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Original poster

Newly diagnosed diabetes? - bounced between gp and hospital

75 replies

tendofether · 19/03/2021 15:59

Hoping someone might be able to offer some insight

Husband has been thirsty, weeing a lot and losing weight, had a urine test and the outcome of which was told to go straight to hospital. Hospital put him on a drip, ran some tests and discharged, advising he absolutely must see the GP first thing in the morning.

Saw GP & Nurse this morning (after getting through the 8am phoneline scramble) and they've sent him straight back to hospital with a letter, saying they can't understand why he's been discharged.

So back to hospital, they've run blood gases and they are trying to discharge again.

Can anyone offer any insight as to what the normal process would be for a new diagnosis of diabetes (i'm assming type 2)? He has had no treatment apart from a saline drip thus far from either doctors or hospital.

OP posts:

greyinganddecaying · 21/03/2021 15:33

How is he doing OP?

I think the GP was right to send him to hospital with those results and wonder if the A&E staff (wrongly) are not getting specialist input from the diabetes team.

WreckTangled · 21/03/2021 15:34

Blood monitors and strips should only be available on prescription for those treated with insulin (not saying I agree with this, but that's the 'rule').

I'm wondering if it's LADA diabetes, type one usually makes you very unwell very quickly. 90 is very high for an hba1c. My type one and mine is 39. A type 2 diagnosis is given when you have an hba1c of 48 or above.

I think the GP was being cautious, and rightly so. I would have expected an urgent appointment with the diabetes nurse at the doctors following his discharge. As someone else said they really know their stuff. He should look into starting a low carb diet (anything below 150g a day is considered low carb, personally I prefer much lower but its individual).

Kazzyhoward · 21/03/2021 16:55

Blood monitors and strips should only be available on prescription for those treated with insulin

That's not true. I'm T2 and have had the machines and strips on prescription for many years (at least 20 years!).

Interested in this thread?

Then you might like threads about these subjects:

Diabetes General health

Original poster

tendofether · 21/03/2021 16:56

They did some blood tests, ketones and blood sugars, but sent him home again. Although, they did take a bit more time to talk through some things.

Hospital said that they were unconcerned about ketones at his level (0.8), and would only be concerned once above 2.5 and he said they didn't seem concerned about the blood glucose level at all

So, it'll be the 8am phone scramble for the gp/nurse again tomorrow. He's not feeling great, but says it might just be stress. Ketones on the urine test strips are still at the level where it says call your gp immediately, but no idea how quickly these things reduce. I wouldn't say he has a bad diet, but we're sticking to things that should be fairly low GI and he's cutting out sugar in drinks.

OP posts:

greyinganddecaying · 21/03/2021 17:59

OP - if you've not already, buy a blood glucose testing machine and monitor his blood sugar. Then you will have an idea of the levels at different points (& this will help when he finally gets to talk to a diabetes nurse).

As someone with diabetes I've been told not to be worried about any ketone readings under 2, so if he's below that level it's slightly less worrying (apologies if I've misunderstood).

Original poster

tendofether · 21/03/2021 18:14

The nurse at the GP was actually going to give him a monitor on Friday before they sent him to hospital and told him it would all be sorted there. He'll buy one if he doesn't get one given.

OP posts:

WreckTangled · 21/03/2021 19:06

It is true. Unless the doctor deems it necessary they're not routinely prescribed (sorry, should have specified it's not a blanket ban). 20 years ago things were different and many more things were given on prescription that aren't now.

The urine ketone strips are notoriously inaccurate which is why all type ones, and maybe toe twos on insulin(?), have blood monitors for ketones. I wouldn't be worried until it got above 3 and/or I was feeling very unwell but I have years of experience and know what is normal for me.

Sorry he doesn't seem to have any answers it must be really stressful. Worth joining some groups on Facebook if he's on there.

GreenSlide · 21/03/2021 20:15

@tendofether

They did some blood tests, ketones and blood sugars, but sent him home again. Although, they did take a bit more time to talk through some things.

