Honestly, if you can’t replicate a lab result, it’s hard for me to understand making any treatment decisions based on it. I had one random high urine protein (like… indicative of moderate CKD) result once out of the blue, was urged not to panic by my endo and retested next time I did lab-work within a couple months, once again totally fine. Same thing has happened to me with cholesterol, a random blip reading that is well off from my normal, fairly stable levels, never to be repeated (and that was many years before, in a different lab system). Labs can be wrong, and urine samples in particular can get contaminated. Always a good idea to repeat if possible and especially for informing longterm care, before assuming something is meaningful…
3 Likes
Thank you so much for your response, this makes me feel so much better. I think many endos will put tons of their patients on either ACE or ARBs because the side effects are minimal and the (just in case) benefits would be substantial. I guess there is little hurt in keeping blood pressure low.
I feel that he isn’t adamant about keeping me on losartan, and even asked a couple times and confirmed my kidneys are fine, but I think he figures it is a potentially helpful thing since I have had minimal to no side effects. I am sure he would have let me get off if I really didn’t want to take them, seeing as he asked me several times.
What was so weird is that he saw protein ONCE and then immediately put me on losartan.
It went:
“Oh, little bit of protein, I’m going to put you on losartan.”
and then next appointment, 3 months later
“Protein is gone”
It’s like…yeah…well…you didn’t even confirm it bro…
Maybe the Losartan worked? 
I know I’m coming in late on this but I feel that doctors in general are all too quick to prescribe medications. I am totally against preventive chemicals just because I am a T1. I take insulin, levothyroxine and an occasional Tums. I eat a lot of veggies often laced with a bit of meat. I refuse to ever have any cholesterol tests. My endo even wrote it into my medical record that I am NOT to have tests for cholesterol. And I don’t. No point to it because I would refuse to take a statin. I consider myself to be a very healthy individual in spite of T1 and several auto-immune conditions. None of it interferes with my life. My dentist even commented once that, unlike almost all of his other senior patients, I produce copious amounts of saliva. And that’s because I take NO medications. Other seniors my age take a bucketful and all suffer from dry mouth and whatever else. I also stay away from doctors as much as is possible and refuse ALL so-called “preventive” testing. I feel that is the reason I got to be 81 years old and am aiming for another ten at least.
3 Likes
Yeah but we don’t know if I needed it, aka I probably would have been negative without the losartan. He never conducted a follow-up test before putting me on the drug
Individuals who have all sorts of personal and family medical issues besides diabetes!
My personal pet peeve is the conversations with my doctor about my feet. I have very high arches, wide toe spread, and one leg is 5/8" longer than the other. I have had ligament problems in my feet since I was in my late 20s. I have nerves in my feet that get pinched easily, so I have to make sure that shoes don’t put pressure on certain areas. However, as one of 7 siblings, but the only T1D, I see variations on all of my foot issues in 4 of my siblings (that’s 5 out of 7, including me). But all my doctor will do is to go on and on about neuropathy!
That’s frustrating! I have a podiatrist whom I really like who listened to my symptoms (I was concerned about numb areas on one of my big toes) and took one look at my hypermobile feet and said it didn’t sound like diabetic neuropathy at all (apparently highly localized diabetic neuropathy is not a thing), but rather joint inflammation from hypermobility impinging a nerve, resulting in numbness. Physical exam confirmed all numbness was very specific to that one nerve. Nothing really to do about it (besides do things to prevent worsening joint problems, which I am), and I still have to be careful with that foot, but it was a huge relief to know it wasn’t part of progressive diabetes complications.
If you aren’t seeing a good podiatrist about your feet, definitely go that route, and then if your other doctors ask, you can say it’s being addressed. And if you already are and that’s who you are talking about and they aren’t recognizing and addressing what sounds like structural problems (including from your description likely hypermobility), they are not a good podiatrist, and I would find a new one! It was seeing a smart podiatrist a long time ago that was one of the initial reasons I eventually got evaluated for and diagnosed with a genetic connective tissue disorder that explained my feet and so much more.
3 Likes
Being a member of the Type 2 clan, a possible reason for higher retinopathy and other diabetic complications in my confreres might be that many of us aren’t intensely managing our disease as Type 1, Also many are not diagnosed until symptoms occur. There could be wildly oscillating BG levels, doing silent damage to kidneys, nerves and eyes.
I was diagnosed because I had two incidences of very blurry vision, not caused by retinopathy but high BG. The ophthalmologist suggested I get my PCP to do a fBG as this was a symptom of possible diabetes. Yeah, fBG was 400 tp 450mg/dl, I forget the exact number. Chances are my BG was running higher that 200mg/dl for several years.
As to non-compliant type 2 DMs, my internist cycling friend is angry that her type 2 patients won’t take their condition seriously.
Yes I think the biggest danger to type 2 is that you can go years without knowing you have it.
All that time it is doing damage.
A type 1 can’t ignore it because we will die pretty fast if we try.
Of course a type1 can manage poorly and allow high sugars etc.
but at least we know that what we are doing is bad for us.
The older I get the more I realize how important it is to stay in range, I am also grateful that I can still ride a bike and go hiking in the mountains, go swimming and enjoy my families company.
For now I don’t really have any diabetes related issues, and I want to carry that torch to the finish line.
I’ve tried so many different ways of eating none is perfect.
Right now doing high carb and low fat and being relatively successful. I’m not hungry and my sugars behave pretty well.
I am always open to new ideas though.
2 Likes
What I have learned from 32 years since diagnosis, it this diabetes is not static, no matter which type, how old you are and what gender. From Mad Eye Moody of Harry Potter, “CONSTANT VIGILANCE!”
I am showing some microalbumin the last 2 labs. That causes me to worry about kidney function. As to diabetic retinopathy, about 6 years ago my ophthalmologist detected a small spot. At my last exam by a retina specialist, it is gone. He did see a thin spot in the retina of that eye, but no blood vessel abnormalities.
The big changes in my BG management has been going on MDI with a Dexcom CGM. After a year of MDI I got a pump in January. My time in range is very good, since starting MDI. I have no clue what it was in the years of finger sticking. In the 2 months before I started MDI I was doing between 10 and 14 daily tests, because I was seeing an uptick in fBG and postprandials that weren’t responding to diet and exercise.
1 Like