How Do I Know if I am Being Treated Correctly by the Doctor

I have to go to a doc assigned to me thru this state plan.
He is an internist.
My home readings are higher than my fasting glucose test, which was 129, and my AIC was 6.2
At home, my readings, before meals and post prandial are between 120 and 220.
Sometimes, I have gotten those lows, where I HAVE to have something sweet. I try to hold off, and boy, I feel so guilty about reaching for a soda in a store, but I get weak and shaky.
The doc put me on Metformin. He put me on 500 mg once a day. Is this enough to make a difference? I am trying to lose weight, and I can’t…
I am very tired all of the time, and I am wondering if the Metformin will help. Since this is such a low dose, is it going to do anything?
The doctor said I do not need to monitor my blood sugar, but I got firm with him and said my home readings are higher than that glucose test. Maybe home meters aren’t as sensitive, but these readings are over a period of time.
Has anyone else been on Metformin 500mg ONCE per day?

Well, basing on the info you gave me, it seems that you do just have a “mild” case of type 2. having too many lows means either you are taking too much mes, not eating enough, or both. If unsure, you can always check with another MD. I am on met 3x/day, 500mg a dose. Don’t feel guilty about the soda, you needed it. But seems to me that you are doing ok. As i have seen on a hospital ad here in the Philippines, “Only your doctor can tell you what is right, but only you can tell what is right FOR YOU…”

But why is it when I take my blood sugar it is high? I am so fatigued all the time. The doc said its the diabetes. I have the red-brown vascularity on my legs, constant thirst, I wake up nauseated, and I can’t lose weight. I have gone down to 1200 to 1000 calories and still, I only lost ONE pound in 4 months!! I was exercising one hour a day,b ut now, I have no energy. I could fall asleep all of the time. Why have I felt so awful for the last year? Years ago, my doc said my insulin was very high. Now, my insulin is low.

I don’t have those lows all the time…

Do you go to a regular doctor or to an endocrinologist?

PS You have a cool name.

Hi Twixcookie,
I think it would be a good idea to give the Metformine once a day a try. But I do NOT agree about not checking your blood sugars. This is how you know how you are doing. I think you should use a controlled diet and the Metformin and definitely check your blood sugars and keep EVERYTHING written down, from sunrise to bedtime. It is nice if the Metformin will control things for you. You should also get a copy of the blood work and keep it in a file at home so you can go back to check it yourself the next time you have blood work done. If you don’t like the way things are handled by one doc, there are plenty more. But watching the way your body reacts to things is a very good idea.

Thanks for the information. I can’t change docs on my plan, so I am stuck with this guy.
If I don’t have a real case of diabetes, I wonder why I am on the Metformin.
I have been on the Metformin one time per day for about 2 weeks now.
I read that dosage of 500 mg isnt enough to cause any changes in the body.

First things first, I go to a GP, since consultations with her are free with my HMO.

By the way, what are you eating most of the time, and what medication are you taking? As i have read in the inserts of my glucometer (ACCU CHECK active), some medication can give falsely elevated levels. Or you may try pricier medication. (Insider’s tip: I was advised by a pharmacist assistant that the pricier the medicine, the better it works, i.e., branded vs. generic)

I am fat/obese, so her main advice was to eat less, and lose weight. I do hope you still are eating frequently. When I was on vacation in Singapore a week ago, I was eating every now and then, given all of the tasty food and deserts in that country. But since my cousin (an experienced GP), had us all walking all the time, my sugar amazing went down to 108 mg/dl! To think that I have been eating all of those delicious food and deserts all the time!

Check your sugar regularly. It is beneficial to know where you are at at any given time. And please, eat properly, even a normal person would feel sick if he eats less food than usual. It’s ok to eat, as long as the calories have somewhere to go to, that is, physical activity, which you are doing good, so just keep it up. And I do understand that you are stuck with your internist, but it should be your right to consult another doctor/health practicioner regarding the status of your disease. (I’m not sure about the US, but in the Philippines, doctors encourage it.) You can at least consult another doctor just for their opinion, though you are not necessarily coming under their care.

I am not a doctor, I just say these things from experience. Your best shot would always be health care professionals. But do remember, it is your body, not theirs.

