Is it time to change Drs?

Hi Guys…

I just got back from my Drs because I wanted to check with her about my continuing weight loss and get another prescription for test strips.

Firstly, she told me I was using too many test strips and that because my numbers are only “borderline” I shouldn’t be testing after every meal? Why should she care how often I test my blood sugar? I have health benefits which pays for these… Then when I told her I’m still losing weight (18 lbs in 4 months now) she said that she doesn’t really see any other problems with me so I shouldn’t be too worried about it?

She then said that I should go and have a “Primary Air Contrast Barium Enema” done for this Friday… I think she is making me have this test to shut me up?

Do you think that this test is really necessary or if I should have it just in case?

I have cut out a lot of carbs over the last 4 months to stabilize my post meal BS numbers but I think that is what has caused my weight loss?

Just a little frustrated right now :frowning:

Thanks, Paul

What are your BG numbers post meal ?
What is your A1C presently ?..this number, if " perfect " does not necessarily mean you feel great .
Has it been tested , that you are indeed a type 2 ?
Have you seen a CDE /Dietitian ?
Just a few thoughts, that popped in my head .

Hi nel,

My post meal number are averaging 90-140 depending what I eat but if I do have a higher carb meal then its gone as high as 180 but has always come down after 1-2 hours… I usually keep it under 140 for the most part.

Not sure what my A1C number is as my Dr hasn’t had this test done…

My Dr hasn’t told me anything as far as being Type 2, Type 1.5 etc, she has only said that my numbers are a little high (last fasting lab blood glucose test was at 97)…

I haven’t seen a dietitian yet, when I asked my Dr if I should see one she flat out said no…

I have called the Diabetes center here in town and have an appointment on Jan 4th. They are supposed to have specialists and dietitians available to talk to… That’s really what I want is to talk with someone who will do more that just tell me to “come back in 3 months”…

If I hadn’t found this forum I wouldn’t even be testing my BS because my Dr has never suggested anything like that…

thanks for your input…

If you don’t feel your doctor is being supportive & taking your concerns seriously, get a new one. Many doctors don’t believe it’s necessary for Type 2s to test often. You’d think they’d be more encouraging of patients who are proactive. How else will you know how food, exercise, other medications are effecting you without testing? How will know if you’re becoming more insulin resistant? Her thinking may be is that since you’re not on meds, you can’t do anything with test results so why bother.

Certainly wouldn’t hurt to have the test to rule out another reason for your weight loss besides your reduced carb intake.

This test is used to screen for a variety of medical issues, including unexplained weight loss. If she isn’t worred about your 18 pound weight loss, why is she asking you to undergo this hour-long fairly uncomfortable test?

I am glad to read, that you have contacted the Diabetes center …being pro-active will be in your BEST interest, always . Have your questions ready for the Team by Jan . 4 . Can you bring someone along ??..2 set of ears , better than one set.
I personally think your weight loss not a good one , as you do …it maybe muscle you are loosing , but I am no doctor .
By the way , my Doc did not like the number either, when I told him how many times I check my BG ( the final straw , that broke the camel’s back !) …and I changed to another ( am type 1 ) .
Keep us in the loop after your Jan 4. appointment , please .

Hi Barrie,

The last visit to my Dr, prior to today, a couple of weeks ago I told her that I was worried about the weight loss and she said that everything else looked ok and that if I felt normal, which I do then not to worry about it and come back for another fasting glucose test in 3 months. If I hadn’t seen her this morning then she wouldn’t have told me to go for the BE test… So I don’t think its something she would have suggested on her own but maybe because I’m concerned about it?

I’ve just called my sister and she is trying to get me in to see her Dr who she says is excellent…

I know I’m stressing out about all of this too much and it probably isnt helping my BS numbers as I noticed I was 167 1 hour after lunch when I’m usually 130…

Thanks again for your input, Paul

Hi Gerrie,

Your right about the test, but I’ve had it done b4 and hated it… Just not what I was looking for just b4 the holidays…

Thanks, Paul

Paul,

It sounds like your doctor does not want to support your goals. Your interest in controlling your post-meal BGs is totally valid. The only way that you can see how your BGs react to different meals is to test. Have you been keeping a log? Writing down what you eat, when and how hard you exercise, and your post-meal BG numbers would teach you a lot about what certain foods (and food combinations) do to your blood sugar.

