Told by offhand 'phone call

[Barfly]

Hi all - My local surgery does a blood for me every year and the receptionist rang me to say there was an issue with my bloods, the doctor would call me 3 weeks down the track.
He called to tell me he had issued a prescription for 500mg Metformin 3 times a day.

That was it, no advice other than I was slightly overweight 70 year old ethnic British male with a BMI of 26 but not to be concerned about it. Don't eat refined crystal sugar.
That 's the sum total of my contact with the doctor.
Is this normal?

Wondering, Tony.

 

[trophywench]

No idea if it's normal Tony - but it's certainly utterly c**p - but you already know that ....

The trouble is, ALL carbohydrate turns to glucose within our body - not only sugar itself. So, it's carbs you need to cut down on - less spuds, bread, rice, pasta, pies - well the pastry, the filling's probably still OK! Click on the tab at the top of the page 'Learning Zone' register and start educating yourself since your GP has no inclination to bother.

 

[Felinia]

0 out of 10 for patient service! And it's very unusual to go straight in with 3 Metformin a day - you usually build up to it as it takes time to acclimatise and has side effects. As you have been prescribed quite a high dose, it does suggest that your HbA1c is quite elevated, but you need to ask exactly what it was. The receptionist would not be permitted to tell you.

As far as eating is concerned, you need to cut down on your carbs, not just sugar. That is bread, potato, rice, pasta, root vegetables, processed food, most fruits, as those are what cause your blood sugar to spike. As you do not have much weight to lose, I suggest you fill up on protein instead. In the meantime, I suggest you work your way through the learning Zone for Type 2 diabetes, one module a day to take it in. Also I suggest you keep a food diary, and prepare a list of questions to ask your GP.

You should take your Metformin in the middle of your meal. If the Metformin upsets you, you can ask to be put on slow release, which is what I take. Diabetics are supposed to get regular tests - the Learning Zone will outline them, and you should ask your GP when you will get them, an appointment with a dietician, and a training course.

 

[Ljc]

Welcome to the forum @Barfly . Oh dear I am really sorry to hear you h@ve been treated this way
I do hope things at the practice improve . Did the dr mention anything about starting Metformin gradually then building up the dose, his is to help prevent Metformins well known digestive tract side effects.
Or that you would hear from the diabetes nurse soon.

@trophywench has already explained diabetes is about carbohydrates not just sugar .
The learning zone is a great 0lace to start.

We are fine with dairy, protein in all it’s forms and providing you don’t have a condition where you’ve been told to reduce them, good fats are fine too in moderation.
Some of us need to be careful with fruit, fir the time being stuck to fruit that has berry as part of its name .
Ask all the questions you need too we will do our best to help .

 

[Barfly]

0 out of 10 for patient service! And it's very unusual to go straight in with 3 Metformin a day - you usually build up to it as it takes time to acclimatise and has side effects. As you have been prescribed quite a high dose, it does suggest that your HbA1c is quite elevated, but you need to ask exactly what it was. The receptionist would not be permitted to tell you.

As far as eating is concerned, you need to cut down on your carbs, not just sugar. That is bread, potato, rice, pasta, root vegetables, processed food, most fruits, as those are what cause your blood sugar to spike. As you do not have much weight to lose, I suggest you fill up on protein instead. In the meantime, I suggest you work your way through the learning Zone for Type 2 diabetes, one module a day to take it in. Also I suggest you keep a food diary, and prepare a list of questions to ask your GP.

You should take your Metformin in the middle of your meal. If the Metformin upsets you, you can ask to be put on slow release, which is what I take. Diabetics are supposed to get regular tests - the Learning Zone will outline them, and you should ask your GP when you will get them, an appointment with a dietician, and a training course.

Felinia-c**p doctor c**p service you are right. I have had no reaction at all to the metformin, not even the mostly reported loosening (how do you really say that politely?) that most have reported. I eat pretty healthy (mostly) although I do love my fillet steaks and chips. I suppose chips will now be a distant memory..... poxy salads here I come.....!!!

 

[Barfly]

@Ljc Thanks for the reply, I very much doubt the surgery will improve anytime soon. It is a revolving door of new doctors and new faces, the practice nurse has been there for 3 years and she is regarded as an old hand! The doctors can barely hide their furtive glances at their watches when with a patient. What do you expect in Poole, there are so many wrinklies like me on their books here.

