Does anyone have a recommendation for an endocrinologist in the Austin/Central Texas area that gets low carb?
Sorry, I don’t know endo in Austin, but I do moderate low carb, or whatever I want, without help or input from my endo or diabetes team. I can’t even remember last time the topic of food or diet was discussed with my endo.
Why is that important for you ?
Are you looking for endo that will just not object to it, or one that will actively help and support you with it. How long have you been going low carb, or switching to it ?
Just seeing if anyone has found someone in this area. I’m no stranger to “smiling and nodding”, since I have gone through functional medicine. I have been low carb for several years, lately going keto since my current endo is hesitant to start insulin as my A1C is “normal”. BS initially went down nicely, but has been creeping up lately and my insulin level tested as going down, so know insulin is not far off. I am working on a plan for our next meeting.
When I was looking at New endos, one thing I wanted was someone who was my coach, not my manager. Some new doctors will set up interview appts, some by phone or letter, and this is how I eliminated those that wanted to be the boss.
From other discussions , I know some have problems with getting started on insulin as some doctors treat it as the last resort, and wait for A1Cs to be clearly out of range.
I’ve had to find a new endo this year after the doctor I liked retired. As it turns out, I did find one that agrees with my approach to managing my diabetes – and he does advocate low-carb, by the way - no, not in Austin. This doctor and his CDE/dietitian, as I said, advocate a low-carb approach – and, although the definition of “low carb” to them and to me is different, they admit that they have higher targets to make it easier for patients to follow. They do, agree, that even lower-carb works fine for those patients willing to follow it.
From my experience, all doctors want their patients to be the CFO of their healthcare team – I insist on also being CEO and COO!
I was also surprised at the wide range of amount of carbs per day that different people would consider low, medium, high, etc…
Finding an endocrinologist based on understanding my low carb (for me, < 75 grams/day) is not a top or even deal-breaking criterion. My last and now my current endo tolerate my eating lifestyle and I don’t think they fully appreciate how important low-carb eating is to my health. They have each chosen to remain quiet about my eating choices and they do acknowledge that my BG control is certainly good.
I find it hard to get past any appointment without what I’m sure they consider “due diligence” about warning me about the danger of severe hypoglycemia. Neither agreed with my low BG targets (80-90 mg/dL, 4.4-5.0 mmol/L) but do not push that too hard.
In turn, I try to hold back the dim view I take of the hyper-phobia they hold toward hypoglycemia. I also respect the power of a severe low to compromise my safety, I just don’t let it dominate my tactics. (I’ve lived with T1D for over 290,000 hours and I fully respect what a severe hypo can do!) With an average blood glucose of < 100 mg/dL (5.6), a standard deviation of < 25 mg/dL (1.4), and time spent low (under 65, 3.6) < 5%, I have the hard data that demonstrate my competence to safely manage my diabetes.
My biggest need in an endo is one who will be willing to write prescriptions for all my diabetes meds and supplies and also be open to try something new, like Afrezza. I also prize an endo’s willingness to prescribe something “off-label” to me, like a med indicated for T2D that might be able to also help a T1D. Their willingness to listen to my thinking and take some risk counts for something to me.
Their office staff must be willing to put up with all the frustration that pharmacy benefit managers seem to want to throw in their way.
All these factors and many more, including being a good listener, are important to me. I’ve become the world’s leading expert on how to treat my body’s needs for diabetes. I like when a doctor sees and acknowledges that simple fact. In turn, I respect their wide-ranging general knowledge of diabetes and their ability to thoughtfully read a lab report.
Good luck with your endo search!
I love these comments:
I wonder if you could contact Dr Stephen Ponders office in Temple. He is author of sugar surfin, a T1D, and an endo. May be able to provide recommendations for Austin.
Yes, this is certainly important – and something my current endo also has. Though he admits that he is waffling about my diagnosis, he has me listed as T1 (or perhaps LADA…), but considers the possibility that I’m a “burnt-out T2.” Regardless, last appointment, he prescribed Victoza off-label for T1 in hopes that I might be able to take advantage of its potential for causing weight loss. When that proved useless to me, he prescribed Symlin (with similar ideas), which, of course, is usually prescribed for T1s… He’s unwilling to try an SGLT2 inhibitor without some further testing, because of some studies that he saw that counter-indicated it for at least some T1s – but even that is an informed opinion, not a knee-jerk, or ‘by-the-book’ approach.
When the severity of the pancreas dysfunction is being masked by a keto diet. It’s common for the doctors to hold off on the next step in medication. I think there are benefits of adding insulin early, that waiting till the pancreas is fully burnt out. The insulin level testing…glucose drink OGTT and c peptide should resolve any push back on the need of a basal insulin to be started. you should fail that and a high BG with low c-peptide should trigger a need with your doctior.
I know this thread is old, but @SusanA1 were you able to find a doctor? I’m in a similar situation as you.
not seeing an endo, but rather a DO. he doesn’t take insurance, so I pay a monthly fee. supports Dr B, quick response for questions, labs, rx. I see him remotely via video conf, text, and his app.
Dr. Larson at Euphora Health
711 W 38th St Ste D1 Austin, TX 78705