Hospital said that they were unconcerned about ketones at his level (0.8), and would only be concerned once above 2.5 and he said they didn't seem concerned about the blood glucose level at all

In the meantime make sure he drinks plenty of water, doesn't take anything sugary and doesn't go too long without food

Original poster

tendofether · 22/03/2021 17:09

So appointment with the diabetes nurse on Friday. No glucose monitor as they were only going to give him one as they thought the hospital would give him insulin.

He's bought a blood sugar monitor so can keep an eye on things this week.

First reading 19 something 4 hours after eating so a long way to go. I don't know how quickly these things improve. But his current HBA1c means he can't have the operation he was meant to be having at the end of this month

OP posts:

WreckTangled · 22/03/2021 18:06

Oh what a nightmare. It's important he doesn't bring the levels down too quickly though as that could make him feel unwell too.

I know you mentioned low GI but he really should look into low carb. Lots of info here on diabetes.co.uk and Google Dr David Unwin he's a GP in England.

Original poster

tendofether · 22/03/2021 18:22

He's doing lots of research which I'll leave to him

OP posts:

greyinganddecaying · 22/03/2021 18:34

Is that the hospital diabetes nurse? 19 is really high, I'm surprised they haven't agreed to see him sooner.

Original poster

tendofether · 22/03/2021 18:42

No, nurse at the GP. They all seem very relaxed now in contrast to the two "Go straight to hospital, do not pass go" messages last week

OP posts:

WreckTangled · 22/03/2021 18:51

I expect they're used to seeing lots of poorly controlled diabetic patients, so are quite blasé about high levels, and are satisfied that the hospital have checked him over. Doesn't make it any easier for him though.

Original poster

tendofether · 22/03/2021 19:09

I expect they're used to seeing lots of poorly controlled diabetic patients, so are quite blasé about high levels

Yes, i would imagine the above is the case given the demographics of our local area.

It's rubbish though when every professional you see seems to have a totally different idea. Reminds me of when i was first diagnosed with something else and i had two different doctors constantly changing my meds around with comments like "young doctors are far too cautious" etc.

OP posts:

WreckTangled · 27/03/2021 16:50

Hope your dh got some answers yesterday.

Sorry you had a rubbish experience being diagnosed with something. Makes it all so much harder doesn't it?

Barksmum12 · 07/04/2021 18:27

What treatment has he actually been given?

Original poster

tendofether · 07/04/2021 19:19

He's taking metformin. About a week after seeing the diabetic nurse at the gp he had a letter from the hospital saying they were referring to endocrinology, it indicates blood tests were taken for a GAD antibody test. Last he spoke to the diabetic nurse at the hospital they were still waiting on those results. So there still appears to be a question mark over diagnosis. He's testing blood sugars daily and huge improvement there.

OP posts:

Barksmum12 · 07/04/2021 19:44

How much Metformin?
What’s his BMI, any family history.

What are his blood glucose readings?

WreckTangled · 07/04/2021 19:47

With his original levels I wouldn't be surprised if it comes back that he has LADA but I'm pleased he finally has some medication and his levels have improved, it must have been really stressful for him before.

Original poster

tendofether · 07/04/2021 19:52

500 twice a day. BMI is 29.

Blood sugar this week consistently between 5 & 7. He's low carbing in addition to the metformin

OP posts:

Original poster

tendofether · 07/04/2021 19:54

He still had some ketones last time he tested with the urine strips.

OP posts:

WreckTangled · 07/04/2021 20:00

Those levels are great, hope he's feeling more energised etc even though I think you said he wasn't feeling unwell before. Sometimes you don't realise you've been feeling rubbish until you actually get better.

Original poster

tendofether · 07/04/2021 20:09

Sometimes you don't realise you've been feeling rubbish until you actually get better.

He has said exactly this, definitely feeling better now.

He was having some trouble with his eyesight the first week or so after starting treatment, struggling to read close up but that seems to have resolved itself. I think he is getting referred for some sort of specific eye test.

OP posts:

WreckTangled · 07/04/2021 20:18

Oh yes long term high sugar levels can damage the eyes and cause diabetic retinopathy. Short term fluctuations can cause blurriness which should resolve. For the eye screening he will have drops put in and a photo taken of the back of his eye, the drops make your pupils really big so I recommend wearing sunglasses afterwards and he won't be able to drive for a few hours afterwards. I think he will get free checks at the opticians now too (I know I do).

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