advice for dealing with dr

Go Back   The Diabetes Forum Support Community For Diabetics Online > Diabetes Forum Community > Diabetes Treatment

Diabetes Treatment As there is currently no cure for the chronic, Diabetes mellitus – the emphasis must be on treatment and management to avoid complications. Please use this section to discuss how you carefully control and manage your Diabetes. Please let us know what is and isn’t working for you. Feel free to discuss all areas of treatment and management of Diabetes including diet, exercise, weight loss, insulin usage, oral drugs and more.


Like Tree28Likes

advice for dealing with dr


Closed Thread
 
Shared Thread Thread Tools
Old 11-30-2013, 15:03   #1
Active Member
 
Join Date: May 2013
Posts: 10


8 likes received
Default advice for dealing with dr

I am T2 - i was diagnosed as IR 10years ago while trying to get pregnant. Now that i'm done having babies i have officially been diagnosed T2 so all my treatment is now through my GP instead of my OBGYN. The new dr does not seem invested in my treatment and i'm getting frustrated. All he has done is put me on the max dose of metformin for my weight and scheduled no follow ups or bloodwork. I am supposed to check my fasting a few times a week but he doesnt even want me to report it. My fasting is typically in the 130s and i'm starting to worry about that. 6months ago i got really serious about my health and have lost 35lbs and now exercise 4-5x a week. I thought that would start to have an impact on my bg and it hasnt. I live in a rural community and have terrible insurance so he is literally my only option for a dr at the moment. Im not very assertive generally but am willing to be pushy for my health's sake. I plan on calling next week to go back and at least ask for an A1C. If it's poor I wonder if we will have to talk about insulin? Or do T2 not do insulin? I also have other disorders he isnt monitoring either (PCOS, MTHFR, hyperlipidemia). With the MTHFR he literally was like "what's that?" and has done no research to learn how to treat it. Does anyone have any thoughts/advice?

foxl and Dodie37737 like this.
libraterra is offline  
Old 11-30-2013, 15:11   #2
Senior Member
 
Mary,'s Avatar
 
Join Date: Mar 2013
Location: USA
Posts: 6,071

Member Type
Type 2
Diagnosed in 2013

5574 likes received
5676 likes given
Default

How's your diet? How many carbs are you eating each day?

Dodie37737 likes this.
__________________

View Mary0110's full Diabetes Forum profile here.
Mary, is offline  
Old 11-30-2013, 15:22   #3
Active Member
 
Join Date: May 2013
Posts: 10


8 likes received
Default

Most days i am between 30-60 but sometimes it has been has high has 90-100. He didnt give me a range so i've been just using my fitness pal app to track it. I try to only do the "good carbs". Thats a good a point though, i should try to lower my carbs more consistently.

Dodie37737 likes this.
libraterra is offline  
 
Old 11-30-2013, 15:35   #4
Senior Member
 
Join Date: Dec 2009
Location: Kansas City, MO USA
Posts: 5,911

Member Type
Type 1
Diagnosed in 2009 as Type 1.5

5212 likes received
9205 likes given
Default

A couple of things, here: I just had a dx of MTHFR on my 12 yr old who is on the autism spectrum! So I have read a bit (NO it does not always result in autism, readers!). I would leave that be, perhaps treat with supplements over the counter, for now (methyl B12, methyl folate) -- sad truth is, most docs know NOTHING about this condition! Also perhaps the mitochondrial "cocktail," and avoid statins like hell!

Now, then ... your diabetes could be mitochondrial, in origin, something to research ... OR:

Could be LADA. Either might cause low response to your efforts. I belong to a FB LADA group, and SOOOOO many there had GD, before a LADA diagnosis. So you need to see an Endo and get GAD-65 autoantibody testing, and also a c-peptide. Could be you are making to little insulin! I know that's a lot, but Blood Sugar 101 has a terrific explanation of LADA in lay terms ...

Keep us posted on MTHFR genes -- did you do 23andMe, like I did, or how did you find out? I am still at the start of learning about it!

yannah, Shanny and moon like this.
foxl is offline  
Old 11-30-2013, 18:27   #5
Senior Member
 
Join Date: Dec 2009
Posts: 24,394

Member Type
Type 2
Diagnosed in 2009

23930 likes received
32255 likes given
Default

Quote:
Originally Posted by libraterra View Post
Most days i am between 30-60 but sometimes it has been has high has 90-100. He didnt give me a range so i've been just using my fitness pal app to track it. I try to only do the "good carbs". Thats a good a point though, i should try to lower my carbs more consistently.
For us diabetics, there are NO 'good' carbs. All carbs raise our blood sugar, and that is not good. But the good news about it is that carbs are not essential nutrients . . . there's nothing in carbs that we can't get from other non-carb foods like dark leafy greens, fish, etc. So we have a nice big loophole for avoiding carbs!




