Unbelievable Dentist!


#21

I am so sorry to hear about your experience. I cringed a little reading this - I am a dentist, and I am embarrassed by the way you were treated. Dentists learn a little about diabetes in dental school, but not a tremendous amount. I am a lot more knowledgeable on the subject since I married my (Type 1) husband, but I would never say the things this doctor did.

It IS important that you tell your dentist about your (or your child’s) diabetes. Diabetes has an impact on oral health.
I always ask people with diabetes when they last checked their blood sugar, what it was, and when they last ate, not
for purposes of judging them, but because I want to avoid a hypoglycemic episode.

I think DrBB is right - a lot of people think they are experts on diabetes when they know very little about it. This is especially frightening when people in medical professions act this way. My husband was hospitalized a number of years ago. After he had told the ER doctor that he had had TIDM for over thirty years and had an insulin pump, the nurse did a fingerstick. A few minutes later, she came in with a syringe. I asked her what she was doing. She said that the doctor had ordered her to give him an insulin injection because his blood sugar was high. I asked how he came up with a dose? She stated that he used a sliding scale. I mean, why would you ask someone who has had diabetes for thirty years about the dosing, when you can just use a sliding scale?!!! I asked her if she was trying to kill my husband and told her to get out.


#22

Did the doctor order the dose with no adjustment for already delivered pump insulin?

Good for you! I hope both the nurse and doctor learned something from your advocacy.

This archaic practice should be banned from modern medicine. It’s lazy, degrades healing, and promotes comorbidiities. Using this protocol screams, “I don’t care if you remain in constant hyperglycemia. You will not go hypo on my watch!”

I think the 2017 ADA standards of care say something like the sliding scale insulin dosing protocol should not be the default or only method a dosing insulin.

Here’s one mention of sliding scale insulin use in the hospital in the 2017 standards. They’re moving in the right direction but need to slam the door shut on this practice.

A randomized controlled trial has shown that basal-bolus treatment improved
glycemic control and reduced hospital complications compared with sliding scale insulin in general surgery patients with type 2 diabetes (23). Prolonged sole use of sliding scale insulin in the inpatient hospital setting is strongly discouraged (2,11).


#23

I’ve heard similar stories to this in the past, and it really is amazing that any health professional would behave in that way.

I once had a General practitioner tell me that I should never be making adjustments to my Insulin regime by myself, without consulting a doctor. Which was in direct contradiction admittedly to anything any endocrinologist has ever said to me.

She then said if I’d been told that by my endocrinologist perhaps they weren’t good enough and I should find another…


#24

Let me get this straight. A doctor looked at a point in time BG reading, didn’t ask whether there was any IOB, and immediately prescribed a bolus based on a fixed scale?


#25

David, happens all the time in hospitals, to this day.
A friend of mine had a minor operation done, the following night she stayed in hospital, and when she rised, the doctor prescribed regular insulin to correct that, based off a weird scale, even though she had already corrected with her pump.
Doctors can be a pain…


#26

Well, I know one who is certain not to be. :wink:

Have you chosen a specialty yet? The last time I asked, a year or so ago, you were considering something in the pediatric area.


#27

Was I?
still no idea… GP is starting to appeal more and ore to me, but i am still pretty indecisive…
Well i have some time left to contemplate, still over 3 years! :wink:
What has clarified though is where i will do my last 3 years of medschool, as you might know I can only do the first 3 here in Fribourg, which are ending in summer, and i will move on to Basel in fall, which I am very looking forward to!


#28

I am sorry to say that the ignorance of diabetes in your average dental professional is astounding. I have been a practicing dentist for the past forty years and t1 for the past forty five. I am continually amazed at how little so many of my colleagues know about s disease affecting so many of their patients.

The best advice I can give you about how to deal with any ignorant medical professional is to stand firm and educate them.


#29

Nobody checked the pump, but what really upset me was, the doctor did not
see fit to ask my husband (who had had diabetes for decades) how much
insulin he needed.
My husband is very insulin sensitive, and the doctor ordered something like
eight units. I don’t think I have ever known him to take that much at one
time. It would have caused a
severe hypoglycemia.


#30

That’s amazing, isn’t it?

What is much more frightening is: if this is what happens with diabetes, something we know about, is the same pattern happening with every other condition? Is it possible that many possible procedures you get in a hospital are the result of a half-a$$ mental process? I had never thought of that, but your last comment is now making me wonder.


#31

and your experience has me scared to death…I’m facing a procedure with up to three days in hospital (gastric) so will be limited to IV then liquids. The Endo at the hospital was already fired by me, for essentially the sliding scale and telling me they type of diabetes doesn’t matter. We are going to be on our guard anyway, but wow…just what we were afraid of…My husband is kindly doing all insulin dosing approvals if I’m not awake…he and I know my numbers and doses best.


#32

If your husband is there with you, you should be fine. I have come to the
conclusion that whenever someone is in the hospital, it is best if a family
member or someone close is there with them most of the time. It is
especially helpful if the person with them is medically knowledgeable.
Even if the patient is pretty knowledgeable about his/her own condition,
when you are in the hospital, you may be sick/drugged/overwhelmed and not
always able to effectively advocate for yourself.
The last time my husband was in the hospital, his blood sugars were out of
whack, so the doctor assigned to him wanted to change his pump settings.
When I asked her how much experience she had with insulin pumps, her answer
was along the lines of, none, but she had treated a lot of patients with
diabetes. I told her that I would adjust his settings before I would let
her mess with them. Only then did she suggest that she contact his endo,
which I was fine with. His endocrinologist ended up calling me. I gave
her his glucose readings and she told me how to reset the pump, and we were
good.


#33

Hi Kathyc
Thanks, so much for this. Really, really helps…