I found out I was diabetic during a stay in hospital August 2012. On leaving I was told to see an endocrinologist once a year. The rest of my care is by my family doctor. I left the hospital with a battery of tests to get (eyes, plaque, heart, etc), did them and the results were good.
I saw the endocrinologist in April and she was very positive. Among other things, she explained that my goal was to lower my A1C to under 6.0 and then we could look at stopping meds, to keep up the good work and to repeat the eye, heart, etc. testing this year too. This is a very, very short summary
Fast forward to last week. I took my latest A1C results to my doc. He was on vacation and there was a replacement doctor. My results were 5.9 (now I know that I'm not going to suddenly stop taking my meds and that there is a long road still ahead of me). Anyway, the replacement doctor looked at my meds (Metformin 850 2 x per day) and said that I wasn't at the optimal dosage and that I should add another Metformin midday. He also said that as my results were good I wouldn't need any testing other than A1C this year.
Thoughts anyone? Is the testing necessary? Is taking 3 daily doses of Metformin really better than 2? I'm just looking for feedback from people who have actual experience of these things. What I intend to do is talk to my own doctor about this in 3 months with my next A1C results and see what he thinks of it all. In the meantime, I'm looking for information.
Thanks in advance for any help, thoughts, advice, etc. you can give me.
Now you know...There's no consistency or recognizable pattern to what diabetes specialists tell their patients. With that said, I prefer your first doctor, no question...
Now that you have a better understanding of the affect diet, exercise and lifestyle habits (like alcohol, stress and the importance of rest) has on your diabetes, do you see the importance of self education and regular testing has on the control of the disease? Over time, as your control becomes more improved, you begin to realize...There's really only one diabetes specialist you can trust. Guess who?
I have still another take on this. I don't test, I don't medicate, and I diet and exercise as if my life depended on it-which it does. I really don't believe in the modern medicine in that popping a pill seems to be the solution. I have good numbers <6 A1C, don't have the symptoms I used to have, am healthier than ever in the last 30 years, and feel great. Dr told me not to test unless I feel ill, but I know that with going to medicare next year, and the new restraints I may have to test at least some.
With that said, "modern medicine" and diabetes drugs such as insulin and metformin are keeping millions, alive.
imo, drs should assume upon initial diagnosis that patients will not succeed in controlling diabetes through adjustments in lifestyle, alone, and prescribe the meds, straight away. The reality is clear. The vast majority of the population have been advised to eat a healthy diet, exercise, daily, and watch their weight, countless times; nobody, in this day and age, can claim this is their first "rodeo". Drs know better than anybody else, people like to gamble... especially, with their lives.
Beta, you do know that you are in the minority with respect to diet and exercise as if your life depended on it. I am, too, as are a select few others that I see here.
I work with seniors 60 and over and with the exception of one of them that I talk to, most don't care what they eat or that they do not do exercise. 90% of the seniors I see day in and day out (luncheon program) are overweight. There are four out of the 100 (give or take) that are actively active each day. We have a gym (work in a Salvation Army) that is available with weights, treadmills, bikes, etc. It's available to this age group for FREE.
I have made it known to most of them that I am diabetic and to feel free to ask questions. Mostly they want to know how I stay thin. LOL. It takes work, people. It takes work.
Bruno, my own endo has said that most of his patients do not succeed in controlling their diabetes. He has to keep adding medicine to their regimen. In reality, it's just too easy to take a pill rather than make such changes as eating healthy and being active.
Had a doctor appointment today for something different and mentioned that my A1C has lowered dramatically due to physical activity. Big smile on her face and she said "if only most people would do that." This was my PCP and she sees the same thing. People looking for the magic pill rather than really working at controlling their diabetes.
I'm on a roll here, so I better stop. One senior tells me that her sugar went way up after eating. She can't figure it out. I told her maybe get a carb counter and read it like it's your bible.
In my own humble opinion, if your testing supplies are not restricted, I would keep testing. It will let you know where you stand. If you can keep your numbers in the lower range of the scale your doctor gave you, you need to know your numbers through testing.
I don't take metformin. Is this doctor trying to lower your A1C some more with the addition of the extra medication? Your A1C is 5.9 because of the medication and dietary changes you have made. You may be able to lose the medication if you can keep eating healthy and exercise - for the rest of your life. You will also have to maintain your weight. Any extra pounds make a difference with diabetes. Being physically active allows your skeletal muscles to use glucose as fuel.
I will say that I don't understand why the doc added the extra medication. If you stay on the good path, it's really not needed. Again, only my opinion. I'm not a medical health professional.
