New Doc want to see me evey three months

Diagnosed 6 years ago and have had different doctors which I would visit every 5 or 6 months or twice a year. I am 76 years old and try to keep my A1C in the 5% range. My cholesterol is around 240 or lower and statins are out of the question for me.
I take no meds except for a basal insulin Levemir and I take 7 units in AM and 6 unit in PM. I follow Dr. Bernsteins lo carb diet and exercise.
My new doctor a primary care insists that I see him every 3 months and when I asked why he said because he is type2 diabetic also. Didn't make sense to me.
On my second visit I went after 4months and he still wants to see me every 3 months. I see my eye doctor once a year my dentist every 4 months but to have blood drawn every 3 months seems excessive for my situation.
I guess I will be forced to get a new doctor or see what happens if I make an appointment in 5 months. I would appreciate any feedback from you nice folks on this forum.

I have to tell you, the standard of care for someone with diabetes is that they see their doctor every three months. Your doctors didn't make this up, this is the guidance they have been given on how to treat patients with diabetes.

And frankly I think you are doing great. But that being said, a lot of things can totally go south in 3 months. And you might not even notice it, but hopefully your doctor will. And he has a better chance of catching things early if he sees you every three months rather than six. I am not as old as you but as I get older I know that stuff just goes wrong. So I see my doctor every three months and I feel good about that.

I see my Endo & lab every 3 months, going on 12 years with that cycle.

Almost 31 years with the every 3 months cycle as well. Brian is correct, it's the standard of care in the D world. Actually, I like going there and "checking in". It's a good feeling when my numbers are good and they give me an "atta girl" for all my hard work.

I disagree with the others. I think it's important to remember that the doctor is there to meet our needs not vice versa. I have always gone to my doctor PRN. I manage my own D and go to the doctor only for prescription refills, testing (every 6) and as needed. I am 10 years younger than you and I still feel the need to make sure my life doesn't turn into nothing but "medical stuff". However, since I got on Medicare they require me to go every three months. She still only does labs every 6. Isn't Medicare requiring you to go every three months or is that just Type 1?

Although the standard of care is a visit every three months along with an A1C blood draw, I have rarely adhered to this schedule.

I agree that if your BG numbers are relatively stable AND your A1Cs are in the 5% range, there isn't a great need for the 3 month schedule. But ...

What other steps are you taking to get your cholesterol lower?

I would ask the doctor to have a discussion with you about treatment goals. For example, if your standard deviation is high, how can you bring it down? If your cholesterol is 240, what diet, exercise and lifestyle changes can you make to bring that down? Could you get blood draws at an independent lab every three months, have them sent to the doctor (and you), and go every 4 or 6 months as appropriate for you. IOW, establish the goals and then come up with a plan to monitor the results that satisfy both of you.

i agree with everybody else. i go to my doc every 3 months for prescription refills, general check-up, A1c, that sort of stuff. They download my meter and we make any fine tune adjustments to my dosages. by the way i am 39 year old male and doing this keeps me healthy with A1c's in the upper 5's.

35-40 years ago, the "standard of care" seemed to be a visit every 6 months. But for a good while now, the standard of care actually calls for getting A1C and other blood tests every 3 months, and cholesterol test every 6 months, and eye test every year.

For 28 years I faithfully went to the endo every three months. That visit also coincided with a blood draw and lab tests. I did this because I thought it was prudent.

In the latter part of that period my A1c's had climbed as high as 8.5% from being steadily in the mid 6% range. I was the one alarmed, not the doctor. I was the one calling for more appointments because I felt sick, tired, and out of control. Looking back, I see clearly that I had become insulin resistant. That topic and how to treat it was not discussed by any of my docs. I am T1D and didn't realize that insulin resistance could happen to T1Ds, too.

I went through three endos during this time and none of them helped me out of this bad patch. All during that time I was dutifully visiting the D-doc every three months. One of them referred me to a liver specialist because she was concerned about some liver enzyme numbers. I double-checked this with my primary care doc who thought this referral was unneeded; she thought my numbers were marginal and not a cause to see a specialist.

