Had my annual diabetic review with GP today.
Got the normal bollocking for being overweight.
Mentioned my hip and inability to exercise but she was having none of it.
“It is mainly about diet not exercise” she admonished
“Carbs Carbs Carbs!!!”
“What is your BMI?”
“Hmmm, not quite obese enough for Manjaro”
I slunk out feeling I was leaving the headmaster’s office!
I’m sorry but fuck doctors. I’ve properly struggled with my weight all my life and only been ‘normal’ once, that was with physical job, a lot of partying, silly amounts of exercise and a very high protein diet.
Mounjaro has given me a window into how it is for most people, where there isn’t a ridiculous craving for food, any food to be shoved into my body, where a plate with food left on it isn’t a challenge and where the thought ‘I fancy some M&Ms’ isn’t instantly translated into the action of driving to the co-op for a sharing bag to inhale.
Certain cunty docs need to understand that sometimes times weight management is not easy. Just as mental health is getting a bit of a rep change so obesity needs one
Nowadays I’m much more likely to tell a doctor to go fuck themself if they start that lose weight horseshit. In a nice way of course but they can still go fuck themself.
She is right about that at least.
Given you’re not obese then it would have been more helpful to have pointed you towards practical help with adjusting your diet. If we’re just gonna hand out Mounjaro to guys like you then we’re really fucked.
To be honest she did, and I have had referrals to dieticians from the specialist diabetic teams, but the conversation was heavily edited for posting/dramallamaforum reasons. 
The biggest impact (to me) was the fact that my A1C, while on a downward trend was not far off the number that could mean my hip op could be refused,
Interesting to me was that the actual blood test gave a higher rating than the FreeStyle app connected to the monitor.
Blood test = 69
App = 63
You know this of course but the blood test is real whereas the monitor is a proxy.(sugar level in intercellular fluid). You can get a number for recent rainfall by using a calibrated rain-gauge to collect rain (real) or by measuring the height of your lawn (proxy). If they disagree then trust the real one.
That said, 63 and 69 are within 10% of each other. If you ask the path lab they will tell you the measurement uncertainty on their number.
If the doctor is harrassing you then ask her where you are on her spectrum of patients. I’ll bet you’re not a lot worse than average. She knows what she wants. The patient spectrum reveals what real-world humans can achieve. I’m not wanting to undermine her encouragement for you to do the best for yourself, but flying an endocrine system on clunky manual controls while also trying to live a life is not easy.
I have never seen her before, and likely won’t until my review next year, if she is still here.
She didn’t tell me anything I didn’t know, and her main point seemed to be to get me to stop taking Gliclazide as I was already injecting insulin and she didn’t see the point.
I said I would take that under the advisement of the Sussex specialist diabetes team at my next appointment.
It seems that if you inject insulin your GP has a minor role, as the specialist team deal with adjusting dosages and meds.
It was interesting that she didn’t adjust my medication herself
I guess that situation will vary on a trust-by-trust basis, or even GP-by-GP.
I moved under the care of what’s now the OUH trust’s specialist diabetes centre in 1979 or 80. My various GP’s have had different approaches to trying to be involved with that over the years. To start with their proposed ‘shared care’ idea sounded good and I signed up for it. But it worked pretty badly, with the two hands on the steering wheel often pulling against one another and the communications between them being always dreadful and sometimes hostile. Ever since I’ve resisted, politely and with a smile, whichever GP I’ve had getting involved in my diabetes care. Some have been snotty about it as they’ve always had to write my prescriptions and once or twice they’ve pointed out that they’ll be the ones picking up the pieces if my kidneys fail or I get leg ulcers or I go blind. Still I’ve stuck with the diabetes specialists. The downside of that is that they are also researchers and sometimes I feel that they might not be seeing the really big picture nor be really taking an interest in the patients when there’s academic work to amuse themselves with. The staff move too, so continuity of care is hard to achieve. Swings and roundabouts …
Typical capitalist running dog article. Don’t do anything to mitigate the price gouging it might cause infections, or profit loss.
I’ve just ordered my latest pen at the pre increase price and I’ve been intending to drop my dosage anyway to start weaning off / down. So I’ll just do it from the pens I have. I can math.
Then if it’s too expensive after the initial clusterfuck, I’ll switch to Wegovy or whatever if I need to.
I read the FT article so you don’t have to.
One of the journalists is on Mounjaro and she recommends in addition to the jabs, Zoe, the personalised nutrition people
and resistance training to avoid losing muscle mass. She cites Suzi J on Insta
but at a glance it might be aimed more at laydeez.
Don’t shoot the messenger.
Hopefully we’ll soon be able to change the last word in this thread title from jabs to tabs……
I’ve been offered to trial the munjaro tablets but as there are real tabs and placebo tabs involved I chose not to. Knowing my luck I’d get the placebo.
I have a friend who is a doctor in nutrition at Bath university. He says there are still a lot of unknowns with it as a drug and he wouldn’t advise taking it.
Wasn’t this what speed was invented for* ? (OK, side effects, but hey !)
*And for staying awake while flying aircraft.
Don’t they give every patient both tabs (a month or two on one then a month or two on the other) ? A lot of the trials I’ve been on try to work that way.
With Mounjaro you need to build up to a management dosage, month on month off would be pointless.
Plus you wouldn’t have any control cases if you mixed the placebo with real.
I know it doesn’t always work. Obviously it wouldn’t for a vaccine (those who had the vaccine first wouldn’t get whatever the disease was whether they then had the placebo or not, for example). But for a drug whose effect switches on then switches off again, as I gather the skinny jabs do, isn’t it just a matter of timescale ? Let’s say Tim would have had to build the tabs up to the management dose over 3 months (or whatever). He could have run with that for a couple of months then had 3 months (or whatever) for it to flush out before trying the placebo. Or the other way round. He wouldn’t know.
I was put on a placebo-controlled trial a few years back with Lixisenatide - another GLP-1 agonist, like Wegovy, although Lixi isn’t a weight loss drug (OK, it is, but mostly because of horrible side effects). Phase 1 (Lixi or placebo) took a few months then Phase 2 (placebo or Lixi) followed over the next few months. Like all proper trials it was double-blind so the doctor (young, earnest, a bit new to the job) said “Neither you nor we will know whether you’ve had the Lixi first or second until the whole trial is over”. When she’d left the room the nurses (been round the block time after time, and they were the ones dealing with the consequences of injecting this stuff) said “If it’s the Lixi it’ll kick in in about 20 minutes and believe us, you’ll know”. They weren’t wrong. I couldn’t get off the sofa. The next few weeks were a bit of a wild and nasty ride.
Well 6 months in and I’ve gone down from 19st 12lbs to 14st 5lbs so 5.5 stone lost.
Walking around 6 miles per day with the dog and managing around 3.5mph which is not bad after 2months of exercise following 5yrs of absolutely fuck all beyond straining to open the bags of maltesers 
Excellent work.
For me it’s been a loss of 5 kg in 7 weeks post heart attack.
Diet and alcohol intake reduction.
Great effort Chris!
That’s a top effort; great work.
The Medium Lebowski?
