Am I the only one thats bothered about healthcare providers having 24/7 access to BG numbers?

What type of insulin therapy are you on? MDI, insulin pump, or something else? I’m on a Dexcom Tslim with Control IQ and my endo sees my reports every 3months. If anything my doctor would ENSURE I had full Dexcom access if I had too many lows. I’d be altering my basal rate and carb ratio and my Control IQ pump automatically stops any insulin delivered if I hit below 70.

THIS 100%. I would NEVER allow a doctor to talk to me like that.

Yikes, my reaction is the opposite. I spent a couple decades going to an old school endo who had absolutely no interest in looking at any of my diabetic data, even though I carried it with me in detail and summary form on my meter. The problem with that is that managing diabetes is ALL about data, and making use of that data to improve control. I was doing fine on my own, but we can all use the advice and input from others, especially those like endos who should be able to make sense of the data.

As it was my endo was just my prescription writer. After he retired I stopped seeing endos entirely, until I needed to see one to get a prescription for a cgm. My new endo actually is interested in looking at my numbers, and I’m happy to share them with him. Of course I won’t always do what he thinks if I disagree with it. But it is great to be able to share and discuss my data with a knowledgeable doctor who sees diabetics all day long.

Now my willingness to share data goes only as far as my doctors clinic - I wouldn’t want it going to my insurance company or others. The insurance company role is not to advise me on my data, but simply to take my money every month and help cover some of the costs.

Now that Im on the Tandem with the Control Q, I don’t care who sees my numbers. My numbers are good, which is a whole lot of work even with a smart pump and accurate CGM. I used to have to hide my fingers when doing bg test at work because coworkers couldn’t stand to see blood. Diabetic Revenge. I could laugh at them.

Am I bothered by sharing with my medical team, no. But I have a team that has already set goals and guidelines. We have agreed on time in range targets, standard deviation targets & a1c target but that has fallen off now. Not as important as it use to be. I share with my team and the medical team at the research center. If I have an issue they can pull up my reports & offer suggestions.
My endo once last year, jokingly asked me about a high number that happened during the 2 weeks before the appointment. And I looked at him like he was nuts, and than he laughed and said, I got nothing! Everything looks great! That was when we talked about coming in every 6 months instead of every 3-4 months.
I had a doctor once that did the micro managing and I must say he didn’t last long. I certainly hope you can find someone else who talks to you like you are part of the team.

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Hi @mohe0001, I had a similar situation, but my newer doctor draws blood first and tests glucose and Hga1c. My pump and BG meter both were reading a normal range value of ~120. When I was in the appointment, I was informed to have a snack before I left as my BG was in the upper 60s. I can only think the algorithm was off, but it was kind of scary. I thought of blaming the person that drew the blood (so maybe I was low). The doctor said later he has had a patient with a BG of 21 in his office and they were lucid. I’m afraid of going low. I’m glad they checked my BG.

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I am pretty much on the same wave length as most people here. I read an interesting article about how the discovery of insulin had a dramatic impact on the physician-patient relationship because suddenly diabetics could be autonomous and independent from their doctors and self-management was encouraged. I’ve had diabetes for about 53 years and I also was taught that I was in the driver’s seat. In those days our main relationship was with a family doctor, not the endocrinologist who people just saw if it was needed. Things have evolved over the years in both good and bad ways.

I think there’s too much monitoring of patients with diabetes.

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Hi Colleen,
Do you think doctors receive some kind of reward for how well their patients are taking care of their diabetes?

I live in a big city. I have A large insurance company. And the doctors all work for the same entity, different from hmo but sort of in that managed care world.
Not sure if the management tracks it, but the doctors kind of compete with each other.
Diabetic complications are a big one. If one doctor has a high number of patients with complications, then other doctors sort of look down on him, or brag a little.
I don’t think it’s a bad thing. They truly want their patients to do better and that makes them a little more accountable.

But it has drawbacks, if you want to change doctors within the system and you are not well controlled, you are dragging down his averages.

I would be surprised if that were the case. However, it’s no secret that some doctors get money from manufacturers for prescribing the drugs they make. Here is an article about that - one of many (you can Google it): https://www.propublica.org/article/doctors-prescribe-more-of-a-drug-if-they-receive-money-from-a-pharma-company-tied-to-it

It’s against the law for doctors to get anything from drug manufacturers. Even tickets to events or even swag.
Not to say it never happens, but it is against the law. It’s a law taht came into effect in the early 90s.

It’s much more likely that doctors would order un needed tests for laboratories that they might own. Even that is against the law but is easier to pull off.

My doctor tells me she can only order what’s on the formulary and they push the generic drugs because it’s cheaper.
I was changed from humalog to novolog and back again, but everyone was switched, it was an insurance decision not an individual doctor thing.

I am amazed that anyone’s doc does that, mine doesn’t. I would change docs if they did. The only time I upload any data is at my visits about 3 to 4 times per year, less this year due to the pandemic.

I do it at the office the day of the visit with the CDE. I used to do it ahead of time for three months and email it to her- I don’t have time to do that anymore so she looks at a two week period or so when I am there. And of course they monitor a1 c which is stable.

Just when you think the world has run out of maggots

Hi Timothy, unfortunately it isn’t illegal for doctors to receive gifts and money from manufacturers. They also get most of their information about the drugs they prescribe from the companies that make the drugs. That’s true in the US as well as other countries, including Canada. Drug companies' payments and gifts affect physicians' prescribing - STAT

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This thread reminded me of a website I came across a few years ago on which you could search for your doctor to see what companies gave them money, and how much. I think this is it. It’s from 2018.

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They get gifts, constant free lunches, everyday for some. Cruises and trips (one dayish of training). They get paid/bonuses by insurance companies to prescribe cheaper drugs, especially for oncologists this can be a big payout. They can make money by dispensing said drugs themselves too.

They have proved that even a small $25 gift influences prescribing a specific medication.

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You might be right. It was banned in California. I though it was everywhere in the us.

You can turn off the coaching option by simply not agreeing to receive texts and calls from them. (This is very useful if you are unable to receive phone calls at work.) It’s not very specific: it’s either ON all the time or OFF all the time (useless for nightsiders like me who need to sleep during the “normal business hours” when everyone calls)…

That’s a bit of an inverse of the idea of “Accountable Care Organizations (ACOs)” under Obamacare: they get penalized when their patients don’t do well or need more care.