If you don’t take any meds I can understand why the doctor does not see the need to test to prevent low BGs.

You didn’t say how much you weighed before you lost the 18 pounds. If that weight loss puts you into an appropriate weight for a person of your height and build then I don’t understand the doctor’s concern for this test.

Lastly, is your new diet making you feel better? Do you have more energy and better cognitive clarity?

I view my doctor as a member of my health care team, albeit one of the expert members. Since its my body and only I will accrue the benefits of smart or poor lifestyle choices then I see myself as the captain of that team. If the doctor does not want to reasonably align herself to my team’s goals then I would look for a replacement doctor.

As far as the test goes, did the doctor explain what she was concerned about? Doesn’t she believe that your change in diet to a low-carb one could offer a reasonable explanation for your weight loss? What are the risks of this test? If the doctor can offer some valid reason that she’s ordering the test and the risks are low, I would be inclined to have it done. On the other hand, if her rationale is simply weight loss, and you otherwise feel well then I don’t think I’d want to go through the test prep just so she can experiment with a theory that you don’t buy.

Good luck with your decision.

Hi Terry,

The weight loss only started once she told me my BG numbers were a little elevated. I would have no problem having the test if I was having other symptoms but other than the weight loss I feel normal. I weighed 162 at the time of my last physical, in July (when the BG test was taken) and this morning I was 144. If I wasn’t told about the BG levels and thus hadn’t changed my diet and started losing the weight I would probably have the test.

I have been trying to calculate how many calories per day I’m consuming and it looks like I’m probably only getting 1500-2000… It has been suggested that this number should be more 2500-3500 per day?

I do go on an 75 min walk 5-6 times a week. I was running 4 times a week but have since stopped because of the weight loss…

I’m just more annoyed at my Dr for not giving me any education regarding my BG numbers… As I’ve said before, if it wasn’t for this forum I wouldn’t have been testing my numbers and seeing spikes like 230, 1 hour after a large bowl of pasta… Which I’ve since stopped eating…

Thanks, Paul

I do a lot of testing myself but more to make sure that I am not going low. For a while I was getting around 70 or 80 and felt the low symptoms. I know that is not a real low but my body percieved it as a low and i had to correct that. I started to just deal with them instead of correcting by doing more testing. Also during a workout I had to test to not get the low symptoms. My GP also told me that I was testing too much and I should only test before meals and two hours after meals. My fears were going low not going high.

I guess the reasoning behind the doc not wanting me to test so much is that we really cant adjust like type 1’s. I have done a slide scale for a year before I was put on meds so I know that there is really no level of corrections for type 2’s beside going for a run in the middle of the day. I think that much testing for me gives me a way to adjust my meals based on patterns but really does not do much for what my metformin doses will be for the day. The metformin dose stays the same no matter what you eat until it gets adjust on a quarterly basis. So I would assume the A1C number is what is used. Also if you are still producing insulin even at a low level I would think you are a type 2. I think with your numbers in the 90’s you are not likely a type 1 or even a 1.5. I had to hit a level of 1000 and even then I never knew at that time if i was a 1 or 1.5 or 2.

I understand we should all be concerned about our glocose levels but I would trade you my numbers for your boderline numbers any day. My endo and GP told me that stress for me plays a big role on my BG’s and I should try to live life and stop worrying about testing so often because I may be driving the numbers up myself with the level of stress. I think you should focus on eating right, which you do and working out. It sounds like you and I are very similar on the testing. I do test like 10 to 12 times a day and I realized outside of excercising that is the only thing that works on my numbers. So relax and dont get frustrated. I also should take my own advice and relax.

take care

Paul,

Your first post indicated that you had an HbA1c of 7.2. In my view, that alone is sufficient to diagnose you as diabetic. None of this pre-diabetic stuff. You are not a little bit pregnant. I have also been very impressed with the way that you have faced this diagnosis despite a great deal of confused messages from the medical community. Most doctors will test your fasting blood sugar and when it gets high you will “finally” get a diabetes diagnosis. As far as I can tell, you already have your diagnosis.

You further said when you first joined that you were 6 ft tall and 155 lbs putting your BMI at 21. I would consider underweight, and from what you suggest, you have lost even more weight. It would be prudent to find out why you are unable to maintain and gain weight, that could put your health at risk. It may or may not be related to the diabetes. It certainly seems appropriate to follow through with the enjoyable BE even if it will no doubt totally suck.

