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.

[Babysharkdoodoodood]

My practice waited a year to tell me I had diabetes type 2. I'd had a hba1c test along with a few others for something else. Then went back with another issue a year later and got a scolding from the gp as TK ehh wasn't I doing anything about my diabetes!

WTAF? I was like 'What diabetes?' Your blood test from last year. Nobody had bothered to let me know and I had no inkling so didn't know to ask.

Another gp a few years previously told me to do yoga for my excruciating abdo and under shoulder pains. Went back after 2 years as I thought I was dying or something as the pain was getting worse. Different gp. He suggested an ultrasound so I paid £80 to get it done fast rather than wait for nhs. Chock full of gallstones. Classic presentation apparently Yoga didn't help obviously but I got really flexible.

[Rollmopsrule]

Op your getting a really hard time on here. I think people hear the words Type 2 diabetes and think they can give the person a bashing and act like they know everything about the condition because they believe its all down to being overweight and lazy. Everyone's an expert it seems when it comes to diabetes. Your situation sounds really difficult. I would have thought in normal times you would at least some guidance how to avoid pre diabetes developing further if that could have been possible. If you feel your Gp has not provided adequate care I would flag it up with the practice manager or at least ask what care you should expect in your situation. There is so much variance between the quality of Gp care - you are absolutely right to raise questions.

[mummydoris2006]

@foreverold I would be more likely to say your doctors were being negligent if they put you on the maximum dose of metformin daily when you are showing pre diabetes. Diabetes is a progressive disease so if you were to be prescribed such a high dosage immediately thete is a much higher risk you will get to the point of becoming insulin dependent. I would say the course of medication you have been prescribed is correct

[RavingAnnie]

@foreverold I've PM'd you x

[MoroSun]

Nurse here. 500mg of metformin is in no way a ‘ridiculously low amount’. Your facts a skewed. Oh and you’re unnecessarily aggressive

[SirVixofVixHall]

Op being chronically unwell is really hard. I sympathise as it took a decade of feeling rubbish to get my Hashimoto’s disease finally diagnosed, and my mother had been ill for a decade longer than that before her diagnosis.
I also wonder if you actually have type 1 and not type 2 ? I hope you get some answers tomorrow.

[littlewedding]

OP I'm not entirely sure why you're so angry, you phoned the GP and asked for a blood test which you're getting very quickly, and then will discuss the results with the doctor. Unless there's a history of you repeatedly calling for help and being dismissed then what is the issue?

I would also remind people that the average GP has over 2000 patients per doctor.
Is this ideal? No.
Is this GPs choice? No.
Does this mean sometimes things will not be exceptionally perfect? Yes.
Does this mean we have to be our own advocate? Yes.

No doctor is infallible, and even less so under current pressures. It doesn't mean they don't care and don't want to help.

[AbsentmindedWoman]

7.2 doesn’t seem dreadfully out of control.



7.2 is absolutely far too high.

7 is only a target for type 1 diabetes because of the hypo risk.

Many of us aim far lower (in the fives or low sixes) and with up to date tech that is, for some of us, safe and possible at least some of the time.

OP you have my sympathy, people who don't know what it feels like to have swings in blood sugar, spikes or insulin resistance just don't get it. They will never understand how shite and frustrating it is.

[Bagamoyo1]

[quote 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. [/quote]
I am a doctor and I agree with Mmn654123.

[Taciturn]

Raw vegan diet can help reverse type 2 - you should aim for high fat, good ones obviously, and low meat.

Lots of research about this on web

[Bagamoyo1]

With an HbA1C of 7.2, it could be reasonable to increase your metformin to 1000mg daily, but not mandatory. It would certainly be inappropriate to increase it to 2000mg daily.

[TurquoiseDress]

Why did they start metformin if you were pre-diabetes?

Surely they'd encourage you to make lifestyle changes first and then recheck the numbers

And that dose of metformin seems ok for starting out, I remember an uncle had a horrible experience with it at the start- v bad gastrointestinal side effects- until they got him onto the modified release stuff which made all the difference for him,

They definitely seem to start low with metformin to try and hopefully avoid the diarrhoea etc!

I really wouldn't say any clinician has been negligent!

[Mamanyt]

The initial dosage of Metformin for those with FULL D-2 is 500 mg, increasing incrimentally by 500 mg until effective dosage is reached. Had your doctor given you a higher dosage, you could have gone into lactic acidosis. They did exactly right. In fact, many doctors do NOT prescribe medication for pre-diabetis at all.

[Emeraldshamrock]

You need to see another GP. My Dsis was misdiagnosed with PCOS for years like you she was healthy but exhausted.
She has hashimoto's autoimmune disorder she takes B12 and thyroid medication she'd no issues with her thyroid all the years she was been treated for PCOS.

