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.

[JerichoGirl]

Look I don't know anything about diabetes but what you're experiencing sounds extremely difficult to tolerate.
Would you consider changing GP for a second opinion?
Or looking into supplements?
Years ago when I saw an "alternative practitioner" basically bc I was desperate to have a baby and the usual fertility treatment wasn't working.

She prescribed a heap of supplements comprising B12, something called B100, zinc drops, magnesium, iron, and some tonics.

Within three weeks I felt amazing - and was pregnant!

I no longer take the tonics mainly bc of cost but I still take the others.

Obviously you and I have different dietary needs but sometimes the medical threshold for iron levels is pretty low and you can feel a lot better with a good supplement. Would it be worth taking Floradix for a few weeks?

[foreverold]

@Mmn654123 oh you're a doctor? So the diagnosis of prediabetes was in fact false since you have declared 7.2 'within the target range'. Got it, what a relief.

[foreverold]

@LookingForSalt yes, I will do some reading up on that now and additional supplements. At the moment I just take a multivitamin, thank you

[Changechangychange]

[quote foreverold]@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. [/quote]
Unless this is a private GP, the practice gets a flat rate of around £160 a year per patient to look after you. Not £160 per visit, £160 per year. Hardly “big bucks”.

They have started you on appropriate treatment and are titrating it up. They aren’t going to refer you to secondary care diabetic services with uncomplicated T2, because the referral will be rejected.

Perhaps you are right, and private medicine would better meet your high standards.

[Mmn654123]

[quote foreverold]@Mmn654123 oh you're a doctor? So the diagnosis of prediabetes was in fact false since you have declared 7.2 'within the target range'. Got it, what a relief. [/quote]
You had prediabetes. Now you have diabetes. And given you have diabetes, the dose you have been prescribed sounds adequate. It would be increased if your hba1c increases.

[slashlover]

So you felt fine and and now feeling bad again? What did the GP say when you phoned to tell them this and ask for an appointment?

[Mmn654123]

[quote foreverold]@Mmn654123 oh you're a doctor? So the diagnosis of prediabetes was in fact false since you have declared 7.2 'within the target range'. Got it, what a relief. [/quote]
Oh and that message was also grumpy. Was that your intention?

[Forwhatitsworth101]

Don’t worry doubt op will get anywhere once the hospital/healthcare/expert witness/legal team review the case

[foreverold]

@Mmn654123 no not at all, I'm just relieved we have a doctor on the case and that I'm now in good hands.

[RiojaRose]

You’ve been unlucky with your health. So have I, and I know it can feel really unfair. However, from your description I don’t think your doctor has been negligent or incompetent. It takes quite a while for anyone to get the hang of managing diabetes. I’ve never heard of anyone with pre-diabetes being prescribed 2000mg of metformin from the outset. It’s normal to start at 500mg and work up gradually. It looks like you are already managing your diet and exercise, which bodes very well. Over the coming months I’d expect your doctor to offer you a higher dose of metformin and eventually (if appropriate) other diabetes meds to keep your HbA1c in the acceptable range. But there’s no quick fix, and what works for some people doesn’t work for others. It can take time to discover what works for you. Yes, it’s frustrating. But once you find the right combination of meds it does get easier.

[foreverold]

@slashlover yes, it was the receptionist, I said, I don't feel very well recently and I know my next hba1c is due can you book me in with nurse to get it tested. And she said yes no problem, is Wednesday at 8.10 am okay? I said yeah that's perfect. So haven't spoken to doctor. I will when results come back I am sure.

[JerichoGirl]

[quote foreverold]@LookingForSalt yes, I will do some reading up on that now and additional supplements. At the moment I just take a multivitamin, thank you

[/quote]
You don't get much in a multivitamin.

I can recommend Floradix (the liquid), it's organic and vg.

Beyond that, the good brands are Clinicians and Radiance. Good luck. It sucks being constantly exhausted.

