To think my doctors have been negligent?

[foreverold]

I was diagnosed with PCOS in 2018. Had my HBA1C tested every 3 months since then as fasting bloods were high a few times.

During the summer I began to feel unwell, despite healthy eating and daily exercise (cardio/weight training/yoga) I felt constantly exhausted. Sleep 10 hours a night plus 3 - 4 hour naps in the day. Has constant dry mouth despite drinking 4-5 litres of water a day, peeing more and feeling quite nauseous.

On last HBA1C test I was told I was pre diabetes, given 500mg of metformin (which is a ridiculously low amount) and basically left to get on with it.

I felt okay for a few months but have now started to feel exactly how I did in summer, nausea, napping, dry mouth, peeing more.

I have my HBA1C tomorrow and I'm pretty positive they will tell me I am now in type 2 diabetes category.

I feel really frustrated as feel I have been left to get on with it! AIBU? Or is there really not anything else they can do? I really feel the doctors dealing with this have been incompetent and not helpful in the slightest.

What is it that you wanted them to do differently & in what way did you want them to help? -not being goady I’m genuinely curious as to what else they would do except give a prescription & repeat bloods at some point.
I would probably wait until you have the results tbh but do they have a diabetic nurse that you could have a consultation with to discuss your concerns once the results are back?

Have you googled pre-diabetes? Or diabetes and plans / books out there to reverse it?

@Howdoin not put me on a ridiculously low dose of metformin that has no effect on a person whatsoever. Even an endocrinologist agreed with me on that one. Said I should be on 2000 mg not 500 mg.

@Sparky888 yes, I know low carb is the way to go and is what I do, I have always been relatively healthy and a healthy weight so the problem here is not my diet. I have insulin resistance PCOS which has a high correlation to developing diabetes unfortunately. Still feel shit even with eating well.

Can you post what you eat in a typical day please?

Yabu, you seem to be venting your frustrations by looking for blame. What were you expecting?

Also BMI or height/weight

@Wondermule yes.

Breakfast - either skip it or have one scrambled egg with spinach and smoked salmon.

Lunch - chicken or salmon salad with cheese and 30 ml ceaser salad (sometimes add some avocado or some quinoa but mostly not) or a soup with a slice of whole meal bread and 10 g lurpak lighter.

Dinner - chicken in a sauce, like cholula sauce with peppers, mushrooms, onions, chillis, 20 g cheese if I want something spicy. If something a bit creamier then chicken in 30 g sour cream with mushrooms and leeks and cheese. Sometimes I will have some salmon with a sweet chilli sauce, not often. All this accompanied with asparagus, green beans, broccoli etc.

All meats organic.

Snacks - not everyday but will have a few small chicken satays or spoonful of organic peanut butter

Drinks - 2 decaf coffees with skimmed milk and 2 sweetners - 1 diet irn bru with dinner - the rest of the day water - once in a while green tea

What does the prescription bottle label say, OP?
I wondered if you were given 500mg tablets, and does the bottle say "Take one a day" or what?

It is normal to start patients on a low dose though, that way they can redo the bloods after it has had time to work and they can more accurately set the dose for you.

5 ft 3 - 9 stone 8

@lljkk it says take one a day with a meal or just after a meal

I'm on metformin for PCOS and was started on 500mg and moved up to 2000mg over about 6 weeks. Metformin can give you terrible stomach problems if you start it too quickly, so I would assume that's why they've started you low.

I don't think they've been negligent. It sounds like given your circumstances and the current climate they've done a pretty good job and have you moving in the right direction.

bnf.nice.org.uk/drug/metformin-hydrochloride.html
Starting dose seems to be 500mg once daily. An endocrinologist might recommend more but your GP is not an endocrinologist and would follow guidance such as the BNF.
Not sure how soon your bloods should have been repeated after starting it though. That might be an area where you have been let down depending on how long it has been.

YABVU
They monitored and treated you. What more do you want them to do?! They don't seem negligent to me at all. Metformin can cause terrible diarrhoea so starting on a low dose is to protect you from that.
You seem like an unpleasant person looking to blame someone.
I'm sure you want people to agree with you so you can claim some compensation

YABU. The treatment for type two diabetes is Metformin. What were you hoping they'd do for you? Give you the medicine they already have to treat a condition you were already on the way to getting? What have you asked of the doctor? What support were you denied? Or were you hoping that they'd spend their free time finding information you might find helpful and bringing it round to your house?

A starting dose of 500 mg of Metformin was the correct dose. If he had started you on 2g you would have had a terrible upset stomach and abdominal pain, that is a dose to titrate up to. Not usual also to start a pre-diabetic on medication. If anything I think they have been proactive.

It sounds like you could be type 1 diabetes rather than pre-diabetes / type 2. That’s a super low carb diet that should do little to your blood glucose levels. If I were to follow your diet then I would not need to take any fast acting insulin throughout the day and I have type 1. Your symptoms sound identical to mine when I was diagnosed. I would insist on an immediate ketone test there and then tomorrow as if you are extremely thirsty you may be in dka which can be fatal if not treated quickly.

@BananaHammock23 I've been on this 'starting dose' for four months and no they absolutely haven't done 'a pretty good job'. I also won't accept them doing 'a pretty good job' when it comes to my health. They need to do an excellent job which they are getting paid the big bucks to do. This has been an ongoing issue since 2018 with them sitting back and watching my HBA1C levels continuously rise. Was told on the phone by the doctor, 'you do know metformin won't restart your period' and what do you know, 11 days after starting it what appeared for the first time in months? My period. They don't have a clue and they don't give a toss. They have left me here for months at a time without a period, with no advice, just told to get on with it. I feel horrendous and this is not how I will be living my life I tell you that much.

@BigMomma164 compensation? What the hell are you dribbling

Gosh, I was going to post something useful but given your aggressive replies I won't bother

@toomanycremeeggs oh I do wonder how I'll sleep tonight

You should be careful with metformin anyways. They are recalling it and trying not to prescribe it because it has high amounts of carcinogens.

😂😂😂😂

@foreverold
I’m guessing your diabetes isn’t well controlled given your poor mood control. Hope your endocrinologist can adjust the doses and get that under control. In the interim given we have been in the midst of a pandemic it’s not surprising you haven’t been referred as most services in secondary care weren’t functioning. What exactly do you want from your GP? An apology for not being a secondary care diabetes expert?