DIABETES, so what do YOU do?

Skinback

What am I supposed to do when I get a few repeatedly high readings (9.8) on my blood glucose device?
I'm already watching what I eat so what am I supposed to do?....worry to death....call the hospital....stop eating altogether for the time being? ......beats me.

sam34

speak to your diabetes specialist nurse or your gp

mike65

for all your diabetic queries

DazMarz

My father is a diabetic, and if he could keep his bloods at a steady 9.8, he'd be loving it... He's an utter bollix for sweet stuff, fast food, etc. and is always skirting the teens with his bloods. Or else going into hypos of 2 or lower...

Don't worry too much about it, tbh. If you can maintain it kinda healthy you should be grand. Talk to your doctor in the clinic too.

Bottle_of_Smoke

If its type 2 what's your bmi?

Toes

My dad is type 2. Your readings are v. high. I would suggest cutting out a lot of foods with sugar added with a high level of natural sugars. Do yourself a
favour and visit your gp and nutritonist, they can advise you as to a type of diet that you should adhere to.

On a side note, the sheer amount of food we have in our diets is ridiculous and a high proportion of it is absolutely rubbish. On a side note; OP I wish only the best for you. I would also reccomend reading the Paleo Diet by Lowen Cordain available on amazon.co.uk quite cheaply.:P

r3nu4l

Moved from tGC.

1967

As has been said make an appointment to see your health professionals whether its your g.p. clinic or endocrinoligist also make an appointment to see a dietician and also try and drink plenty of water it will help bringing your readings down.

cards

There is a good documentary that can be found by googling
"Raw for 30 Days". Worth watching.

robinph

cards wrote: »

There is a good documentary that can be found by googling
"Raw for 30 Days". Worth watching.

A documentary from the guy who spent a month eating BigMacs filming himself throwing up out of his car window, and Woody Harrelson claiming to "cure" anything and that they are experts in anything related to medical matters should be regarded with extreme suspicion.

Go and speak with your diabetes specialist nurse and ask to see the dietician as well and get some proper advice.

Anthropology

1. Stop eating more than 100g carbohydrate (Sugar, Pasta, Bread, Potato, Beans etc) in a 24 hour period.
2. Eat things to make you more sensitive to insulin (Cinnamon, Fish Oil, Alpha Lipoic Acid)
3. Exercise to increase muscle sensitivity to insulin/sugar (weight training)
4. Stop eating things with flavour enhancers:
E620 Glutamic acid
E621 Monosodium glutamate
E622 Monopotassium glutamate
E623 Calcium diglutamate
E624 Monoammonium glutamate
E625 Magnesium diglutamate
5. Cook with only grapeseed oil.
6. Eat more fat. Saturated, Omega 3's and Monosaturated.
7. Eat more fibre.

robinph

Anthropology wrote: »

1. Stop eating more than 100g carbohydrate (Sugar, Pasta, Bread, Potato, Beans etc) in a 24 hour period.

I'd be approaching 100g of carbs per meal*, so as with everything diabetes (or anything) related "your mileage may vary".

* I would easily be getting through 80-90 in the evening meal and maybe 60-70 midday'ish, so only a slight exaggeration.

Terry

robinph wrote: »

A documentary from the guy who spent a month eating BigMacs filming himself throwing up out of his car window, and Woody Harrelson claiming to "cure" anything and that they are experts in anything related to medical matters should be regarded with extreme suspicion.

Go and speak with your diabetes specialist nurse and ask to see the dietician as well and get some proper advice.

I hate that bastard. He ruined McDonald's over here. Getting rid of the supersize menu just made a gluttonous fecker like me buy more crap from the Euro saver menu.
Those portions are no good when you're hauling tiles around all day.

Woody Harellson? He has good ideas, but at the end of the day he's just another stoner who wants to change the world, but is too high to actually do anything about it.

I too would avoid any of their advice.

Anthropology

I am quite serious with the 100g carb or under point.

100g being the max in a day. You would get good solid results from only eating 50g carbs in a day.

This is to get your cells sensitive to sugars once again.

You would obviously have to eat more fat and plant fiber to balance your hunger and welbeing.

robinph

I wouldn't be able to function on that low a number of carbs a day.

I am type 1 and am supposed to be training for Dublin Marathon and have also now started doing some cycling as well, although nothing today as I just decided to pig out and sit in front of the telly watching football for the evening instead. I've probably had close to 400g so far today. Although my hba1c's are not the greatest, the large number of carbs is not the reason for that, it's just general laziness that causes my numbers to be rubbish but I am trying to get better with the testing.

