that doesn't have them.
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I feel the same. Sometimes sod's law says I'll have a hypo even though I perhaps took less insulin at the previous meal and I haven't been active.
 
It's pretty meaningless to ask "do you have hypoglycaemia?" A better question is "can you detect when your blood sugar is getting low?"
 
Copepod said:
It's pretty meaningless to ask "do you have hypoglycaemia?" A better question is "can you detect when your blood sugar is getting low?"
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I agree. In my experience the question usually doesn't come form people who know very much about diabetes. Last time I had it was from the dentist. When i said that yes I do occasionally have hypos, he started to get worried, and I had to reassure him that I had good warning signs and would let him know If I was low. I think what people are trying to ask is 'are you going to without warning collapse on me?'
 
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