Visit to Practice Nurse- walked out

[Oh dear]

i am so upset. I had an appointment to go for my annual check-up. This is the only time I am seen by the GP practice about my DM and the only time I have a HbA1c test.For the last 9years I have had DM Type 2 but, atypically, I have had great swings in levels with rapid almost instantaneous changes from hyper to hypo. Consultant has really been great, trying various tablets to try and prevent the hypos which occur about 3x week.
Back to my appt: went in and was asked if I was on any tablets. I told her Forxiga. She then looked at my HbA1C and said it was pre-diabetic and had been ok last year so she didn't think I was diabetic and why on earth was I taking tablets. I said "to try and control the hypos" to which she replied " are you sure you are having hypos?" I had just described a severe one to her that I had had last week. If she had looked at the consultant's letters she would see the long-running problems and CGM a year ago.
At that point, I walked outweigh I felt she did not understand the problems I had
Now feel so on my own. Consultant is community-based and the one diabetic nurse who worked with him that knew about me has retired. Feel like stuffing my face with a white chocolate Magnum and forgetting all about this Diabetes lark and just dealing with any complications if they arise in the future.

 

[Pumper_Sue]

If she had looked at the consultant's letters she would see the long-running problems and CGM a year ago.
At that point, I walked out.

Why didn't you ask her to read the consultants letter it would probably saved you a lot of grief in the long run?

 

[AngelaY9847]

Although it is odd to have hypos when you're type 2, the nurse should have been a little more sensitive!

 

[Oh dear]

Yes, in retrospect I should have but I was just so taken aback by the fact she hadn't looked at any of my notes that I didn't think sensibly at the time. What an idiot I was!

 

[grovesy]

Welcome! Sorry to hear you had bad experience!

 

[Amigo]

Why don't you drop her a line asking her to read the Consultant's letter and reschedule the review?

I have my annual review next week and I won't be taking any cr*p either!

 

[Ljc]

Hi Oh dear, Welcome. Sorry to hear of your bad experience

 

[Jonsi]

Although it is odd to have hypos when you're type 2, the nurse should have been a little more sensitive!

I was told years ago that "Type 2's don't have Hypos" however, I have a sister who is Type 1 and has been for the last 50 years since she was three. When I described my 'wobbles' to her and explained how I felt, the tingling top lip, the shakes, the anxiety, the sweats, the Ready Brek outline of things, the confusion and the completely drained afterwards she said "Yup ...that's a Hypo". When I actually went Hypo in front of a Hospital Consultant acting as a locum for my GP he was fascinated and told me a few days later that he regularly sees people after a Hypo, rarely going into one and he told me that it was a Hypo. From my own experience, I don't think that Diabetes, sneaky thing that it is, plays by the rules with anything.

Please, go back to the surgery as has been suggested. Ask for the review to be repeated only this time could they please read the notes before they casually dismiss you and your condition

 

[Martin Canty]

"Type 2's don't have Hypos"

Very easy for T2's on sulfonylureas or insulin to get Hypo's................ Man, I don't miss those Hypo's one bit......

 

[Owen]

Can also be caused by reactive hypoglycemia.

Anxiety attacks are similar though. I get both.

 

[AndBreathe]

@Oh dear - I must admit, when I read your story I wondered if Reactive Hypoglycaemia (RH) had been considered. There's not a huge amount generally known about it usually, but there are more and more folks being diagnosed these days.

I do sympathise if you've had a rotten day today. Many folks have bumps in the road with their practices, but retaining some form of more positive relationship with your practice makes sense. I'd echo the suggestion to re-schedule your meeting, but maybe go prepared to help the nurse understand how your brand of blood sugar challenges work.

I tend to try to keep reminding myself, that over time, I will need medical support from time to time, and it's not all about diabetes.

Good luck with it all.

 

[Owen]

Can also be caused by reactive hypoglycemia.

Anxiety attacks are similar though. I get both.

Hypo's and anxiety, not RH.

 

[Oh dear]

Now a few hours have passed, I feel I was a complete idiot and drama queen. I think I was feeling a bit scared by my severe hypo last week which had brought back bad memories of the early years when the doctors were not sure of the diagnosis and I kept collapsing and ending up in A+E to be told one thing, which was contradicted the next visit - so the nurse today unfortunately caught a raw nerve and just added to it.
Excellent idea to write to her and ask for it to be rearranged after she has read my notes.
Thanks everyone.

 

[Owen]

Now a few hours have passed, I feel I was a complete idiot and drama queen. I think I was feeling a bit scared by my severe hypo last week which had brought back bad memories of the early years when the doctors were not sure of the diagnosis and I kept collapsing and ending up in A+E to be told one thing, which was contradicted the next visit - so the nurse today unfortunately caught a raw nerve and just added to it.
Excellent idea to write to her and ask for it to be rearranged after she has read my notes.
Thanks everyone.

Do your hypo's happen shortly after eating

 

[AlisonM]

There's a significant number of T2s on sulphonylureas, such as the likes of Gliclazide and Sitagliptin who can indeed get hypos, though it's unusual if they aren't on these types of drug, it's by no means impossible. Also, a significant percentage of T2s aren't T2 at all, but more likely to be LADA/1.5s like wot I am. All of these folks are likely to have regular hypos. Are you on insulin at all? And, do you have a meter in order to test your BGs?

 

[Oh dear]

No real pattern to them, but not really. Same food on different days at similar times can get different reactions - raise BS levels ( excessively or normally) or no reaction at all or BS continue to fall - challenges the medical bods!
Yes,I do monitor regularly as it changes so rapidly. Have been really lucky getting enough test strips etc. No not on insulin at the moment

 

[Owen]

No real pattern to them, but not really. Same food on different days at similar times can get different reactions - raise BS levels ( excessively or normally) or no reaction at all or BS continue to fall - challenges the medical bods!
Yes,I do monitor regularly as it changes so rapidly. Have been really lucky getting enough test strips etc. No not on insulin at the moment

The drug you are talking forces glucose out through urine. Not normally causing hypos unless combined with other meds. However if you glucose intake is low then there is a possibility of hypo. I had a period on canagliflozin and gliclizide, where similar events were present. The problem resolved the minute I switched to insulin. The problem is that because these drugs suppress appetite, they have become the new trend. I almost lost my life due to DKA whilst having a normal bg reading. I would give some credibility in your DSN challenging this particular drug. You still need to seek guidance as to why you have erratic spikes and lows.

Do you keep a food diary. There may be some correlation that you have not noticed.

I had to force the issue by refusing to eat any carbohydrate. I then proved that glic was having no effect as my bg came down only when carbs were removed. I then added small amounts of carbs and immediately went into 20+, I suppose it is a bit like basal testing.

I now have a correct diagnosis and manage it with small amounts of insulin. More importantly, I have control