The endocrinologist seems to be a great guy. He might be a few years older than I am, but not many. Very pleasant, easy to talk to, with a nice sense of humour. He started out by complimenting on the great referral my family doctor had written. She was thorough, detailed and clearly interested in keeping on top of my healthcare needs. He said that it's rare for him to get such a well-written referral and this one was very helpful. I like my family doctor a lot, too.
I discussed my suspicion that I may have LADA and asked to have antibodies testing, c-peptides, GAD65 etc. He was very interested and agreed immediately. He also said that if he had 100 patients with diabetes, he knew that they would be 100 different types of diabetes because everyone is different and responds differently to treatments and changes over time. Having the blood tests is a great idea; he's also intrigued with how well my BG has already responded to the low-carb diet. He must have congratulated me four or five times over the course of an hour for such excellent results. He's also ordered a blood test for celiac disease. We agreed that those test results aren't conclusive but it's a more moderate way to proceed than to order a gluten-challenge biopsy right off the bat. If avoiding gluten works for me, I should keep on doing it, he said.
While the dietician thought that it was extremely difficult for a diabetic person to achieve normal BG, when I told the endocrinologist that this is my expectation, he said that it was completely possible and that he believed I would do it. If I need insulin to get there, that's a good option. He said that many people prefer to try oral drugs, first. I knew that, but I my understanding is that insulin always works and I want to avoid stressing my pancreas. He respected that.
He prescribed the long-acting version of Metformin for me because I've had such a hard time with the regular one. He also prescribed a thyroid supplement. I've been testing my BG 8-10 times a day and gave him a copy of my records. He said said he would be delighted if more of his patients would be as actively involved in understanding their healthcare needs. In the end, he told me to keep on doing what I've been doing because it's obviously working beautifully. For him, that means I'm doing all the right stuff.
I'll have the blood tests tomorrow and wait to see what the results are. Unless they come back with strong indications of LADA, I will see the endocrinologist again on January 11. If the LADA signs show up, I can get an appointment in a few days. I'll have my thyroid tested in early February and another A1c in early March, to be repeated at 3-month intervals for the next two years.
I'm happy with how things went and I'm feeling a lot more confident about everything. It's also great to feel like I really can work with this doctor over the long-term.