Interesting doctor visit

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Interesting doctor visit


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Old 02-03-2012, 01:04   #1
AnnC
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Default Interesting doctor visit

I'm just back from my visit to the doctor to get the script for my HbA1c. My doctor is on leave and I was the first in for the day to see her partner. There was nobody in the waiting room, so we had a good chat. He is very thorough, this doctor, and also naturally more informative than my usual doctor.

Anyway, he said a few interesting things. One was that the aim for newly-diagnosed T2s is an HbA1c of 6.1. I was under the impression that anything under 7 was OK. He was also impressed with my log, and said that I should expect a 6.0 when we get my results back.

He said that they would not put me on any medication at this stage, but that I would need to go to medication, then stronger medication, and eventually insulin. I queried this, asking him if I could keep my bg down in the normal range, could I stay on diet and exercise only for ever. He said no, my pancreas would continue to deteriorate, and that while I could delay the deterioration, I couldn't stop it. He reassured me by saying that it wasn't my fault (wow!) and that I should continue with what I was doing.

Oh, and he didn't turn a hair when I told him I was on LCHF, just agreed to get my cholesterol tested.

He also answered a couple of questions I had about some of the test results I'd recorded.

All in all a good visit, but bad news about the progression of the disease...


Last edited by AnnC; 02-03-2012 at 01:05. Reason: Grammar!
 
Old 02-03-2012, 01:46   #2
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I'm not sure I believe the progression theory. After 5 years I am still on metformin and usually keep my bgs around 100 or under. I have gotten my HbA1c down to the low 5's. I think if you do that and continue with the low carb you may be able to beat progression. I think doctors are used to seeing patients who keep their bgs a lot higher. My husband has been Type 2 for over 15 years and keeps his HbA1c in the 5.3-5.8 range and is still on oral meds.

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Old 02-03-2012, 02:08   #3
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I'm not sure I believe the progression theory. After 5 years I am still on metformin and usually keep my bgs around 100 or under. I have gotten my HbA1c down to the low 5's. I think if you do that and continue with the low carb you may be able to beat progression. I think doctors are used to seeing patients who keep their bgs a lot higher. My husband has been Type 2 for over 15 years and keeps his HbA1c in the 5.3-5.8 range and is still on oral meds.
That's good news. Has either of you had to increase the strength of the oral medication since you started?

 
 
Old 02-03-2012, 02:26   #4
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I now take the maximum of metformin - 2550 mg and my husband is on the same dose of Actos for 15 years. I want him to get off of Actos because of some of the side effects. But so far it has worked very well for him for 15 years. I've been D for 5 years. I stick to a fairly low carb diet, my husband eats a normal carb diet.

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low carb organic diet
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moderate exercise- mostly walking 3-5 miles, tennis - 4 hours per week, weight training, hiking on weekends and vacations 7-10 miles

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HbA1c 6.1 5/12

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Old 02-03-2012, 02:31   #5
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Ann sounds like a great visit with an open minded doc, wish he was in my area
My thoughts towards deterioration I feel depend on a number of factors ie how many beta cells are left, BG control etc, Jwags & hubby have done so well & worked hard at keeping tight control which gives great hope to us all that yes we can at the very least pause the progression for many years, if not completely stop it
My worry is that as I get older I may not be able to keep up the same level of intensity as I do now, & I know for me from recent illness & being unable to exercise my numbers did increase by almost 10 points, for me exercise is almost as important as diet, but no point worrying about what May happen
You are doing all you can with diet & exercise & getting good results within a short period of time
Looking forward to hearing your A1C results

Sent from my iPhone using Diabetes

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Old 02-03-2012, 03:22   #6
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I don't believe the progression theory either, Ann . . . I think all of these progression notions are predicated on cases of poor control. They don't know how to act when patients take responsibility and succeed. They're going to get another surprise when your lipids profile comes back . . . I hope this partner doc gets to see it too.




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Old 02-03-2012, 03:33   #7
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I don't believe the progression theory either, Ann . . . I think all of these progression notions are predicated on cases of poor control. They don't know how to act when patients take responsibility and succeed. They're going to get another surprise when your lipids profile comes back . . . I hope this partner doc gets to see it too.
I'm really looking forward to the lipids profile, even though it's only 3 months, because I've been really good, and it hadn't been too bad before I changed my breakfast from mixed fat/carb (wholemeal toast with lots of butter) to totally carb (noodle soup). So I am really hoping that there is a definite pattern of sudden change to the bad to sudden change for the better.

I'm hoping he will approve the results on Monday so that I can access them online. I forgot to tell him I had signed up for this at the lab's website, but I can always ring up on Monday and ask the receptionist to request that for me.

 
Old 02-03-2012, 03:37   #8
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My worry is that as I get older I may not be able to keep up the same level of intensity as I do now, & I know for me from recent illness & being unable to exercise my numbers did increase by almost 10 points, for me exercise is almost as important as diet
Yes, my bg numbers have increased a bit with the weather problems, so I can see how effective the strict adherence to exercise can be. Having the Wii has helped, I'm sure, but illness and increasing age can't be helped with a Wii.

I'm sure you will get back down to your previous levels very soon now you're getting over the cold.

 
Old 02-03-2012, 11:24   #9
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Yes, my bg numbers have increased a bit with the weather problems, so I can see how effective the strict adherence to exercise can be. Having the Wii has helped, I'm sure, but illness and increasing age can't be helped with a Wii.

I'm sure you will get back down to your previous levels very soon now you're getting over the cold.
I'm 100% with Shanny on the subject of progression. Yes, the condition of your pancreas will deteriorate if you continue to stress it with high carbs backed up by insulin stimulating drugs like Prandin or worse yet, using the ADA standard to define "good control".

Letting your pancreas go at its own pace by keeping the carbs down will allow it to keep on coping for a long time. Consider the situation with diabetics like Dr Richard Bernstein ("Diabetes Solution" well worth a read), or our own forum member Richard. Both these gentlemen are in their 70s and have been managing their condition for over 60 years! Ok, they are now on medication but they went through the period before the availability of meters that allow us to track our figures quickly and easily. In his recent post Richard acknowledges the issues he had before the advent of the HbA1c test and meters, so his success is to be applauded even more for that!

If I can go as long as he did(even with medication), I'll only be 125 - I suppose that'll have to do

John

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Old 02-03-2012, 11:48   #10
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Last edited by AnnC; 02-03-2012 at 11:58. Reason: Munged the quote
 
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