Have a nice day! (and thanks for the complement…)

Okay, last visit to the doctor…he said not to bother with monitoring my blood and doing any special diet. I said, Well, my meter shows readings that are above the normal range. Maybe to him, if they aren’t 300…
I looked at him and said, I know enough about Diabetes to know it can ruin my eyes, kidneys, and heart. I said I had microvascularization on my legs. He didn’t seem to care. I know this is a vascular condition caused by the diabetes. He wouldn’t even look, but you CAN see it. It is very noticeable.
I go to an endocrinologist next week. So far, my experiences with doctors with this is that they don’t really care.
I have had really bad problems with the Metformin causing me sudden explosive diarrhea, and yes folks, I have lost it in my car. I couldn’t make it to a bathroom.
I had one near miss in Costco, and had to literally run to the bathroom.
This stuff is making me lose my dignity.

While it may be true that in the Phllippines, “the pricier the medicine, the better it works,” in the US generic medication is required by law to be effectively equivalent to the brand-name. The only difference is in the fillers or dyes, and of course shapes, etc. But the active ingredients, the time it takes to work, etc. must all be identical to the brand-name equivalent. This article explains a bit more:

With medications being so incredibly expensive, I can’t imagine any reason for insisting on brand-name, unless you are allergic to one of the filler ingredients or dyes (I have a friend who is allergic to Red #40 and has to be very careful to avoid it). But, as I said, the FDA requires generic drugs in the US to be functionally identical to the brand-name equivalent.

And Twixcookie, I agree that you should definitely be checking your sugars yourself. A fasting level of 129 IS high. “Normal” would be below 90. It’s practically criminal the way some doctors treat you. You were right in being firm with your doctor. As an internist, he is not necessarily the most up-to-date on proper diabetic treatment. I’ve had family lose toes and feet, eyesight, and eventually their lives to “a touch of the sugar,” all the while their old-fashioned doctors marginalizing their disease. See what the endocrinologist says.

If you can’t get help through your health-care system, do some research online (through reputable sites, there are a lot of “cure your diabetes through willpower alone” type of sites out there to prey on your fears). Start with Dr. Bernstein’s book, he advocates working primarily through diet and exercise. It really isn’t as important HOW MUCH you eat (although that is a factor) as WHAT you eat. You could be eating only 1000 calories a day, but if it’s all carbs, you’ll have a problem.

My best advice is to hang in there, be persistent, and be aware of your own body. Be as informed as possible, and make the changes that are within your power to make. We’re all rooting for you!

My doc put me on Metformin 500mg once a day two days ago. I was tired all the time, so I asked for something, and for the two days I’ve been taking it I’ve felt better (but I guess there’s still a long way today). I’ll let you know how it goes.

I see that you are on a state plan, but can you ask to be referred to a specialist? When I was on state insurance, this is what I did. Seeing an endocrinologist doesn’t mean that they will treat you right either, but it’s a start to have someone who deals with endocrine diseases all the time.

Hi, Twixcookie. You’re presenting tipical symptoms of diabetes. Your fatigue, nausea and thirst are symptoms of diabetes (my daugther feels the same way when she is high for to long and it coul be the begining of a DKA, so be very careful) You mentioned that years ago your doc said that your insulin was high; it seems to me that you had INSULIN RESISTANCE and due to lack of treatment you ended up with diabetes. I have Insulin Resistance and I take 1,500 mg of Metformin, 500 mg 3 times a day. I try to eat right and I do excersice a lot. My mother is T2 and my daughter is T1, so if I do not take care I might end up with a T2 diabetes.
My best advice is that you find an Endocrinologist, eat right and excersice more. Walking 30-45 minutes a day may do the difference.

I am going to an endocrinologist.
And I am looking for another internist.
I decided I am not taking that garbage from this guy.

Like if I suddenly got full medical insurance coverage by a private company, he would treat me better?
Thanks for everyone wrote!

I agree. I know years ago, when I went on the Atkins diet, and I wasn’t eating steak swimming in butter, mostly chicken, fish, eggbeaters, and tofu and tons of vegetables, I felt better.
I will take a look at Bernstein’s book.
I know my body cannot handle refined carbs anymore.

It is too bad too many docs don’t want to deal with diabetics, or if they do, they are so bad at it.
So is the ADA. They told me I could eat bread, cookies (just 2), and donuts (one, not six). I looked at them like they were crazy. I said I don’t eat those foods now. I said, "It’s not about me trying to get to sneak in goodies, I want to get well."
They advocate refined carbs, “in certain amounts”, but I agree with you.

The microvasculation on my legs shows I have vascular disease.

I will tell you, after working in medicine, I know how these guys are. I feel like writing to the AMA. Everything is money and liability now.
They don’t like me because I know how to take a history, and I know anatomy and physiology and disease. I know enough about diabetes to know it can cause strokes, heart disease, renal failure, gastrointestinal disease, and more.
All of those are in my family, so I feel I am for the fight of (for) my life.

Thanks for your good words, you sound like a strong lady!