CramCycle

Anthropology wrote: »

I am quite serious with the 100g carb or under point.

100g being the max in a day. You would get good solid results from only eating 50g carbs in a day.

This is to get your cells sensitive to sugars once again.

You would obviously have to eat more fat and plant fiber to balance your hunger and welbeing.

That is an incredibly low amount of Carbs for anyone who is even mildly active. Maybe it would be ok if you led an incredibly sedentry lifestyle. I believe you should talk to your dietician. My own recommendation would be more excercise, even very low increases above your norm will do wonders for your insulin sensitivity, as well as leading to lower blood sugars in general, even at times when you aren't excercising as the benefits stay with you for awhile.

I have a few interesting papers on this somewhere and if I can find them at work I'll post them up.

eilo1

OP I have had type one for 14 years, my dad has had it for 36 years, my two uncles had it for over twenty each before passing.

Firstly the information given out here so far is mixed between type one advice and type two advice and also absolute nonsense!

Please please disregard most of what is written and have a look at the diabetes federation of Ireland website. Take up some regular exercise a few times a week, strength training and a cardio will both help you. Dont extreme diet, but have regular balanced meals. Also make sure your testing either just before eating or at the earliest 2 hours after eating (otherwise you could be getting fake hight readings)

But most importantly please call your diabetes team and explain your worries. they are the only people who are really qualified to advise you!

Diabetes is very complicated and you need to be under the supervision of a good diabetes nurse and an even better endocrinologist! It is also a very personal disease, what works for one person may not work for another.

I wish you all the best!!

Anthropology

CramCycle wrote: »

That is an incredibly low amount of Carbs for anyone who is even mildly active. Maybe it would be ok if you led an incredibly sedentry lifestyle. I believe you should talk to your dietician. My own recommendation would be more excercise, even very low increases above your norm will do wonders for your insulin sensitivity, as well as leading to lower blood sugars in general, even at times when you aren't excercising as the benefits stay with you for awhile.

I have a few interesting papers on this somewhere and if I can find them at work I'll post them up.

I can understand all the points you have made but I really believe the human body was not designed to eat a hi carbohydrate diet (as the rise in insulin resistance demonstrates).

Diabetes runs in both my genetic streams (mothers family and fathers family; 80% of my uncles and aunty on my mothers side, 40% on my fathers side…including my dad) so I have the gift of low sugar sensitivity (compared to a ‘normal’ person).

I was really overweight until I was 19-20 when I discovered how low carb diets make you more sensitive to sugar, lowers cholesterol etc.

Type 1 is more complex; your pancreas does not produce much or no insulin. It is often a immune system issue. Low carb diets would help.

Good Research:
http://www.realage.com/the-you-docs/you-on-a-diet/you-on-a-diet-the-99-second-edition-dr-oz-drroizen

Excellent Resource:
http://www.fourhourworkweek.com/blog/2007/04/06/how-to-lose-20-lbs-of-fat-in-30-days-without-doing-any-exercise/

All in all I would start out with a Slow Carb Diet; its easy, has variety and it works.

http://www.ehow.com/how_2243463_follow-slow-carb-diet.html

CramCycle

Anthropology wrote: »

I can understand all the points you have made but I really believe the human body was not designed to eat a hi carbohydrate diet (as the rise in insulin resistance demonstrates).

Diabetes runs in both my genetic streams (mothers family and fathers family; 80% of my uncles and aunty on my mothers side, 40% on my fathers side…including my dad) so I have the gift of low sugar sensitivity (compared to a ‘normal’ person).

I was really overweight until I was 19-20 when I discovered how low carb diets make you more sensitive to sugar, lowers cholesterol etc.

Type 1 is more complex; your pancreas does not produce much or no insulin. It is often a immune system issue. Low carb diets would help.

Good Research:
http://www.realage.com/the-you-docs/you-on-a-diet/you-on-a-diet-the-99-second-edition-dr-oz-drroizen

Excellent Resource:
http://www.fourhourworkweek.com/blog/2007/04/06/how-to-lose-20-lbs-of-fat-in-30-days-without-doing-any-exercise/

All in all I would start out with a Slow Carb Diet; its easy, has variety and it works.

http://www.ehow.com/how_2243463_follow-slow-carb-diet.html

Your first link reiterates what most Diabetic clinics will tell you and mentions nothing of Carb levels. It justs says to not eat high saturated fat and high sugar foods in any large amount. Good advice all round.