My point here is while a three month endo visit seems like a great standard of care idea, it doesn't always serve the patient well. It was not until I, as the patient, took the bull by the horns and figured out what was ailing me. I discovered a lower carb way of eating. I added vigilant BG monitoring (added a CGM and increased fingersticks) as well as walking every day. It was the peer support I found at TuD that enabled me to escape that health trap.

This three month standard of care is all well and good but it certainly didn't help me and wasn't timely at all!

I felt like these three endos over a five year period were simply acting as medical stenographers documenting my slow demise. These were not run-of-the-mill endos. They were well established practices in a major metro setting. Two of them were affliated with a prestigious teaching university. They didn't have a clue about insulin resistance and how to neutralize it. It wasn't until I took charge and radically changed things that I started a return to good health.

This experience radicalized me as a patient. I realized that I'm the only one with skin in the game; I'm the ultimate authority. I hire doctors to help me; I don't put them on a pedestal. They are simply humans with a little bit of expert education. But when it comes to dosing insulin and daily BG management, they are amateurs. I have over 250,000 hours dealing with BG management; their experience pales in comparison to mine.

Nothing wrong with that, but I needed to clearly understand the real hierarchy in the relationship. The doctor is not in command, I am. I seek his/her advice but only heed it if they can make a logical case to me. They are not responsible for my health and welfare; that's my job!

I now see my endo every six months and she's OK with that. She downloads my pump, CGM, and meter. She sees how hard I work to keep my BGs in check. She knows I'm a strong-willed person and repsects me. I know I am a "difficult" patient; I demand competence from the doctor and will speak my mind when needed. As you see from my story, I'm not afraid to fire an endo and move on, if necessary.

For most PWDs, the three-month endo visit standard of care seems appropriate but I think doctors need to step up their game, too, give proper credit where credit is due, and realize that tactics like low-carbing are viable clinicaly.

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"This experience radicalized me as a patient. I realized that I'm the only one with skin in the game; I'm the ultimate authority. I hire doctors to help me; I don't put them on a pedestal. They are simply humans with a little bit of expert education. But when it comes to dosing insulin and daily BG management, they are amateurs. I have over 250,000 hours dealing with BG management; their experience pales in comparison to mine."

Excellent points and this one in particular, Terry.

I will say that I firmly believe that part of the 3-month standard of care, tests, downloading of meter/CGM data, etc is an example of our doctors practicing defensive medicine. It is easy for them to get caught up in this and not always see the needs of the patient.

We should decide how often to see docs. I really only need 1x a year to renew my scrips but my endo says he gets chastised by insurance companies for failing to see pwd often enough. He wants to see me 4x and I negotiated 2x a yr. What a dumb game.

I had a conversation with my doc recently after I finally decided to go on the pump (about a year after he recommended it).

He told me, on average only half of the diabetics in the US get access to proper care. Of those only half participate in their treatment decisions, only half of those actively so, and only about half of those are capable/responsible enough to self manage, and only a portion of those actually do it.

By and large the folks here on TUD are an extreme minority of the diabetes population in the US.

Mike and brboyer - Yeah, I had this sense during that time that I was not acting like the typical disinterested D-patient and they just couldn't adjust to this new reality. If anything, I was over-compliant, demanding answers to help bail me out of what felt like a desperate health crisis. I wonder if they didn't feel that I was really non-compliant and secretly sabotaging their efforts. I don't know; I just moved on after I fixed it, my attitude towards doctors forever changed.

I often think that if I could buy my Rx's without doctor involvement, I would do it. Seeing doctors as needed, as Zoe says, "PRN," seems like a good fit for me. I probably would still like to get a blood draw and lab tests at least once per year. Then only see a doctor if s/he saw something in the tests that they need to talk to me about.

Agree wholeheartedly and I am glad you found a good endo!

I will definitely go more often if I have problems even minor ones. We'll see what the future brings but testing right now 4 times a year seems excessive to me and I would like to catch things early and hope I do.

I am glad you are comfortable with every 3 months and if you have a good endo you are in great shape.

Fully understand and respect your 3 month protocol.

Lowering BGs is the best way to lower cholesterol and it has not been proven conclusively that cholesterol causes heart attacks. Most doctors would have had me on statins when I was first diagnosed and under 200 but I didn't take statins then and have seen so many problems with people who did take them that I do not believe a statin would benefit except perhaps if there was a family history or maybe an extremely high number.

You are doing very well.