[VivaLeBeaver]

I think 7.2 s in the target range for someone with type 2 diabetes....not for someone who is pre diabetic and hoping to avoid diabetes?

Can you ring the GP and ask why they haven’t increased your metformin?

[foreverold]

Exactly, I've not been diagnosed type 2 yet, still pre with blood sugar of 7.2 and been tracking at home and can sometimes be up at 14 fasting bloods in morning but they're not interested. Well I'm going to see the results of the hba1c hopefully by Friday then see about getting them increased.

[TheUndoingProject]

You seem well informed about your condition and well able to advocate for yourself here OP. If you think your GP practice have behaved negligently then why not take it up with practice manager?

I suspect you’re expecting a level of care beyond what is reasonable from the NHS during a pandemic.

[foreverold]

I'm also only 28 and have always lived a fairly healthy lifestyle and so am really upset that I have no periods, hair growing all over the fucking joint, acne, basically infertile (thank god I have a child already) and now have pre diabetes / diabetes and feel like a 80 year old woman with exhaustion

[RavingAnnie]

I think you are getting very hard time on this thread.

I have chronic illness and I have to say ime most doctors do NOT know whet they are doing. You have to do your own research, and be your own advocate to get adequate healthcare. I agree you should expect excellent healthcare but you are probably going to to be disappointed on that one I'm sorry to say.

It's fucking infuriating being chronically ill, being gaslighted and/or no one wanting to fucking do anything about it. Often doctors are rude, patronising and, at the same time, wrong! So I am not surprised you are angry. I am fucking angry. When I can muster up enough energy to be angry! Most of the time I just desperately want to feel well again.

I will now only see two GPs at my surgery, and I also sometimes see an excellent private GP. I am currently on my second private endo who seems pretty good so far and came well recommended. Happy to PM you details if you like.

I have just joined a chronic illness group on FB. Everyone there tells the same tale of misdiagnosis, arrogant doctors, gaslighting for years, poor or inadequate treatment. It's so depressing.

Keep on battling and you will get there. It's the "doctor knows best" types that I really worry about. Good luck.

[foreverold]

Thank would be great! Thanks so much! Good luck to you too, it is severely shite but hopefully we will get there eventually

[PumpkinPieAlibi]

@MaxiPaddy - Just a slight segue here. From what I've been told by more than 1 doctor, as well as a couple pharmacists, the NDMA levels were elevated in specific batches of Metformin, not all. The levels were higher than preferred but not necessarily high, per se.

Either way, I doubt the OP's Metformin would be part of the affected batches. Anyway, I digress.

[bumbledeedum]

2000mg is the maximum daily dose of Metformin, doctors will usually start at 500mg daily and see how effective that is before increasing. Metformin can be incredibly hard on your kidneys and the lower dose that can be effective the better, it's not an automatic step up to 2000mg if 500/1000/1500 could be effective for you. Yes you probably should have had follow up bloods scheduled before now but in my experience it's not unusual for there to be a couple of months on a dose before checking/potentially increasing especially since HbA1c reflects 2-3 months glucose levels so would need at least that long to check effectiveness. I would disagree that 500mg is a waste of time, it can be sufficient for some people (diabetic or with PCOS).

[TheYearOfSmallThings]

You’ve been unlucky with your health. So have I, and I know it can feel really unfair. However, from your description I don’t think your doctor has been negligent or incompetent.

I agree. It might also be worth considering that poorly controlled blood sugar levels can be associated with irritability and anger, which may be colouring the way you feel right now.

[Advic3Pl3as3]

I was diagnosed with polycystic ovaries 15 years ago after a scan and have had zero input or monitoring since. Extremely irregular, non existent, super light periods for years, and now all of a sudden the last year and a half really heavy, large clots, every 4-5 weeks, with random spotting in between, amongst other things. No idea what’s going on but there’s just no point in going to the drs because they couldn’t give less of a shit.

[foreverold]

@Advic3Pl3as3 yep they do not give a hoot you're right

[foreverold]

@Advic3Pl3as3 we are second class citizens