Your second link also, is just a diet, says nothing about keeping your carb intake as low as you recommend.

Your third link mentions low GI food. Again recommended by most diabetic health professionals, no mention of keeping your carb intake levels as low as you say.

I am not disagreeing with you but you are one person with a view rather than any wealth of research behind it. You are calling 100grams a day and under a low carb diet, whereas, most health professionals would have to look at each person, case by case to decide if it is indeed a low carb diet for that person or if it was borderline starvation. Each person is different and I can only recommend going to a dietician/doctor to discuss this. Personally, with my lifestyle if I was to eat that little I would be hospitalised within a week. Insulin resistance also varies between patients and cannot be applied as a defining factor for diabetes.

Can you explain what you mean by "low sugar sensitivity"? as it's not clear what your eluding to hear.

Also just to clear it up, T1DM results in no insulin production after a relatively short term period. Low carb diets would not "help" to stop this if that is what you are trying to insinuate.

kowloon

I'm not sure I'd be able to do a 100g limit. Breakfast and a bag of crisps at lunch would eat up half of it, more if I had a sandwich. Dinner would have me over the limit.

Anthropology

100 grams would be to get the most effective results, most will not but up for it.

It is a little 'extreme' but I choose efficiency/results over convenience.

Type 1 is a immune system issue, i recommend getting Vitamin D levels checked.

CathyMoran

Anthropology wrote: »

100 grams would be to get the most effective results, most will not but up for it.

It is a little 'extreme' but I choose efficiency/results over convenience.

Type 1 is a immune system issue, i recommend getting Vitamin D levels checked.

It is actually multi-factorial...but you can not cure type 1 with a low cho diet...from a type 1 diabetic who studied genetics among my many other things.

CramCycle

Anthropology wrote: »

100 grams would be to get the most effective results, most will not but up for it.

It is a little 'extreme' but I choose efficiency/results over convenience.

Type 1 is a immune system issue, i recommend getting Vitamin D levels checked.

Again, effective for who, each person is different, I'm in good shape and have reasonably good control, I wouldn't last a week on 100g a day, at the minute I pry take in about 300/350g per day.

Good Diabetic care does not have to be "extreme" as you say, in fact good diabetic care usually only seems extreme when it starts, as for some, it maybe a huge lifestyle change but once the adjustment is made, I think (only an opinion) that many (not all) find, once under control, it is far from extreme. Hugely irritating at times, I know, but IMHO not extreme.

Also vitamin D levels. I have read a bit saying that low levels pre dispose you to Diabetes but so far these studies are weak at best and can only really refer to T2DM as the T1DM studies are appalingly weak IMHO. The reference to Vitamin D and Diabetes is the link between reduced insulin synthesis/secretion in Vitamin D deficient mice but in this case as most cases of Diabetes (as CathyMorgan pointed out) are multifactorial and keeping a healthy levels of all vitamins in your system is vitally important, Diabetic or not. In fact if you go onto google and type in any essential vitamin/dietary supplement you will find an article/paper telling you how important it is and its deficiency can be used both as a preventative treatment and an ongoing treatment.

Getting your vitamin D levels checked in T1DM won't help, even if its deficiency was a contributing factor as you already have it.

I developed T1DM just before my third birthday. At the time scientists said this wasn't likely as the thinking at the time meant obvious onset of the disease and its symptoms would not be noticeable until the age of 7, something still taught in many university lectures today despite evidence to the contrary.

My point is that Diabetes has many different causes/faces and blanket statements like 100g cho will get the most effective results are both inadequate and misleading. The vitamin D advice though, is advice that doctors would pry give everyone, Diabetic or not, ie get outside and get some sunshine (when we have some;) ).

robinph

Some people may be able to survive on such a low carb diet. I most definately could not...and no amount of vitamin D will change anything for me now as far as diabetes is concerned as it's here to stay.

I just found this calculator for figuring out how much carbs/ protien/ fat they think I should be taking in per day during my training and it gives numbers around 600+ for me for carbohydrate intake:
http://www.marathon.ipcor.com/marathon-nutrition-calculator.htm

Been a while since I totalled up my daily intake properly, although I'm expecting a dietician/ specialist nurse/ GP to give me a kick next week about my current control. I'm probably not far off the numbers that calculator give though.

They also have a claim of 150g per day for a basic sedentary person just to stay healthy, and anything I've every seen about a diabetics diet is basically just eat the same healthy diet that anyone else should be eating. There are not actually any special requirements for a diabetic diet.