yannah and Dodie37737 like this.
Shanny is offline  
Old 11-30-2013, 18:52   #6
Senior Member
 
Join Date: Apr 2011
Location: United States
Posts: 8,795

Member Type
Type Undiagnosed
Diagnosed in 2010

6333 likes received
12139 likes given
Default

I'd not feel too badly for not getting advice from your doctor. I agree you need more than a diagnosis, but even there maybe that's all you need. I set my own goals and I've found over the last 3 years that if I read all I could, especially BS101 thoroughly that we end up treating it ourselves. The medical field with a few exceptions are full of wrong information and thankfully I found that out soon after diagnosis. I do report how I'm doing, but my pcp just listens and will answer a question, but he doesn't pretend to treat me...he leaves that to me. After all, we are on our own with this monster and have to live with the consequences!




Dodie37737 likes this.
__________________

View Patdart's full Diabetes Forum profile here.
Patdart is offline  
Old 12-01-2013, 05:51   #7
 
Join Date: May 2011
Location: Illinois, USA
Posts: 1,476

Member Type
Type Pre
Diagnosed in April 2011

1540 likes received
1166 likes given
Default

Quote:
Originally Posted by Mary0110 View Post
How many carbs are you eating each day?
Quote:
Originally Posted by libraterra View Post
Most days i am between 30-60 but sometimes it has been has high has 90-100.
Quote:
Originally Posted by libraterra View Post
I am supposed to check my fasting a few times a week

My fasting is typically in the 130s
I hope as a new member in May that we didn't neglect sending you to Blood Sugar 101 to do some very important reading.

It is important to keep our bg below 140 to avoid diabetic complications. We do that by eating to our meter... testing 1 and 2 hrs. after taking the first bite of food. If either of those readings is 140 or above, we eat less carbs at our next meal. Before long we know which foods and how many carbs we can eat and still control our bg.

Gizmo is offline  
Old 12-02-2013, 19:29   #8
Active Member
 
Join Date: Oct 2008
Location: Ohio, United States
Posts: 36

Member Type
Type 2
Diagnosed in 2008

37 likes received
11 likes given
Default

Hi!!!! I have been very frustrated with Doctors!!!!!!!!!!!!! so I have taken on a huge amount of personal responsibility for Diabetes. I own it. This is a never ending journey. curves, bumps, trials, failures, triumphs. all in your own little world. Things that work for you, don't work for others. Things that happen to you, and don't happen to others. test, try change, exersize. count carbs, listen, reject, try. unbelievable the amount of time that goes into giving yourself as much good time on this earth as you can. its tough. its up to you. its lonely. except for the forums. and you can do this. be assertive.

Shanny, foxl, Shalynne and 2 others like this.
yannah is offline  
Old 12-02-2013, 19:31   #9
Active Member
 
Join Date: Oct 2008
Location: Ohio, United States
Posts: 36

Member Type
Type 2
Diagnosed in 2008

37 likes received
11 likes given
Default

Quote:
Originally Posted by Shanny View Post
For us diabetics, there are NO 'good' carbs. All carbs raise our blood sugar, and that is not good. But the good news about it is that carbs are not essential nutrients . . . there's nothing in carbs that we can't get from other non-carb foods like dark leafy greens, fish, etc. So we have a nice big loophole for avoiding carbs!
I have decided there are NO GOOD carbs. some though are more evil than others.

Shanny and foxl like this.
yannah is offline  
Old 12-02-2013, 20:23   #10
Banned
 
Join Date: Apr 2013
Posts: 283

Member Type
Type 1
Diagnosed in 2006

239 likes received
8 likes given
Default

Quote:
Originally Posted by libraterra View Post
I am T2 - i was diagnosed as IR 10years ago while trying to get pregnant. Now that i'm done having babies i have officially been diagnosed T2 so all my treatment is now through my GP instead of my OBGYN.
The best I can tell you at this point is get an endocrinologist that will take your condition seriously. T2 can EASILY turn into T1. The glucotoxicity your body experiences can shut down the islets of langerhans (sp?) and effectively mimic T1 without the autoimmune response.

It's what happened to me and I've had bad days ever since.

Quote:
The new dr does not seem invested in my treatment and i'm getting frustrated. All he has done is put me on the max dose of metformin for my weight and scheduled no follow ups or bloodwork. I am supposed to check my fasting a few times a week but he doesnt even want me to report it.
This guy is a farce and a half. A true caring doctor would schedule your follow ups immediately during your appointment. The problem here is without the blood work a bad thing can happen on metformin.

