For a long time, I created detailed 2 week BG records with everything I ate and did in order to prepare for an endo appointment. There were different motivations for doing this, but one of them was to protect myself from getting my drivers license taken away and have really detailed data in case they did yank my license and I had to appear in front of the state medical court.
Now that stuff is all over because state law was changed.
I’m kinda at a loss for what I’m required to bring to a Doc appointment. I adjusted my numbers so that insulin dosages are perfect about a month ago in preparation.
I don’t really want to collect detailed data anymore.
Can I get away with not bringing any BG records to an apt? I haven’t done it. Apt is on the 3rd. I’m exceedingly busy and have neither the time nor the interest in putting in weeks of preparation for this apt.
The endo I have been seeing wants blood and urine labs prior to the appointment. My pump gets downloaded by staff and I do a one off share code from Dexcom Clarity. I don’t do any logs of meals, exercise, insulin use.
I don’t think a primary care Doc will have access to any software to download data. But, you give me hope that this will work out. I think the worst thing that they could do to me is refuse to write prescriptions. I don’t know if they would do something like that. I had had Docs threaten to do that before if I didn’t do this thing for them or that thing. But, this a nice guy and I doubt he would be that extreme.
You can certainly share your Dexcom Clarity software with your doctor. He can download the professional version if he wishes to do a deep dive into your numbers or just use the regular share and he sees the same you see. I don’t bring anything to my visits, my endo just looks at the various indexes in my clarity reports.
For my CGM data, my doctor’s office through NYU has access to the Dexcom site. I ignore requests to bring data as they can access or print it themselves. If they don’t have access - you should check - and if possible, go to the site that collects your data and print it out.
I get all my bloodwork done before I come to the office. I verify ahead of time that there is an order in for tests, with a little reminder that I get a more comprehensive set of tests than they usually order, then get the work done a few days in advance, although NYU gets tests done in one day, and I get the result as soon as they are available.
I don’t take many extra meds and NYU’s Epic system has them all listed, but you might want to write them down it is not already in their system, and you won’t remember them.
I dress in clothing amenable to an office visit, e.g., easy off/on shoes, track pants or board shorts, t-shirt or tank top, and hoodie.
I normally have supplies with me anyway, so glucose packets for low blood sugar, plus pen and meter.
I’ve been calling for some weeks, asking them to put in an order for an A1c. No beans. Maybe they will do it the day of, but I doubt it. This is not an endo, so hard to know what to expect.
Sometimes it is faster, better, and cheaper to just do your own bloodwork through UltaLabs, Quest Diagnostics, or one of the many other places you can order and pay online and then just go have your blood drawn locally. That allows you to get the tests you want and need. Many clinics and doctor’s offices are stingy on ordering necessary blood tests because internal or insurance policies restrict them. Since reasonable diabetic control requires the management of blood glucose, cholesterol, and atherosclerosis as they all work together, most doctors and clinics do not carefully monitor all three areas. The more our diabetic population ages, the more we will hear about the importance of controlling APOb and other indices rather than we have reasonable BG control, but oh well, we will all die from heart conditions.
PS, it will cost you less, if your time has any value, to order your own A1C than the time you spend calling your doctor’s office for it.
I would think that he would write them. If knowing you are a diabetic and not giving you insulin, I would think that would be a failure to provide appropriate care.
The PCP I see has a regular “diabetes panel” of blood tests that I get done before every appointment. I also print off a one-page Clarity report for my chart showing time-in-range.
Thyroid dysfunction is often seen with both types of diabetes. All three of my endos since the 1990s routinely test for TSH (thyroid-stimulating hormone).
This is true, before I got an endo (doctor who it trained in the function of the endocrine system) my PCP said, “Let’s do a thyroid test.” Guess what I was hypothyroid.
I didn’t realize it but I was experiencing symptoms for some time - I would chill easily especially when walking past open top freezers in the grocery store. Also, I had thinning nails.
My endo watches my thyroid levels as closely as he does my glucose regulation.
My usual blood tests are for thyroid function, liver, lipid panel, fBG, HbA1c and those concerning kidney functions. Along with blood test he orders urinalysis. These tests are ordered for each quarterly visit.
Because of some odd results that have been trending on kidney issues with an eGFR in the high nineties we decided that I should see a nephrologist.
I share my data with my doctor. They already know all about my medical condition, I don’t se why my cgm data is any different. It makes my visits easier too. I get wanting to keep it private, but is it really private anyway. I don’t know I mean once someone knows you are diabetic, the glucose numbers just sort of support that diagnosis.
Luckily my thyroid has been steady with no issues, type 1 does not run-in my family, but thyroid issues do.
I think autoimmune diseases suggest our immune systems are whack. So having a second or third is almost expected.
I was diagnosed with eczema early on in my type 1 dx but it hasn’t come back since. I also developed a strong allergy to shellfish and tree pollen after my diagnosis.
It’s difficult to tease those things apart.
Diabetes is a package of issues.
I share my pump and Dexcom data with my endocrinologist. She is able to review all my data and typically her assistant prints what she wants and then she reviews it with me at every appointment which is every 3 months. I either get my HbA1c at the lab or she does a finger stick test in the office, typically an alternating schedule for where. The appointment would be pointless without reviewing my blood glucose values.
Oh I get that as well. I’m positive for antibodies but at a fairly low level. In my first visit with the endo he palpitated my thyroid feeling for size and nodules.
My primary care doctor pretends I don’t have diabetes because she knows nothing about treating patients with Type 1. She literally doesn’t bring it up at all except to maybe ask if I’m still seeing an endo.
California has always had this law, but it isn’t as horrible as you might think. They will only report you if you are losing consciousness or having seizure, whether from glucose control or not. Police and Fire already do that and have done for more than 25 years.
I was reported to the DMV from an ER doctor because I was having pancreatitis. That was not making me pass out or anything, it was just severe pain. I told him I was having a hard time driving to the hospital because I was in pain.
I don’t know if he misunderstood or if he does that as a rule.
I brought my medical record to the DMV and showed them the doctors notes, and it was dismissed. I don’t like sharing this stuff with the DMV, but back 20 years ago we had to, in order to be allowed to drive, and we had to reinitiate it every year and get a doctor to sign off that we are not going to pass out while driving.
They dropped or reformulated the question so that I can honestly reply “no” to the question.
I currently hold a license in California and Washington, and Washington doesn’t ask the same question as California.
Basically “ do you have a condition that might make you lose consciousness “ and I can say no because that has not happened to me in a very long time thanks to cgm.
