Discussion with Dr

Hey everyone!

My name is Breanna and I was just diagnosed with prediabetes/type two diabetes in May. (I’m on the borderline of the borderline) and so my doctors first knee jerk reaction seeing a 22 year old with insulin resistance and pred/t2d was metformin. Nope. Never again. I straight out refused to take it after 1.5 months.

So we talked about Januvia but she wanted to get with an endo first to get it approved through them. Well here’s the big question: should I ask to speak with the endo she verifies with? Should I worry about an endo at all?

I’m trying to conceive and so since pregnancy throws a big wrench in glucose control I’m thinking I should but…

Also, I got a one touch meter but it never seems correct for my glucose results. I’ll be getting 140 on another meter and yet on the one touch I get 105. That’s way out of the 20% range that they are allowed to be. So I called one touch and they are replacing that meter. So I wanted to be happy about that.

Though a lot of your questions are outside my experience, I can tell you that I had very inconsistent readings with one-touch… So much so that I chose to buy my own strips out-of-pocket instead of using one-touch, which is the only option covered by my insurance. Some other people love them though, so all I can figure is that for some people they are accurate and consistent, and for other people they are not.

I frequently saw back-to-back comparisons with the same drop of blood varying by more than 20% with one-touch. Plus the ultra blue, which was the only strip they offered then, requires more than twice as much blood as the strips I like… And I’m not much of a bleeder so that was a big difference to me also.

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Thank you! I am glad I am not the only one having issues with it. I have used the AccuCheck Aviva and the Relion Confirm and they both gave me pretty spot on answers. But this one touch. YUCK! Numbers all over the place.

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I have seen GP’s and endos for my diabetes. I can attest that Endo’s are in my opinion far superior. I feel strongly that seeing an endo is a terrific step. This does not say all GP’s are bad, only that an endo’s are in my opinion a more specialized and yes i have never regretted my decision to find a specialist.

rick

I hate to disagree, but I will probably never see an endo again. They seem so afraid of hypoglycemia that I was encouraged to let my A1c rise above 7.0% to nearer to 7.5%. This could be because I am over 70 years of age.

I am on insulin as a type 2 and have been since three months after diagnosis. I fortunately have a nurse practitioner that is encouraging me to have the best A1c I can obtain and I am also working with a PharmD that is monitoring my blood glucose readings. I only see them two times per year.

I use the accu-check aviva and would not use any other meter or test strips. I can understand those people that need to use the Relion. I have a friend on them and he says he gets fairly reliable readings and has been within 7 mg/dl when he checks them when he has the A1c done.

Best of luck

Ironically, I had better readings with the OneTouch than the Accu-Chek (which I mostly use now). The OneTouch always was right on target with my lab’s results – I am in the habit of taking a test whenever blood is drawn for a CBC - so I can compare. The Accu-Chek usually gives me higher numbers. FreeStyle gives me lower numbers.

All that said, the differences really aren’t that significant - the main concern, in my opinion, is to work on improving your BG overall - as long as you test consistently with one meter and work to get those results more in range consistently, you’re heading in the right direction.

By the way, both meters could be off by 20% - and the ‘real number’ is in the middle.

I agree and disagree, @Robert_Fenton. I am also a type 2 on insulin and, though I have had to change endos, I have overall had a good experience for having seen one (or three). The endos I have seen have gotten me on a CGM and a pump - both of which have helped me a lot.

Yes, endo’s are very afraid of hypoglycemia, but so are many nurses and doctors of all types. One of my docs focused on on hypo eposides ahead of other concerns I had. I’ve gotten past that, however. My approach - right or wrong - has been to learn as much as I can about diabetes management and treatment options. The more you know, the better you can take advantage of the expertise of healthcare professional of your choice. My endo doesn’t ask me about hypo episodes anymore, and my A1c has been in the 5’s for over a year. Don’t know if I can keep the A1cs there, I sure want to try.

You are fortunate Thas. I could not argue or even disagree with the endo. I was given an ultimatum and when I protested, I was told that was what I would do. A friend in our support group was dismissed by the endo when he got a 5.2 A1c. He had been told to get it above 7.5. He had told them it would be what it was. He was also accused of having a second meter for the bad readings which I knew he had only one as we both have the same meter and get them from the same source. In addition, the endo would not do what yours did for you as another type 2 had asked and been told no. And in this person was under 65 and his insurance company would have paid for it as he later got one from another doctor.

This just tells me that there are good and poor endos.

Wow that sounds crazy. How could a doctor like that stay in business and not have a chronically recurring broken nose?

There are good and not-so-good doctors of all kinds. I’m sorry your endo is so unhelpful. My previous endo was generally supportive of the goals I wished to acheive; however, he was convinced that the headaches I get when my BG is a bit high were, ahem, “in my head.” At my last visit, he suggested that I deliberately let my numbers slide up a bit (to supposedly help me lose weight) and deal with the “headaches” by seeing a psychiatrist. I declined, to which he responded that my case was clearly “beyond his level of expertise.” I have a new endo who does not think I’m crazy now :smile:

You don’t have to take Metformin, you can ask for Diabex XR or any of the other XR diabetes drugs, they are long lasting and are MUCH kinder on the stomach. I take Diaformin, the pharmacist sent me home wilth Metformin as a generic medication, it was horrible, so I am back to Diaformin. I think it would be a good idea to see an endo, but do not let them palm you off with Metformin, the extended release drugs are much better to take.

That’s astounding…usually, when your numbers are in "the borderline of the borderline"
doctors will want you to attempt control via lifestyle modifications, as opposed to jumping on the Metformin train, or even Januvia right away!

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Hi @Robert_Fenton! My previous endo sounds like the same one you saw. I call him “He Who Shall Not Be Named.” He also gave me terrible care, had a horrible bedside manner and was corrupt. He refused to prescribe insulin (I was on triple therapy) saying that it wasn’t worth the hypo risk and he pointed to the ACCORD study and also suggested I increase my A1c to 7%. He even told me he was off to give a talk on the subject. When I quoted the principle investigator of the study as saying that hypos were not a cause of excess mortality he just blew me off. He was very arrogant.

But I have to say my current endo is the exact opposite. She has been very supportive of my regime and I have a very good A1c. She does ask about hypos but it is really just a matter of making sure I am not taking any undue risks. Selecting a good doctor can be very hard. But if always have the right to fire our doctor and look for a new one.

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Our main goal is control before pregnancy to minimize the effects that diabetes can have on pregnancy. My body is weird and I trust my doctor. We try to make lifestyle changes but I was up front and honest with my doctor when I told her sometimes I don’t have the willpower to do anything other than eat healthy-ish. I can try to go to the gym but ultimately I’ll forget.