Don't belive everything you read on the internet.

Little Mickey

My own opinion is that the most of them in the clinic are chancers.

I'm type 1 for 15yrs and I've been involved in changing jobs recently before finally being let go so my levels were all over the place because of my lifestyle changes.
After reviewing my stats in the clinic recently they told me to lower my morning dose and raise my evening dose. When I started on this routine it was worse than previous so I changed back to the way I was. At the next appointment I told them the situation and they decided to raise my morning dose and lower my evening dose, the complete opposite to what I was told the first time. This improved my levels somewhat but I decided to try and perfect myself and I've now worked out reasonable doses, not brilliant control but the best I can manage I reckon.
So they call themselves specialists? I prefer to use the word chancers. Like you and me they know about the illness but they're only guessing based on your lifestlye, bmi, etc. You can do the exact same guessing yourself.
Going to the clinic for me is really now just keeping on the, for want of better words, "good side" for if more serious things occur.

As an engineer in say electronics or mechanics things have to be done specific for things to work, an electronic device will not function when the circuit is has an incorrect component for example - you have to know your stuff when you are working in a field like that. You won't succeed or keep a job if you take shortcuts here.
Yet thier pay is huge by comparison and they can guess all they wan't, afterall the adverse effects will be on you, not customers who they are suppling goods to.

Rant over, just voicing my opinion.

eilo1

Im really sorry to hear that Mickey!!
I have to say that I can see why you could become disillusioned with the medical care you are getting,

I have also had type one for 15 years and have definitely had my ups and downs,

I attend Louglinstown now and have to say that the team is excellent.
They are very supportive and up to date with all the latest medical advances (well as much as the HSE will allow)

However you have to know that diabetes is very individual and there is always a bit of trial and error involved. I think we (type 1's) become specialists in our own care after a while. We self medicate and see the results first hand, this isnt to say we dont need our clinics though.

My Dad recently did the DAFNE course, he said that after 36 years of type one he realised that he didnt know everything. The new info he has, is really helping him to control his morning readings.

All I can say is please dont give up!!

CramCycle

I really hope the few chancers don't end up pushing you away from the generally excellent guys out there.

I am in James myself now and find them tops but in agreement with you there are chancers.

One of the male nurses, in his 40s, in James DDC, has a habit of giving out misinformation but I think its just bad habits he has picked up from being consistently disillusioned with patients who just don't seem to care and he in turn has gone the same way.

I actively avoid him, he isn't a bad guy but he has some very random and incorrect ideas stuck in his head but you can tell how frustrated he is with patients that don't care so much so that I don't have the heart to point out any errors to him. In a way its my fault as the next guy in line suffers because I don't have the same strengh to assert my opinion face to face as I do when I am on boards.

That said everyone else there, IMHO, is brilliant both with support and advice and I cannot fault them for one "constant" inconsistency. Terrrific secretary, staff nurses, dietician, head nurse, doctors etc.

Please don't let the few chancers lead you away from generally good health care professionals.

Little Mickey

Thanks eilo, appreciated. I didn't know about the DAFNE course that you mentioned but I've just checked and it's not in my hospital, mid west general!
I also have to say, I seem to meet a different one of them every time I go in, the interns I'm talking about. Each one of them has to ask the same questions as the last one because they've never met you before.
I'm happy to do my own thing anyway, they can disagree but I'll do it anyway because I know it works best for me.

Little Mickey

CramCycle wrote: »

I really hope the few chancers don't end up pushing you away from the generally excellent guys out there.

I am in James myself now and find them tops but in agreement with you there are chancers.

One of the male nurses, in his 40s, in James DDC, has a habit of giving out misinformation but I think its just bad habits he has picked up from being consistently disillusioned with patients who just don't seem to care and he in turn has gone the same way.

I actively avoid him, he isn't a bad guy but he has some very random and incorrect ideas stuck in his head but you can tell how frustrated he is with patients that don't care so much so that I don't have the heart to point out any errors to him. In a way its my fault as the next guy in line suffers because I don't have the same strengh to assert my opinion face to face as I do when I am on boards.

That said everyone else there, IMHO, is brilliant both with support and advice and I cannot fault them for one "constant" inconsistency. Terrrific secretary, staff nurses, dietician, head nurse, doctors etc.

Please don't let the few chancers lead you away from generally good health care professionals.