You can start to lose liver function. That is why a bilirubin check is always ALWAYS checked if you are prescribed metformin. In my experience and with my treatment options I always do a fasting bg check every morning when I wake up. It tells me what I should be doing basal dosage wise for my insulin treatment (doesn't seem you are on insulin perhaps you should discuss it with an endocrinologist?)

Quote:
My fasting is typically in the 130s and i'm starting to worry about that. 6 months ago i got really serious about my health and have lost 35lbs and now exercise 4-5x a week. I thought that would start to have an impact on my bg and it hasnt.
Congratulations on the weight loss! That is inherently important for any T2! Fasting level at 132 mg/dl? Well suffice it to say it could be WORSE. Perhaps a basal insulin injection (such as lantus or, my personal favorite, levemir).

However for your results that you say you are having I offer this:

T2 patients aren't just insulin resistant but they are also ketosis resistant (resistant to losing weight)! Ketosis resistance is good in a way because you won't have to worry about Diabetic Ketoacidosis (a true indicator of a type I condition) but it can suck when you are trying to lose weight.

When you work out, make sure your mg/dl levels are stable. Watch out! If you work out during a particularly high bg level you run the risk of muscle catabolism! The body begins to feed off the present muscle if it can't gain energy from the fat stores (insulin is needed for that process!).

Quote:
I live in a rural community and have terrible insurance so he is literally my only option for a dr at the moment. Im not very assertive generally but am willing to be pushy for my health's sake. I plan on calling next week to go back and at least ask for an A1C. If it's poor I wonder if we will have to talk about insulin?
Well fasting wise it wouldn't be needed because 132 mg/dl isn't that severe (my fasting glucose in the morning is at least 215 mg/dl when I don't take my insulin at night...just to see what my body is doing and how severe my condition is).

BUT we all don't fast before sleeping do we? We eat a few meals a day and we also laze about at night (meaning we don't really burn what we eat). I suggest taking a non fasting level after you wake up. In this way you can further understand what your body is going to be like when it is operating normally, not under the special circumstance of fasting (which is a rare thing for any of us to do before bedtime unless ordered.)

So I would actually do that test above then jot it down. Take that test a few times during the week then take those results to the doc and demand a basal insulin dosage (again that is Lantus or Levemir). Start very low (5 - 8 IU before bed or twice a day if needed at first then climbing from there very minutely until you achieve a good control).

I would also recommend a demanded bilirubin check for your liver as you are on metformin which is secreted in the liver. Just to be safe. Would hate for Jaundice to become an overall issue later on.

Quote:
I also have other disorders he isnt monitoring either (PCOS, MTHFR, hyperlipidemia). With the MTHFR he literally was like "what's that?"
Well if he doesn't know Methylenetetrahydrofolate Reductase is then that isn't surprising so no alarm there. BUT he should have researched it if he was going to be serious about treating you.

Polycystic Ovarian Syndrome can be very painful to deal with (I'm sorry you have to deal with it but I'm glad you were able to have children most with PCOS can't!) and that pain can affect cortisol levels.

I would suggest a cortisol level test as well. If it is elevated it can be playing a part in your overall insulin resistance. Cortisol effectively neutralizes insulin metabolization and effectiveness. So that might be an option for improving your treatment options.

justinervin85 is offline  
Closed Thread

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
Dealing with blood sugar spikes - type 1 diabetics thatladyiris Diabetes Treatment 8 07-19-2013 07:44
Dealing with unwanted advice.. Mr Perchy Diabetes Treatment 77 12-09-2012 03:10
Dealing with relatives and my new way of eating annsrum Diabetes 58 11-24-2011 17:16
As a woman and dealing with female things.... aimster1mo Diabetes Forum Lounge 8 05-25-2011 13:32
dealing with diabetes mona New Member Introductions 4 07-01-2009 18:02

LEGAL NOTICE
By using this Website, you agree to abide by our Terms and Conditions (the "Terms"). This notice does not replace our Terms, which you must read in full as they contain important information. You must not post any defamatory, unlawful or undesirable content, or any content copied from a third party, on the Website. You must not copy material from the Website except in accordance with the Terms. This Website gives users an opportunity to share information only and is not intended to contain any advice which you should rely upon. It does not replace the need to take professional or other advice. We have no liability to you or any other person in respect of any content on this Website.


All times are GMT +1. The time now is 16:26.




Powered by vBulletin®
Copyright ©2000 - 2020, vBulletin Solutions, Inc.
Search Engine Optimization by vBSEO
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2020 DragonByte Technologies Ltd.
User Alert System provided by Advanced User Tagging v3.1.0 (Pro) - vBulletin Mods & Addons Copyright © 2020 DragonByte Technologies Ltd.