After 27 years of Type 1 diabetes and countless appointments with many endocrinologists, I’m beginning to doubt whether the result justifies the effort. Every three month’s it’s the same drill: get blood drawn for lab tests, print seven days of CGM curves, then show up for my 15 minutes of face-time with the doctor.
I think that the 15-minute appointment is a joke. If I carefully prepare my list of issues, he rarely has time to address them all. He looks at seven days of glucose numbers but I don’t see how he can even begin to assess the state of my metabolism, much less make any useful recommendations.
When I started on the DexCom CGM, I brought my laptop to show him several key charts and graphs that I was using to inform my day-to-day decisions. He was not interested. In fact, any data that I give him must be printed.
I feel that he’s not making use of all the data available from the pump, CGM, and finger-stick meter. To just look at seven days of CGM curves leaves out a great deal of available data. It’s like looking at an extensive room through a keyhole. What you see is reality but reveals little of the overall truth.
With the economic realities of the modern practice of medicine, there’s no way any doctor could spend the time required to consider a wide swath of diabetic data. Even if he were interested, there’s no way he could give any one patient that kind of attention.
When my doctor starts to make recommendations regarding my pump settings I feel that he’s relying on an incomplete understanding of what’s going on with my metabolic life. In fact, I don’t respect much of what he offers because I don’t feel he’s done his homework!
I’m starting to think that I’d prefer a more aloof practitioner that will just write the needed prescriptions and accept my primary role. After having lived with Type 1 diabetes for so long, I’m beginning to trust my judgment over my doctor’s. I know they have more training but there’s no way they can fully appreciate what it’s like to live with this disease.
Every time I go in now, I’m finding myself more cynical about the whole process. Sometimes I think that he’s resigned himself to treating the pantheon of maladies that plague diabetics and doesn’t believe that diabetics can ever reach “near normal” blood glucose values.
Maybe that’s what bothers me the most. I think he’s given up on creating success stories and has settled for managing the brutal complications that most diabetics face in their lifetime.
This is my fifth endocrinologist in 27 years. I don’t think that my idea of ideal care exists. I’m considering just accepting the reality of it, visit the doc two or three times a year and reconcile with the fact that I am the best doctor for me.