Today.

[Bill Stewardson]

Hi Bill, it sounds very frustrating to have been given so much conflicting advice from so many sources and I can understand that being frequently signposted to a charity is exasperating.


Going back to your original post, you spoke to an NHS 111 call fielder which was followed by a callback from a GP. Unfortunately, it's unlikely the NHS 111 field caller would have been medically trained and although the Dr who called would be, neither of these people know you, your diabetes or your medical history. Diabetes (as you know) is so varied from person to person, there is no 'one-size-fits-all' answer and so any general info/guidance that HCP or call fielders may have would not necessarily be right for you as an individual. There are some bits of information that are helpful in a more general sense, for example gliclaside holds a risk of hypoglycemia and so we would take the position that you should always be testing if you are taking this particular medication.

In terms of understanding what advice to take, any advice about testing or medication should really be from your own diabetes team who have access to your records and can give a well-informed opinion of the right management option for you. Unfortunately, it sound like you are not getting the patient-focused care that you need with your own DSN, which can be very frustrating, especially when this extends to other HCPs. Diabetes requires a very individual approach from and considerations need to be taken of your results, your medication etc to ensure that you are getting the right balance with your medication that suits you.

In terms of being signposted to Diabetes UK, it depends why they are suggesting you contact us. Although our Helpline are not medically trained and are not here to give individual medical advice, what they can give is the space and time to go through the advice you have been given, help you evaluate what might be the best option for you and importantly, what questions you can be asking your DSN to get the best answers and results. The team have a knowledge of the different medications and how they work, so although they cannot tell you what to do, what to take, they can help you to understand different options, what the implications may be and to get the support you need.

Essentially, it is your diabetes team who should be giving you the specific medical advice & information that you need, but you are limited in your time with your healthcare team and it helps to supplement this with other options such as the Helpline or the sharing of advice and information on here. Diabetes can very much be a case of self-management and I think the peer support on here can play a great part in helping with that.

@Hannah, many thanks for your reply.

Two positive things leap out straight away.

Firstly, can DUK communicate to 111 call handlers the above , as in they have no place giving out instructions regarding testing or not. On a secondary note, we are often told in the media that these people are fully trained and more than capable of doing the job superbly, but, that's another set of stories.

Secondly, that anyone on Gliclazide should be testing, again, when I was given that drug nobody indicated that to me. Clearly this is a huge omission which I will highlight at my practice, it needs highlighting right across the nation, if that is at all possible.

One other thing, after my specified 111 call, the advice from a GP was given to me in person at the NGH, not via a telephone, the Dr concerned had full access to my medical records via his PC yet still told me " testing is a waste of time", again that is another story.

It is a bad state of affairs when patients have to mount "Crusades" to be able to gain confidence in their case management. Fair play to those who manage to do that, however, I see opting to get ones advice from a GP three doors further along the same corridor as the DN as treating the symptoms and not the cause.

Is the challenge not to get the DN to be able to give out the same advice as the GP ? or at least strive towards that goal ?

Surely it can be better than this ?

My thanks to you and DUK for all that you do for us.

 

[Diabetes UK]

@Bill Stewardson - My apologies, I had missed this reply!

First of all, we do not have direct contact with 111 call handlers. We do not hold any medical data on any of the individuals we speak with and under data protection laws cannot share any contact details we do have with external parties.

Secondly, it is recognised that glicazide is in the Sulphonylureas family and recognized to hold a risk of hypoglycaemia. Our position is that anyone on these types of medication should be given test strips on prescription and should be self-monitoring BG levels.

It is disappointing that you received such varying information from all parties involved in your care and this is a key issue that we have identified. our Policy Team are currently campaigning alongside the APPG (All-Party Parliamentary Group in Diabetes) in precisely this issue of varying levels of care and a lack of communication between healthcare professionals regarding the same patient.

I hope that this document will be of interest to you and answer some of the questions that you have raised in this thread and other threads, about how Diabetes UK are trying to tackle this problem.

https://www.diabetes.org.uk/Global/get-involved/campaigns/APPG report 2016 version for website.pdf