[TheTeenageYears]

I agree with @Emeraldshamrock re a second opinion. Female GP was very quick to diagnose PCOS in DD which in fairness did seem to cover her symptoms however having the benefit of private insurance we saw a gynaecologist who asked if hormones had been checked during a specific window (something like day 3-5 of a period) and an ultrasound been carried out to which the answer was no. DD had already been prescribed Dianette by the GP which is now seen as a high risk pill but best for PCOS due to anti androgen but in order to properly confirm diagnoses she will have to come off, wait fir period (which could take months) and have hormones re tested plus a scan. I was so happy to have an explanation of all the symptoms but it's not much good if it turns out not to be the right diagnosis and DD takes a high risk pill for years for nothing.

[tabctrlnoanykey]

Bizarre to be prescribed metformin for prediabetes at all! I’ve known overweight women with PCOS to be prescribed it to try encourage weight loss and a return of fertility (both related to insulin resistance) but seeing as you’ve had your children...

Considering you’re not fat and are only 28, it’s all a bit odd - the diagnosis of PCOS and pre-diabetes. Needs further investigation. Unless your family are riddled with diabetes. Then it might just be on the cards and you’ll have a lifelong disease on your hands.

[moomoomummy]

I understand your frustration but I am not sure Mumsnet is the best place to receive prescriptive health advice. People on here have their own health stories to tell but that doesn't equate to valid sound advice for your specific health issue. You should try and find a GP that you can trust . Its smart to question things but do bear in mind there is a reason why doctors train for many years. A Google search doesn't quite match this training.

[Oblomov21]

How often did you test your blood sugars and record what you ate. How good are your own records.

I wouldn't have been so laid back. How often did you go and see GP in 2018? 2019? I would have been there every week until I got a satisfactory resolution. You have to be on the case and proactive to make these things happen.

Type 1 here, and Dh T2.

[ivykaty44]

Try looking at prof Taylor’s (Newcastle)work on reversing diabetes,

[Oblomov21]

I think a lot of people are giving wrong advice here.

The reversing diabetes advice often doesn't work on people who have had it a long time.

[dontdisturbmenow]

OP, you are bring very dramatic. Treatment for health issues is not a black or white matter.

What works for 90% of patients might not for 10%. You won't know until you've tried.

It sounds like your dose should have been j creased sooner, but maybe they were waiting for blood tests and with everything going on, this was delayed.

The primary care service is in crisis. Not enough GPs who are overworked, so it's essential to take your health in your own hands as much as you can and learn about your condition.

I'm supposed to have an annual test, should have been called for it 6 weeks ago. I haven't. I just called my GP to remind them they need to refer me. No big deal. It would have been picked up at some point.

You might have lost a few weeks feeling poorly. It's not ideal but far from the end of the world and the drama you make of it. You should have made an appointment sooner to discuss it.

[lunepremiere79]

OP, YANBU. Someone who's never experienced what you are going through will never understand what it's like. I was in your position 4 years ago, sheer exhaustion for 2 years, many many tests, have gone through many doctors. The best answer I could get was there is nothing wrong with you, do food diary and hope for the best. The nhs is not set up to deal with complex cases and they will not recommend a solution unless there is something very obviously wrong.

What helped me was doing a food diary every day for 3 months and noticing what made me feel worse, so I cut out carbs and also gluten and noticed that I felt better straight away. Veg smoothies with lots of spinach, get a nutribullet. Bone broths for energy, lots of butter. Good multivitamin, like Solgar or floradix, also look into liquid fish oil. Exercise and lots if sleep, no stress. I can almost guarantee you'll start feeling much much better. X

[BigMomma164]

Poor GP having to deal with your rude and aggressive manner for £160 a year.
Why would you expect "excellent" service for less than a vet's bill?
Frankly I wouldn't spend a minute alone with you for £160 let alone repeated appointments. Your poor GP.
No wonder they are all running away.
Take some responsibility for yourself. Go private. Stop being a burden on the NHS since you clearly are unhappy with it.

[VivaLeBeaver]

@BigMomma164

Poor GP having to deal with your rude and aggressive manner for £160 a year.
Why would you expect "excellent" service for less than a vet's bill?
Frankly I wouldn't spend a minute alone with you for £160 let alone repeated appointments. Your poor GP.
No wonder they are all running away.
Take some responsibility for yourself. Go private. Stop being a burden on the NHS since you clearly are unhappy with it.

There are some really unkind people on Mumsnet. What was the point?

[jacks11]

YABU

Metform in can be used in PCOS and also to treat diabetes. If your HbA1c was at “pre-diabetes” levels, your GP may not have wanted to go in at a high dose because they didn’t want to push your blood glucose too low initially and wanted to see impact. This is not negligent.

HbA1c takes time to change- minimum 3 months. It is really not uncommon to recheck after 6 months of treatment commencement or alteration.

I think you are being unreasonable.