 

[Barfly]

One thing that I am puzzled by is how do I know if my blood sugar levels ar wrong? Up or down, I have never had any sort of symptoms, how do I test for it? I'm an electronics engineer, maybe I'll do a bit of research and see if I can build some sort of test meter. There are probably loads on the market but anything medical has a 1000% markup on it - I can probably build one for next to nothing. Any ideas?
And thanks to all of you who have replied, this looks to be a great resource.
Cheers Tony

 

[Leadinglights]

One thing that I am puzzled by is how do I know if my blood sugar levels ar wrong? Up or down, I have never had any sort of symptoms, how do I test for it? I'm an electronics engineer, maybe I'll do a bit of research and see if I can build some sort of test meter. There are probably loads on the market but anything medical has a 1000% markup on it - I can probably build one for next to nothing. Any ideas?
And thanks to all of you who have replied, this looks to be a great resource.
Cheers Tony

There are several inexpensive test monitors on the market which is a minute drop of blood from a finger prick applied to a test strip inserted into the monitor, test strips are specific to the monitor. A couple recommended as reliable are the GlucoNavil and Spirit TEE2 which are about £15 for the monitor and £13 for 100 strips can be obtained from Amazon. The monitors are usually cheap as the company makes their money from the cost of the strips.
By having a good testing strategy is invaluable for giving you the control of your blood glucose levels as you can adjust your food intake to minimise increases in levels from your meals.
It is unlikely that as a Type 2 you would be prescribes a monitor by you GP so would have to self fund.

 

[Docb]

Hi @Barfly. Poor performance from your surgery, that is for sure. My best thought is to start to take charge and first off would be to demand that your surgery provides you with your HbA1c result. That tells you where you are on the diabetic scale and gives you a decent guide on what you need to do to get things on track. Second thought is to get up to speed on diabetes and what it means and there is no better way to do that than reading around this forum and checking out the learning zone on the red tab above. For somebody with a technical background it is not difficult to pick up the general principles and from that to formulate a plan. Anybody with a bit of nous would soon question whether 1500mg metformin a day is the best opening gambit for treatment.

One thing you will have to get used to is that the medics are very reluctant to measure anything and as such will generally not supply you with the means to do it. Really frustrating if, like me, you spent most of your life measuring things as a means of understanding what is going on and working out the best way forward.

A bit of research will show you that there are lots of glucose meters about and they all work on basically the same principal. You jab a hole in a finger to get a drop of blood, dunk a test strip (all chemistry) into the drop and then use an electronic gizmo to measure some change in the test strip and convert it to a blood glucose reading. Its the chemistry bit which will make things a bit of a challenge when it comes to a do it your self option.

 

[Barfly]

@Docb
Thanks for the detailed response. If they are only a few quid, then I'll buy a few and check them out. Normally medical stuff is hundreds of £, but I suppose diabetes is so common they are cheap.

I spent 33 years in Aussie, repatriating in 2014 and I have noticed the strange reluctance here for the medics to give you any paperwork on your own health. In Aussie they inundate you with paperwork and give you all your x-rays and doppler printouts, they don't want to keep anything-just hand it all to you to look after.
It wasn't always like this, before we emigrated in 1982, we used to be given all our x-rays etc here too. It's really weird how that has changed.
Thanks for the tip on the Hba1c readout - I'll demand that from the surgery.

 

[Barfly]

There are several inexpensive test monitors on the market which is a minute drop of blood from a finger prick applied to a test strip inserted into the monitor, test strips are specific to the monitor. A couple recommended as reliable are the GlucoNavil and Spirit TEE2 which are about £15 for the monitor and £13 for 100 strips can be obtained from Amazon. The monitors are usually cheap as the company makes their money from the cost of the strips.
By having a good testing strategy is invaluable for giving you the control of your blood glucose levels as you can adjust your food intake to minimise increases in levels from your meals.
It is unlikely that as a Type 2 you would be prescribes a monitor by you GP so would have to self fund.

@Leadinglights
Thanks for the heads up on these items, will check them out. Just had a quick look on Amazon- what do you guys think of this one? They claim it's used by St. John Ambulance....? https://smile.amazon.co.uk/Kinetik-...=1&keywords=gluconavii&qid=1625394937&sr=8-28
Tony

 

[catmum36]

I was actually told in the same way by my GP. Took me 2 weeks to get my prescription after ringing the surgery several times with them keep saying it had been sent to my pharmacy. I eventually got it sorted because i had a health check appointment with a locum doctor (my surgery is changing hands) and asked her to have a look for me, turns out the prescription was still sitting there! She sent it straight over and was able to collect it the same day.
I have had a sweet taste in my mouth for over 2 months now which was why I rang the GP in the first place. I asked if this would go away when I started taking the tablets and was told by the locum that they didn't know. I was given Metformin but was told to build up to 3 tablets a day. (Been taking them just over a week now).

 

[grovesy]

@Leadinglights
Thanks for the heads up on these items, will check them out. Just had a quick look on Amazon- what do you guys think of this one? They claim it's used by St. John Ambulance....? https://smile.amazon.co.uk/Kinetik-...=1&keywords=gluconavii&qid=1625394937&sr=8-28
Tony

The strips for that monitor or some of the more expensive one. So if money tight you would be better going for one of the 2 recommended in the post higher up the thread.

