T2 misdiagnosed

[HenryBennett]

I had a quite long session this morning with my GP’s DN. As compared to my first visit she appeared quite knowledgeable. At that first visit I got the impression that she’d drawn the short straw and I was the first patient she’d seen in a new role.

After an initial diagnosis in the Cardiac Care Unit (CCU) my HbA1c has been way below the diabetes threshold. However, notwithstanding the pandemic, my GP has all but gone missing. This morning was my first face to face session since the “official” start of the pandemic. I’ve had way better support from the Cardiology department at the hospital than from my GP.

I don’t want to make this too long, but I had a telephone consultation with my GP just after they put up the shutters and another one with the practice pharmacist a few months ago. I agreed well over a year ago with the GP that I’d reduce the Metformin from two to one a day. Speaking to the pharmacist she suggested I reduce from two a day to one - no note on my records that this had been done a year ago. So, she suggested I stop the Metformin. The DN this morning couldn’t see any of this on my practice records.

Through all of this my HbA1c has remained stable and my daily finger prick is very rarely outside 5.0 to 6.0. I had a telephone consultation with my Cardiologist five or six months ago. Most of my blood tests have been through the hospital and not my GP. Last time it took the GP six weeks to respond to the tests, and only after I reminded them. I discussed my HbA1c results with my Cardiologist and he said I shouldn’t be classified as diabetic.

I worked through all this with the DN this morning and in her opinion I was wrongly diagnosed in the CCU and suggested I speak to the GP about having my records amended. I’m going to write a detailed letter to my GP setting this all out as can’t trust him to properly investigate it.

Has anyone had a similar experience and how should it be dealt with in terms of amending or rewriting my medical records?

Thanks for any comments.

 

[Cherrelle DUK]

Hi HenryBennett, sorry to hear about this.

Given that you’ve had another professional raise concerns, I’d think you’re well within your rights to request a second opinion. Ive changed GPs before for less!

If there’s more that one GP at the practice or they make referrals to specialist, they can go down that route.

This depends on the policy of the practice so worth a call to see if there’s anything they can do directly.

 

[HenryBennett]

Hi HenryBennett, sorry to hear about this.

Given that you’ve had another professional raise concerns, I’d think you’re well within your rights to request a second opinion. Ive changed GPs before for less!

If there’s more that one GP at the practice or they make referrals to specialist, they can go down that route.

This depends on the policy of the practice so worth a call to see if there’s anything they can do directly.

Thanks Cherrell, I somehow feel that I’m in danger of falling between two stools. This happened during the lockdown between the hospital (Cardiology department) and my GP. My GP is behaving as though we’re still in full lockdown. It’s probably easier to focus my approach on the GP rather a department of a large hospital?

 

[Robin]

I worked through all this with the DN this morning and in her opinion I was wrongly diagnosed in the CCU and suggested I speak to the GP about having my records amended

I’d have thought the fact that your first two HbA1cs were in the 50s, and therefore over the threshold for a diabetes diagnosis wouldn’t make that a wrong diagnosis, just that with your hard work with weight loss and low carbing, you've brought yourself back to non-diabetic levels.
I suspect it might come back again if you gained weight again, or ate a bad diet. So I'd have thought the nurse should be saying that, yes, you’ve kicked it into touch and your notes should reflect that, not that it should be expunged from your records as never having happened.

 

[rebrascora]

I agree with @Robin and I think your results reflect that you put in a lot of hard work and achieved remission.

There are advantages in retaining the diabetes classification in that you get regular health checks which can pick up other issues as well as perhaps a change in your diabetes, so I would be inclined to leave things as they are. To me the records indicate that you put a lot of work into dealing with the condition and getting it into remission rather than that it never existed and I think that may be more valid than expunging the diagnosis.

 

[HenryBennett]

Thanks both. Some merit in your suggestions.

My fault, because I didn’t want to make the post any longer than necessary. I believe that I had a dose of Covid before it was officially recognised (other than secretly by the Chinese government). A couple of weeks after coming back from Luxembourg (and we travelled into Germany, France & Belgium) I came down with a horrible bout of what seemed to be flu. I was in bed for some days taking paracetamol and appeared to be ok. Then a few weeks later I had a HA and whilst in the CCU had this marginally high HbA1c. It’s now recognised that Covid can attack your organs.

It is accepted that Covid was getting established in parts of Western Europe from around November 2019, but by the time we were put into lockdown any antibodies would have gone, and there was no way I could have been tested anyway. So it’s just a theory but it was the DN who said it may have been a misdiagnosis.

Am I barking up the wrong tree?

 

[Robin]

Am I barking up the wrong tree?

Maybe, maybe not. Normally, I’d say a non-D's pancreas would deal with any high glucose caused by illness, and it wouldn’t show in an HbA1c, but if there was a temporary attack on the pancreas which decreased its ability, then yes, it may have recovered now and won’t ever reoccur.

 

[HenryBennett]

There are advantages in retaining the diabetes classification in that you get regular health checks which can pick up other issues as well as perhaps a change in your diabetes, so I would be inclined to leave things as they are.

There are, though, the inconveniences of DVLA and travel insurance loading?

 

[rebrascora]

There are, though, the inconveniences of DVLA and travel insurance loading?

Surely there shouldn't be a problem with DVLA since you are not on any medication which would impact your driving.

I find it odd that car insurance doesn't change and I believe can't legally increase even as a Type 1 using insulin, and yet travel insurance can increase for Type 2s.

 

[HenryBennett]

Surely there shouldn't be a problem with DVLA since you are not on any medication which would impact your driving.

I find it odd that car insurance doesn't change and I believe can't legally increase even as a Type 1 using insulin, and yet travel insurance can increase for Type 2s.

Thanks, I didn’t realise that was the issue with the DVLA.

It‘s difficult enough with travel insurance if one takes heart meds.

 

[Robin]

Thanks, I didn’t realise that was the issue with the DVLA.

It‘s difficult enough with travel insurance if one takes heart meds.

It’s crazy, isn’t it. I get no weighting on my travel insurance when I put Type 1 in, but as soon as I put BP meds, statins and blood thinner in for OH, it doubles his premium, even though taking those meds means he’s hopefully not the ticking time bomb he was before he started them.

 

[HenryBennett]

It’s crazy, isn’t it. I get no weighting on my travel insurance when I put Type 1 in, but as soon as I put BP meds, statins and blood thinner in for OH, it doubles his premium, even though taking those meds means he’s hopefully not the ticking time bomb he was before he started them.

It is certainly difficult to understand. Blame the actuaries and underwriters.