Today I went to the dr, they took my copay --asked me why I was there (‘uh, dr scheduled an OGTT for me today and wanted to recheck lipids…’) Then after they took a fasting glucose (with the same type of meter I use at home…) they told me that my glucose was too high to do an ogtt, and to just go home. What was my bg? 140. (It was 115 when I got up at 7am. It always rises in the morning.) I feel like every day my bg is getting higher and higher, and I don’t understand why my dr is being so casual about it.
I would tell my Dr I wanted a A1C and also at the sametime to use one of those high priced machines in his lab that would check my bs just like they do in the hospital. That is if he has 1, if not I would talk to him about me going to the hospital and letting them do it. Just my 2 cents worth.
I’m not sure what the cutoff for taking the OGTT is, but I know the reason why they didn’t want you to take it. If your blood glucose is high before the test, giving you 75 grams of glucose could be dangerous. I’m surprised they took your initial test with a home glucometer. I had one done, and had to wait 45 minutes for the lab to gets the results of the initial fasting test. I would be concerned about that, and make sure all diagnostic tests come from veinous blood in a true lab.
yeah, I was a little concerned about the fact that they used a fingerstick and then an aviva to get an initial reading. Then they did take veinous blood (and bruised up my arm something fierce – told them that would happen!) I’m not really sure what should be happening here. I showed the dr. my record of pp readings for nearly a month,and she was like, “Okay well they aren’t too bad.” What? So they are going to let me wander around like that with no help? It’s also a real inconvenience to keep taking time off from work to go in and pay the copay and basically have them do nothing. Darn it if I could control it all with diet, I’d just do that and they could all just go hang!
Depending on what your numbers were, I would be concerned if he is not taking you seriously. If they took a fasting veinous sample and it comes back above 126, then they might just diagnose you, instead of pursuing another OGTT. Regardless, I would ask to speak to a CDE, and get some information on nutrition, to see if diet & excercise could work. Then, if you are still above the targets (and the DR. should explain these to you) request medication. If he is still not treating you appropriately, then seek another Dr. You have to be an advocate for yourself and your health!
I would ask for an A1c and a referral to an endocrinologist or CDE.
If your doctor is not an endocrinologist or specialist in caring for diabetics he’s going to be casual. The standards he is working with very general and loose. See if you can add a CDE (certified diabetes educator) or endocrinologist to your team.
Getting an OGTT is not going to explain why your blood sugar seems to be getting higher and higher. You need to keep track of your own BG before and after meals and log what you are eating to try to spot trends. My BG also rises in the AM and it doesn’t seem to matter what I eat or how much insulin I take. Suddenly this week it’s fine in the mornings. It just so happens I’m on vacation this week.
Maybe it’s stress?
Dunno. It could be that I’m doing better with my nighttime levels and not rebounding the a.m.
All I can do (all we can do) is collect the data, check it, make some educated decisions and keep trying.
You’ll get a lot more help and patience with this effort if you work with a specialist.
Thanks Terry, all good points. I do track before and after meals at one hour, but I log pp at 2 hr because that is what the dr asked for. I also do fbg and before bed. The whole thing about the OGTT is that it seems she won’t diagnose me without it, and she won 't make a referral to an endo or a diabetic educator unless I’m actually “diabetic” (she’s already got me marked down as “pre-diabetic” so I’m really not sure why she won’t refer me on that basis alone.) Why do I need a referral? I can’t afford to pay for an endo completely out of pocket.
I know a certain someone who when they go to see a new doctor they tell the Dr they are interviewing for their business, they state “If I like you I will be back, if I don’t you won’t see me again”.