 

[Felinia]

Felinia-c**p doctor c**p service you are right. I have had no reaction at all to the metformin, not even the mostly reported loosening (how do you really say that politely?) that most have reported. I eat pretty healthy (mostly) although I do love my fillet steaks and chips. I suppose chips will now be a distant memory..... poxy salads here I come.....!!!

Try baked squash wedges sprinkled with a little paprika instead. I treat myself to a steak once a month, and have it with cauliflower cheese.

 

[Leadinglights]

@Leadinglights
Thanks for the heads up on these items, will check them out. Just had a quick look on Amazon- what do you guys think of this one? They claim it's used by St. John Ambulance....? https://smile.amazon.co.uk/Kinetik-...=1&keywords=gluconavii&qid=1625394937&sr=8-28
Tony

Both the Kinetik monitor and the test strips are twice the price of the GlicoNavil or Tee2 and there is no reason to suppose that just because the Kinetik is used by St John A it is any more accurate as they all have to conform to the same standard.

 

[Ljc]

Hi. Is their any chance you can change to a different practice , possibly not now but ASAP.

A little tip the more expensive meters and their testing strips strangely enough do not mean better accuracy, not sure where you are but meters sold in the uk have to conform to certain standards and the more expensive ones may have a few more gizmos, which in my option someone not on medications that can cause hypo’s may not actually need.

Do you know what your Hb1ac was ?

To find out how to test youself to see how the various carbohydrates affect you soYou can make informed choices.
Test just before eating then around two hours after starting to eat.

As you are not on meds that can cause hypo’s, if you are no more than 3.0 mmol/l higher then that meal was fine, if not which is most likely atm then look to portion size of those carbohydrates or you may need to find substitutes.
In time your pre meal levels will come down .
It will also help if you keep a brutally honest food diary with your pre and post meal BG levels.

 

[Drummer]

@Docb
Thanks for the detailed response. If they are only a few quid, then I'll buy a few and check them out. Normally medical stuff is hundreds of £, but I suppose diabetes is so common they are cheap.

I spent 33 years in Aussie, repatriating in 2014 and I have noticed the strange reluctance here for the medics to give you any paperwork on your own health. In Aussie they inundate you with paperwork and give you all your x-rays and doppler printouts, they don't want to keep anything-just hand it all to you to look after.
It wasn't always like this, before we emigrated in 1982, we used to be given all our x-rays etc here too. It's really weird how that has changed.
Thanks for the tip on the Hba1c readout - I'll demand that from the surgery.

You can get the Spirit Healthcare Tee 2 + by registering on their website, answering an email to confirm you are diabetic and then you order directly and do not pay VAT.

 

[Barfly]

The strips for that monitor or some of the more expensive one. So if money tight you would be better going for one of the 2 recommended in the post higher up the thread.

@grovesy
No not that hard up, although my daughter-in-law is doing her level best to rectify that situation.......

 

[Barfly]

I was actually told in the same way by my GP. Took me 2 weeks to get my prescription after ringing the surgery several times with them keep saying it had been sent to my pharmacy. I eventually got it sorted because i had a health check appointment with a locum doctor (my surgery is changing hands) and asked her to have a look for me, turns out the prescription was still sitting there! She sent it straight over and was able to collect it the same day.
I have had a sweet taste in my mouth for over 2 months now which was why I rang the GP in the first place. I asked if this would go away when I started taking the tablets and was told by the locum that they didn't know. I was given Metformin but was told to build up to 3 tablets a day. (Been taking them just over a week now).

@catmum36
Sounds like you got a worse deal even than I did - hope it gets better for you. Tony

 

[Barfly]

Hi. Is their any chance you can change to a different practice , possibly not now but ASAP.

A little tip the more expensive meters and their testing strips strangely enough do not mean better accuracy, not sure where you are but meters sold in the uk have to conform to certain standards and the more expensive ones may have a few more gizmos, which in my option someone not on medications that can cause hypo’s may not actually need.

Do you know what your Hb1ac was ?

To find out how to test youself to see how the various carbohydrates affect you soYou can make informed choices.
Test just before eating then around two hours after starting to eat.

As you are not on meds that can cause hypo’s, if you are no more than 3.0 mmol/l higher then that meal was fine, if not which is most likely atm then look to portion size of those carbohydrates or you may need to find substitutes.
In time your pre meal levels will come down .
It will also help if you keep a brutally honest food diary with your pre and post meal BG levels.

@Ljc
The surgery is within walking distance for me, less than 1/4 mile there and back. The next nearest ones are 1-2 miles away and both have no vacancies for patients just wanting a change. The priorities are for families with children, which is just as it should be, I'm an old fart and not so important.
I have no idea what my Hb thingy was, they don't want to give you info they don't have to it seems. I have done an online request for access to my full medical records, we'll see what transpires with that but I won't hold my breath.
So meds can cause hypos? Umm..that's something of which I was unaware.

Brutally honest food diary.....now that WILL be hard!! Maybe I should not have had that cheese and ham toastie for lunch.....
Cheers Tony.