[Geoff]

Hi all, I had my annual review today. Nothing special in that, except I always get two of them! The main one at the diabetic centre of my Local hospital, and for some other reason, one with my GP at the local practice near where I live. Today’s was with my GP. My results were as I had generally expected. HbA1c went up from 6.1mmol/lt to 6.3mmol/lt, blood lipids up from 3.4 to 4.1, Blood pressure 110/70.

I put this slight rise in my tests down to the fact that over the last three months, I have adjusted the daily amounts of carbs in my diet down by about 20%, and increased protein and fat intake upwards by about 15% per day. So perhaps I will have to reduce the fat & protein a bit.

What was interesting was my general chat with the diabetic nurse, who does the first part of the review. She asked the usual questions about my BG, diet etc, I then started to explain that I had been adjusting my basal rate, and doing fasting tests to establish this, up to this point she was listening intently, but as I proceed to explain my basal/bolas percentage rates, she stopped me mid-sentence, and said that she did not have a clue about what I was telling her as she knew very little about the needs of type 1 diabetics, as I and one other diabetic was the only ones in the practice using insulin, and the other never asked questions!
So much for knowledgeable medical staff here in the U.K. But on a positive note. My GP actually asked If I had spoken to anybody about using a pump, and perhaps we could discuss it on another occasion?

[gettingby]

Sounds like a good review Geoff.
Sometimes the things that medical professionals say are just scary. Maybe you can educate her.

[JJM335]

Originally Posted by Geoff

Hi all, I had my annual review today. Nothing special in that, except I always get two of them!

That's because the GP's get an extra fee for every patient that they sign up for one of their "clinics". It's all connected to the Government's targets for the NHS.

These GP-practice Diabetes Clinics are primarily aimed at T2's -with the objective of reducing demand on hospital-based specialist Diabetes Clinics, which are often quite stretched. It's generally recognized that most GP's do not have the experience or training to deal with T1's (or I suspect many T2's). I used to get invitations to attend my local Health Centre Clinic. I politely declined on the grounds that my needs were already well cared for by a specialist clinic.

Joel

[Gary_W]

Hi Geoff,

Long rant on this subject coming, so either ignore it or get a beer in first

I found this forum 14 or so months ago in shear desperation as I was purely under GP care and am type 1.

In summary, my local hospital clinic was drowning under the sheer weight of work and kicked out loads of people into GP care. I was given the option of going for it, and how it was sold to me was that the GP had a specialist nurse trained in diabetes care and she would take care of my 'regular' needs. If anything was beyond her, I could get in to the clinic at the hospital.

At the time, the hospital had just cancelled 3 or 4 appointments on me at short notice. To even get a telephone appointment up there meant a 3 week wait. I am not joking. To me, the GP care seemed like a great idea. Better to see someone than wait ad infinitum.

All went OKish for 2 years. I bumbled along with my HBA1c of 8 and a bit and was told that I was doing OK. Towards the end of this period, I had got to the end of my tether. My BG was either 3 or 18 and no-where in between. I was also having severe headaches around 3 times per week. And I was fat. And miserable. I looked dreadful. Asked GP specialist nurse for help at which point she confessed that she'd had a 1 day course in diabetes quite some time ago and that she had no idea how to help me.

The hospital refused to help me at first. They had, as part of this waiting list reduction excercise, discharged me as a patient and due to health + saftey reasons could give me no advice. After jumping up and down, I finally got 5 mins on a phone with a doctor who mentioned this thing called a carb ratio (which I had no idea existed).

I then found this place and life changed for the better pretty much overnight. Having a few probs at the moment but nothing compared to 14 months ago

In summary, give the GP nurses a really, really wide birth. The lady at our local surgery is very pleasant and an excellent nurse, but she just isn't up to the job of advising a T1 how to manage the condition. No reflection on her skills, but you need to throw a whole lot more time at understanding diabetes than an occasional course. Mind you, I haven't yet met anyone at the local clinic that has impressed me as highly as some of the folks on here, though I've by no means met them all and am really hopeful for a change in my luck on that score. I'm meeting the pump nurse in a couple of days time and am hoping to be suitably impressed To date, they have ranged from completely hopeless through to very nice but out of date ('more than 4 blood tests a day is obsessive and correction shots are NOT needed, you just add extra insulin at your next meal' was the advice I got from the best person I've met there...)

Gary

[shiftzor]

Well my current local GP thinks its cool to change my monthly prescription without informing me and has helpfully become ill in the process so right now I’m dealing with a half in the number of test strips this month. Had to fight to get 4 x 50 (test strips) when i started. I love the NHS but really some GPs/Hospitals are shocking, at my last GP I didn’t have this trouble.

If my hospital/GP offered me a pump i would jump up and down with joy. So take the offer, I would , at least you can always change back if it doesn’t work out. Pumping is the way forward in my opinion. There is lots of info about it on this forum as you probably already know.