As to your doctor. You have a doctor who is clearly not aggressive about diabetes diagnosis and treatment and it sounds like you are not connecting with them. So just get a new doctor. Definitely follow up with the diabetes center, they are going to be your new best friend. They can arrange a referral from your doctor. Try to make a strong connection with diabetes center. You will likely find Certified Diabetes Educators (CDEs), RNs and dieticians who focus just on diabetes and can spend the time with you and be available. I maintain strong ongoing connections to my local center years after my diagnosis. The suggestion to take someone with you is helpful, I took my wife.

You are going to be ok. I know that you are concerned about your blood sugar, but it really is not too bad. You will get this under control.

Hi Paul –

Judging by your profile photo, losing weight at the rate of four pounds per month will soon make you a mere wisp. I say it’s time to find a doctor who will not only listen to your concerns but respond by ordering less invasive tests from the outset to gradually rule out causes – starting with infection. Your message is not specific as to this doctor’s practice area; is she a primary doctor or an endocrinologist? Either way, it sounds as if she has only very minimal knowledge about diabetes.

One of the responses implied that you are not on meds, but I don’t see anything in your posts to confirm. (I was told that metformin could result in some weight loss, but certainly not a pound per week.)

Finally, if your fasting BG is 97, what justifies calling that “high”? I would give my eyeteeth for a fasting BG of 97…

-vicki

It’s not a pleasant test. If you don’t mind my asking, why did you have this done already?

Hi bsc,

Thanks for your encouragement… In my first post I did indicate that my HbA1c was 7.2 but that was actually a fasting blood Glucose test. My Dr hasn’t sent me for a HbA1c test as of yet. So in the last 3 months I have been able to get my fasting level down from 7.2 to 5.4 with diet and exercise alone… Although I think my weight has suffered and that is worrying me…

A few of the foods I can think of that I have cut out considerably since dx: I was eating about 1 loaf of bread/week, we had potatoes (and probably too many) about 3 times a week and then pasta or rice the other meals… And I have always had a big appetite so it wasn’t always small portions for me… I have always been a lover of good beer and was probably drinking 12-18 per week. I have since cut this down to about 4 per week now… I have always had a fast metabolism and never really strayed from the 160 +/- 5 lbs weight…

Do you think this is enough for the weight loss given I have a fast metabolism? I’m basically on a low carb diet and wonder what others have lost on such a diet?

My wife is coming with me when I go to the diabetes center in Jan because she wants to know everything she can about this… I’m lucky to have someone who is trying to learn, with me about all of this :slight_smile:

Thanks again, Paul

When I was in my early 30s I had what they called a “grumbling appendix” which fired up from time to time and gave be really, really, really bad cramps which lasted for a couple of hours at a time.The test came back ok and the grumbling went away and I haven’t had any problems since…

I’m stressing just thinking of the test :frowning:

I just read the instructions and I can only drink liquids the whole day before the test so I wonder what that will do to my BG levels?

Thanks, Paul

Hi EV,

Yes, this Dr is only a GP… When I asked her one time what a high spike is for post meal testing she didnt really give me an answer which gave me no confidence in her diabetes education…

I’m not on any medication but have always had a fast metabolism and have maintained 160-165 lbs for the last 15 years or so…

Paul,

Yes, cutting your carbs down from your previous diet will result in weight loss. I eat low carb & had a hard time maintaining my weight. I’ve always been slim to begin with, so at first I was skinny & hated being too thin. I haven’t lost any more weight, so I guess I’m where I’m supposed to be. I stick to eating around the same amount of carbs day to day & the roughly around the same amount of protein. Makes it easier for me because I’m on insulin.

No one can tell you how much weight is a reasonable loss from a change in diet.

Increasing your calories, particularly in protein as has been mentioned several times, helps gain weight.

How many carbs are you eating daily? Are you hungry?

Wonderful to have a supportive wife!

Hi Gerrie,

I’ve tried calculating daily calories and I think its in the 1500 range which I’ve been told is too little… I think it should be around 2500?

Thanks

Yea, think you should eat more calories.

Do you know how many carbs? Would help to know your carb intake.