I have no idea why this doctor wants me to increase my meds and I won't do it until approved by my own doc. My goal (and that of my endo) is to get my diabetes under control so that I can stop taking the meds. In the last year, I've lost 50lbs ... Yes, I'm working at it and I know it will take time.
This doc wanted not only to increase my meds, stop the major annual testing and also test my BG only once per day ... I'm not ready for that.
Yes, auriga, I do realize that there is a small percentage of us that are adamant about beating this disease without a magic bullet. Yes, Bruno, as I said, I may have to start testing on a regular basis just to appease my health care provider. All of this considered, I believe that there are too many questionable practices out there when it come to dietary control. How many of you have heard someone say "I only eat one meal a day", or "I can't eat fibre it give me gas" or "Veggies don't fill me up or I don't like veggies". Then we hear about wonderful processed foods on the tv, radio, and other places with restaurant servings the size of meals a farmer hand working the fields would eat. Duh, time all of us made a change for the good of our kids, ourselves and our country.
"...Is the testing necessary?" First question that needs to be answered: "What's the purpose of testing for blood sugar and who are you doing for?"For me, testing is the best way to learn how to control my blood sugar. There is no better teacher/doctor than my glucometer.
"Is taking 3 daily doses of Metformin really better than 2?" Testing (with your glucometer) would probably be the easiest and best way to answerthat (in other words, dump the replacement doctor!)
Finally, my best advice would be to always take caution when soliciting advice from other diabetics.No two people live exactly alike and blood sugar is affected by so many things. Would you think it wise to base any part of your treatment plan on the experience of a single parent, Romanian, pregnant woman, allergic to peanut butter, with 7 kids, living in Poughkeepsie?...
I would recommend learning from another diabetic, specifically the Glycemic Load diabetic solution author and cardiac specialist Rob Thompson. Have started reading and he makes lots of sense, and does not require a veggee diet, just careful use of glycemic index and load.
beta - I have been on medicare a "few" years and at first got my strips and lancets through that plan --- until I was hit with the requirements of submitting each test over every three month period. I had been testing quite a bit at the beginning to figure out what was happening to my blood sugar and why. They paid for it since it was determined that I was unaware of the rules, but from that time on it would have to be only 1 strip a day with other info, etc. I detemined "to heck with that" and since then have self paid, self tested, bought strips and A1c test kits on Amazon.com inexpensively and am very happy. My doctor is also happy with the results! I tried metformin with the doctor's blessing a fw weeks ago, and we discontinued it because it interferred with my own inate perception of my body's reaction to sugars.
I used to be aware of small rises and falls of blood sugar and that helped keep me very even, and let me identify culprit meals and foods almost immediately. The med, however did its own thing at delayed times which did not correspond to my body's perception. It sounds weird, I know, but my system worked before trying the metformin, and is working again after discontinuing. I had just been trying to lower my A1c, but have since decided to let well enough alone. Meanwhile I have upped my exercise level by hiking up and down the tall sand dunes here.
I will see where the medicare and new rules will take me in a year. I really don't want to test as much as I did the first two years anymore. However, back then I was able to get an early handle on how my BG would climb after different types of meals. As I have said before, I really don't look at it as diabetes so much as starch intolerant. I know that sounds quirky, but true. If I stay away from starches(concentrated carbs) I can keep the numbers down. I also am low on the BMI any more, and have a waste of 30 to a chest of 42. this means that any type of exercise I do anymore seems to drop lbs like crazy. I use nuts as a calorie intake to keep my weight at a steady level. Without them I think I would drop back down to my post high school weight of 125-a rack of muscle and bone.
Many people refrain from adding nuts to their diet because they're high in calories and they're not cheap. I eat pistachios and cashews (in small amounts) and I've maintained a stable weight for the last 5 years. People won't blink to drop $20 on a steak or lobster, but refuse to buy their kids almonds to snack on after school.
Thanks for keeping active on this site. It is good to hear from those who are pro-active!. Your reply sent me to the tape measure. I am 75, 135-138 lbs. a woman, tape: 38-32-38 (medical/exercise info only) Recently my weight is nearer to 138, but same measurements, which means more muscle, less fat. I also feel slightly obsessive/compulsive in my health management, but am trying to live the most active life I can.
I just called my doctor to get my blood pressure water pills lowered or discontinued. This morning my BP was 104/47, pulse 47. I have bradycardia (heartbeat under 60) and the doctor thinks at this time that I don't need a pacemaker, but it is a worry either way. If I need a pacemaker I won't be able to do many of the exercise type activities, such as kayaking, heavy swimming, light weight lifting, anything that might pull out the leads.
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