I do agree that most but not all of the nurses are very good, in particular I am referring to the doctors. I won't go down the road of how the nurses work so much harder and why they should be getting more and the doctors less, I'm sure there's another thread somewhere for that. I'm for the nurses anyway, more power to them

graflynn

Little Mickey wrote: »

Thanks eilo, appreciated. I didn't know about the DAFNE course that you mentioned but I've just checked and it's not in my hospital, mid west general!
I also have to say, I seem to meet a different one of them every time I go in, the interns I'm talking about. Each one of them has to ask the same questions as the last one because they've never met you before.
I'm happy to do my own thing anyway, they can disagree but I'll do it anyway because I know it works best for me.

The Diabetes Clinic in Galway has DAFNE, if that's any help to you?

Little Mickey

graflynn wrote: »

The Diabetes Clinic in Galway has DAFNE, if that's any help to you?

A little bit out of the way but if it's only for one day (?) I could ask at my next appointment if they can organise one up there for me.
The little bit of reading I've done on it seems that indeed it seems to be a useful course to take part in.
Thanks for the info!

tbh

Little Mickey wrote: »

A little bit out of the way but if it's only for one day (?) I could ask at my next appointment if they can organise one up there for me.
The little bit of reading I've done on it seems that indeed it seems to be a useful course to take part in.
Thanks for the info!

5 days, im afraid.

graflynn

Little Mickey wrote: »

A little bit out of the way but if it's only for one day (?) I could ask at my next appointment if they can organise one up there for me.
The little bit of reading I've done on it seems that indeed it seems to be a useful course to take part in.
Thanks for the info!

You are only eligible to do it if you are a patient in the clinic that runs it. There are 5 centres that run DAFNE in Ireland; Galway, St. Lukes in Kilkenny, Beaumont, St. Colmcille's, & St. Vincents in Dublin.

You can find out more on http://www.dafne.uk.com/387.html

I know Galway is out of the way for you but back in the early days before there were diabetes clinics everywhere I had to travel from Offaly to Dublin.

CathyMoran

DAFNE seems like a great idea but I never have enough time to do it, do they have daycare/creches for children?

lucernarian

Little Mickey wrote: »

My own opinion is that the most of them in the clinic are chancers.

I'm type 1 for 15yrs and I've been involved in changing jobs recently before finally being let go so my levels were all over the place because of my lifestyle changes.
After reviewing my stats in the clinic recently they told me to lower my morning dose and raise my evening dose. When I started on this routine it was worse than previous so I changed back to the way I was. At the next appointment I told them the situation and they decided to raise my morning dose and lower my evening dose, the complete opposite to what I was told the first time. This improved my levels somewhat but I decided to try and perfect myself and I've now worked out reasonable doses, not brilliant control but the best I can manage I reckon.
So they call themselves specialists? I prefer to use the word chancers. Like you and me they know about the illness but they're only guessing based on your lifestlye, bmi, etc. You can do the exact same guessing yourself.
Going to the clinic for me is really now just keeping on the, for want of better words, "good side" for if more serious things occur.

As an engineer in say electronics or mechanics things have to be done specific for things to work, an electronic device will not function when the circuit is has an incorrect component for example - you have to know your stuff when you are working in a field like that. You won't succeed or keep a job if you take shortcuts here.
Yet thier pay is huge by comparison and they can guess all they wan't, afterall the adverse effects will be on you, not customers who they are suppling goods to.

Rant over, just voicing my opinion.

Been in two different clinics since I've been diagnosed and I've found entirely the same thing. Most consultants and especially SHOs and registrars in the two outpatient clinics I've experienced go through the same routine of asking for blood sugar recordings, looking for dodgy ones, seeing if there is a pattern and then telling me to increase/decrease a certain dose at one time of the day. This information is entirely useless as I "carb count" and every dose I take varies with what I eat. And the amount of carbs per unit insulin will vary depending on time of day, expected exercise and to what extent do I want to ensure no hypos, etc. The list goes on. So how can a doctor ask me to apply a blanket adjustment to one time of the day is beyond me (except for the basal part of my therapy). That experience is personal and I don't think it applies to others really.

I have rarely found any sort of personalised advice and this is from one or two of the nurses I've dealt with. In comparison, I usually see a doctor who I've never spoken to before and with outpatient clinics as they are, there's simply not enough time to give my whole life(style) story. The doctor's consultation is only useful to me now as the place where I hear blood test results, especially the HbA1c and also where my LTI prescription is renewed.

