To clarify the clarification...

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To clarify the clarification...


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Old 10-30-2011, 09:47   #1
Peter_V
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Default To clarify the clarification...

(Wow they close threads quick around here)
Quote:
Beefy posted:
To simplify it, I meant I was stunned that a Dr. would place someone on ALL THREE AT ONCE without even looking at insulin.

A doctor with any diabetes knowledge, before sticking a Type2 on all those oral meds (in addition to the Met), should ensure the patient is exercising, following a strict low-carb diet (not low-calorie though) and taking their metformin at the maximum tolerable dose.
Fortunately I'm not seeing this doctor (Nurse Practitioner actually) anymore.
However, they didn't have time to see how I would react to exercise, etc.
And now for the rest of the story....

I was initially diagnose with a fasting glucose level of 310 and an A1C of 12.1. The NP put me on 500 mg of Met once a day and gave me a glucose meter with strict instructions to ONLY test my glucose first thing in the morning. She then gave me a hug, told me how sorry she was that I had diabetes and sent me on my way. No instructions on what to do or eat (besides when to test), no pamphlets, nothing.
So the next evening my wife made sweet and sour chicken over white rice and I had a nice large plate of it (though I went easy on the sweat and sour sauce)
About an hour later I started feeling kinda strange and decided to ignore the instructions about only testing in the morning and I checked my blood sugar. But all the meter displayed was a nice cheerful "Hi".
So I dug out the manual on the meter to see what that meant and apparently it can only read up to 500; for anything over that it just says "Hi"
So I called the nurses helpline and asked what I should do and they said I should probably go to the emergency room.

At the emergency room they tested me with the fancy meter they have there and it said "High"... apparently the expensive meters are a little more verbose.
So they admitted me, drew some blood to send to the lab, gave me some insulin and 4 or 5 bags of saline and about 4 hours later my BG came down under 200 and they sent me home. The Lab said my BG was at 520, so probably not a real emergency, but I couldn't tell that without the lab work.

Anyway the doc at the emergency room seemed a little annoyed that I hadn't been told what to eat and was only on 500 mg once a day of the Metformin, so he upped it to twice a day and told me to go back and see my PCP asap.

I got back in to see the NP the next day and she chewed me out for measuring my glucose after a meal telling me "It will always be high after a meal, that's the worst time to test it". Then she upped the metformin to 850 twice a day and added the Actos and Glyburide...and dug up a pamphlet on Diabetes.

FWIW Diet and exercise seem to be doing the trick I stopped everything but Metformin a couple weeks later and I stopped the Metformin 2 weeks ago. Right now my Fasting BG is jumping around a bit from a high of 113 to a low of 92.

A couple months after the above incident they changed my PCP, the new Doc put me added Aspirin and Lysinopril to my meds even though I have reasonably low BP and wasn't leaking any micro albumin into my urine. He said it was a prophylactic to prevent problems. Only it dropped my BP so low that I kept greying out every time a stood up, a month or so of that and I got tired of the sore knees so I quit taking the Lysinopril too.

They've changed my PCP twice more since then. I like the one I have now, she actually listens to me and is willing to work with me. She is the one that did all the tests for deficiencies when I asked for them and she upped my prescription on test strips so I get enough to test ~4 times a day now.


Last edited by Peter_V; 10-30-2011 at 09:52.
 
Old 10-30-2011, 14:14   #2
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Sorry you have had such problems with doctors, Peter. I'm not sure if any of us really get the correct information at diagnosis. I was only 240 at dx and didn't get much different info than you. When I asked about testing they told me it was totally optional for Type 2's. It wasn't until I got online and met a lot of other diabetics that I found out the real story. I had to go in and ask for metformin and then I had to ask to increase it 3 times. Since my insurance doesn't pay for any strips I have to go online and buy my strips. It is expensive but worth the price of my health. Unfortunately I am one of those who still need medication despite low carb diet and a very normal weight. But I'm OK with that as long as I can see those low HbA1c's in the low 5's.

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HbA1c 6.1 5/12

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