My BG has been running in the upper 200's for awhile now. Occasional dips into the 100's but mostly really high. I've called my PCP to see if he'd put me on insulin or at least give me an insulin pen to bring down the spikey highs. He said that he didn't feel it was necessary at this time. I asked for a referral to an endo and was turned down and none of the endos will take a patient without a referral from their primary doc. I'm ready to give up and just let the BG go where it wants to. I'm on Januvia and glyburide but lately they don't seem to be working as well as they used to. Any ideas? Anyone?
OMG! as a patient you deserve to see a specialist, I would insist, and ask him/her if they had diabetes, it they would want to see a specialist to ofset the risk of diabetic complications. really, how absurd, i think most pcp's are more than willing to refer out, it saves them the liability, maybe you need a new pcp! in the mean time have you considered trying low carb or increasing your exercise. I'm a mom of a type 1 but also an exercise physiologist who works in health care, best wishes! amy
I agree you should fire the PCP immediately. You are doing what you are supposed to do as a person with diabetes and it sounds, to me at least, like you are making exactly the correct conclusion that you want to try taking your care to the next level. I had a PCP when I wanted a pump and I could tell he was relieved to say "well, you need to see an endo" as I'd blown off that suggestion for years.
Sunday morning I was at 256 fasting. I ate cottage cheese for breakfast with a little cinnamon and nutra sweet then went on a long walk. Before lunch I was 250. I chose not to eat lunch and before dinner time I was up to 269. No food on board and about an hour of cardio. Before bed - still no food 221. I took extra glyburide before bed and by morning I was down to 177 fasting. That's the lowest I've been. I just talked to the doctor's office and he wants me to increase the glyburide to maximum. He refuses to put me on insulin and he said there's no need to see an endo at this time. I think I'm going to go over his head. BTW I work for a major regional hospital system and so does the doc.
You need to by-pass your PCP and see another one. Just when does he think you will need insulin ? You need to make some noise and tell him if he won't put you on insulin you will seek out another doc. You have to be your own advocate, we all do. I think having all those BG over 200and 250 will lead to complications sooner rather than later. Tell him that !!!
I would hate to see you have to wait until you go DKA and get hospitalized before you get referred to an endo!! Put your foot down and get yourself the help you need. Wishing you the best of luck :)
I dont understand why some dr's are unwilling to get people on insulin??? I never ask my dr for anything I TELL him what we are going to do... its MY body! And I pay his salary!
I always find it places the "fear of god" into doctors to make clear that they are "responsible." The AACE has a treatment guideline that recommends insulin when your A1c is above 9%. Your doctor violating standards of care and placing your health at risk. A simple letter pointing out your doctor's refusal to provide a minimal standard of care or refer you to a specialist places them on notice. A cc to your lawyer will have them calling you at home hoping to "fix things."
With a blood sugar that high, you don't deserve being denied access to appropriate medical care. You deserve a referral to an endo and you deserve proper treatment.
Going on insulin as a type 2 does not mean you've failed. I think it opens the possibilities to better control. Regrettably (or out of necessity), you may need to move on to a GP or primary care physician who accepts insulin for type 2 diabetics as just another tool (preferably if you're ready for it). Personally, the transition wasn't too hard for me, since I had problems with side effects from some oral meds.
This sounds CRAZY. You deserve treatment,those are not acceptable numbers. Go see another GP asap. Best of luck to you!
Thanks everyone for your responses. When I hear from the TuD online community I definitely don't feel so alone with all this merde. I made an appt with the doc in question and am going to give him the choice of referring me or putting me on insulin himself. I've seen this man for 16 years and up until now his treatment had been right on target with all the guidelines and standards. I work in a medical library and have looked them up. I will let everyone know what happens.
Sounds like you need to change your primary doctor if he really isn't interested in listening to you. My doctor tried to treat it but referred me to an Endo and now I am on an insulin pump. My bg readings in the last month have been in the 120's.