Nurses and dieticians can really offer useful advice on how to handle diabetes (type 1 in my case) as it's less formal and not so structured to simply taking effectively a "progress report" of the patient's blood sugar control. They don't have a timetable, more or less, to keep an eye on when talking to you. This lets you discuss particularly tricky problems.

I also think you'd benefit greatly from the DAFNE program, it puts more effective control in your hands. And you will be able to get more out of doctors' consultations too. A pity that most hospitals don't offer it. At this stage, I manage my diabetes quite similarly to the DAFNE way of doing it, but probably not as successfully... My A1cs have been low to mid 7%s for the past 3 years.

Little Mickey

To_be_confirmed wrote: »

Been in two different clinics since I've been diagnosed and I've found entirely the same thing. Most consultants and especially SHOs and registrars in the two outpatient clinics I've experienced go through the same routine of asking for blood sugar recordings, looking for dodgy ones, seeing if there is a pattern and then telling me to increase/decrease a certain dose at one time of the day. This information is entirely useless as I "carb count" and every dose I take varies with what I eat. And the amount of carbs per unit insulin will vary depending on time of day, expected exercise and to what extent do I want to ensure no hypos, etc. The list goes on. So how can a doctor ask me to apply a blanket adjustment to one time of the day is beyond me (except for the basal part of my therapy). That experience is personal and I don't think it applies to others really.

I have rarely found any sort of personalised advice and this is from one or two of the nurses I've dealt with. In comparison, I usually see a doctor who I've never spoken to before and with outpatient clinics as they are, there's simply not enough time to give my whole life(style) story. The doctor's consultation is only useful to me now as the place where I hear blood test results, especially the HbA1c and also where my LTI prescription is renewed.

Nurses and dieticians can really offer useful advice on how to handle diabetes (type 1 in my case) as it's less formal and not so structured to simply taking effectively a "progress report" of the patient's blood sugar control. They don't have a timetable, more or less, to keep an eye on when talking to you. This lets you discuss particularly tricky problems.

I also think you'd benefit greatly from the DAFNE program, it puts more effective control in your hands. And you will be able to get more out of doctors' consultations too. A pity that most hospitals don't offer it. At this stage, I manage my diabetes quite similarly to the DAFNE way of doing it, but probably not as successfully... My A1cs have been low to mid 7%s for the past 3 years.

+1
You've nailed it. You have put across what I am saying in a more detailed fashion, you may be at the same clinic as me for that matter. What you have described is 99.9% the same as for me. To add to that, I'd say I can count on a few fingers the amount of times that I've met the senior "consultant" in there in the last 5 or 6 yrs.

I will ask about that course the next time just in case they can organise something.

eilo1

can i asked where you both attend??
Im just curious coz your clinics sound so awful!!!!!!
its such a shame this can happen!!!

Little Mickey

eilo1 wrote: »

can i asked where you both attend??
Im just curious coz your clinics sound so awful!!!!!!
its such a shame this can happen!!!

Mid west regional hospital for me.

lucernarian

It used to be the Lourdes hospital, Drogheda which was pretty poor. There wasn't even an endochronologist based there until a good while after I was diagnosed, and then only once per week. I don't know if it's still the case. I've been in St. James for nearly 4 years now and it's much better overall, though the consultants/doctors are worse if anything. I hear great things both from people within the system (doctors, trainees etc) and from members of the public about Prof. Nolan but I think I've never had an appointment with the man.

Speaking of which, appointments every 6 months are no way to keep a regular eye on even A1Cs let alone daily blood sugar control. I don't think any hospital public outpatient in this country would experience much different as even the best doctors (of which I believe Professor Nolan is one) can only do so much in less than an hour per year.

Unfortunately, I simply can't afford to go privately and have more frequent appointments though I do arrange another 2 A1C tests with a GP per year so I have that every 3 months at least. And even at that, they're highly reflective of the previous 6 weeks even though theoretically they reflect control over ~120 days. For me anyway.

robinph

I'd view the 6 monthly/ yearly checkups with a the consultant/ prof/ senior diabetes person of some description as just a check to see if there is anything else missed during the year that the rest of your care team couldn't deal with or that you'd not brought up with them for some reason. If there was ever any issue during the rest of the year then that gets dealt with by the nurse, who then moves the issues up the chain of command if needed, but they are available much more often than every 6 months/ or year.

If you have the inclination you should be in contact with the specialist nurses throughout the year if you need them. Maybe the visit to the consultant is just actually an annual reminder that there is a whole bunch of people there available if you are willing to make use of them.