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[IPk] Check-up report back + tit-bits

Well, I went for my "GP" checkup last night (review with GP on double appt
because my hospital appt has been delayed until late Feb 2002). A number of
interesting tit-bits, which may be useful to some for different reasons:

* Generally all happy with treatment etc., apart from post-meal highs still
too high, and occasional precipitous drop in bg (10 points or more in half
an hour sometimes) in late afternoon, perhaps due to combined
characteristics of Insulatard taken am and Novorapid taken for a late lunch
or afternoon snack. He filled in a data point - my HBA1c's have been: data
not available from hospital at diagnosis (Feb/Mar), June 9.5, late August
8.6, late Nov 7.9 (a nice straight-ish line).

* A number of detailed questions (e.g., splitting Insulatard doses half and
half at midday/midnight rather than on 26u:6u evening/morning bias) he
referred to the db nurse at the clinic ("they know more about the fine
tuning than us"). Sensible reply.

* In my area (South Camden Primary Care Trust in Camden and Islington Health
authority) they are looking to appoint a community-based diabetic specialist
nurse in the future, working for the Primary Care Trust rather than the

* As a practice they will follow prescribing recommendations of the db
consultant at the clinic, and the recommendations of Diabetes UK. This was
in relation to low-dose aspirin. Stupidly, I didn't have a copy of the Db UK
policy to hand - it would marginally recommend me for the treatment (over 30
+ slightly overweight - bmi 26). My bmi has gone up because the GP's
computer thought I was 6'1" not 5'11" :-( )

* He indicated that the Primary Care Trust would probably follow the
recommendations of the clinic for pump funding (presumably consumables
only). This was a probability, so would need to be explored in practice. I
would expect to have to self-fund the capital cost, because I don't think I
come into the categories for NHS funding, and I don't have any incriminating
information about the key decision-makers!

* He does not know whether DAFNE courses (Dose Adjustment for Normal Eating
- basically advanced carb-counting and bg control taught in a 1 week
residential course) are planned in London (again referred to the db nurse),
but if a case can be made out it may be possible to get one funded by the
Primary Care Trust. In my case I reckon I would have to pitch this to them
as a "pilot" for the area and be willing to report back to the Trust in
detail. Though I see that there is a part of the DbUK DAFNE research project
based in London, so I will talk to them.

* And they are about to go hi-tech: there is going to be an email link to
the hospital clinic from my GP!

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