[georgepds]

So I had my first A1c: 6.9 after 3 months of treatment (metformin 2x500 mg ), and some modest weight loss (~5% of body mass). I'm not happy. My GP , by contrast, says this is fine. Myself, I'd rather treat the BG more aggressively. After a heated discussion (who really wants a heated discussion with their doctor) he upped the metformin (2x1000 mg)

My idea, other than switching GP, is to consult with an endo. My wife, the RN, says the endo is going to tell me the same thing as the GP: wait a while and see how the meds do. As the sig indicates, I'm type 2, and not in danger of immediate problem.

So I'm wondering if any type 2 here has seen and endo, and how soon did you do it?

I realize that I'm a bit obsessed with the problem, but hey, obsession is one way to focus one's attention on something that needs to get done.

[MJB]

I've never been to an endo but basically it is because I'm doing well without one.

"Myself, I'd rather treat the BG more aggressively."

The key word you used here is "Myself".

Pay attention to your diet, exercise and weight. Don't expect a change of docs to necessarily be the answer. Take some time to learn how to manage your disease. MHO.

[notme]

It took me about six months after diagnosis to see an endo. I have one now, but haven't been in awhile. Time to make an appointment.

[shockme]

never been.....my dr treats me and does well! beasides,the multispecialty clinic where i go has no endos.....trish

[princesslinda]

I've always said that once my diet/exercise and medications failed to give me the results I expect, i'd see an endo. So far, i've not needed to. If you are eating low carb, getting regular exercise and taking your meds and still not getting good results AND your doctor isn't taking the situation seriously, time to find a doctor who will, whether that be an endo or another internist.

That being said, my doctor writes my prescription...the rest is up to me. The "education" I was given was eat between 45 and 60 carbs/meal and test once a day...I soon found out that this way of eating and testing had no positive effect on my blood sugars, so I took matters into my own hands and read a lot and made up a plan that works for me.

Diabetes is a progressive disease, so if/when my current regimen is no longer controlling my blood sugar, i'll see whoever and do whatever it takes to keep those numbers in line. Good luck to you George. Hope you find some answers soon.

[lewsterr]

I made an appointment with an endo three months after being dx. My GP appeared to be having problems prescribing the right meds for me, so I took the liberty of seeing an endo. Not only did he immediately put me on Byetta, but he also, four months later, stopped accepting my insurance. I'm back with my GP.

[paulT2]

I haven't seen an endo either - just my regular doctor and a dietitian when first diagnosed about a year ago.
Since then, I've only seen the people at the lab I get my A1C taken at. I get my results in the mail, usually my doctor scrawls a note on the results along the lines of keep on doing what I'm doing. Thats it.

to what MJB said.

You know, taking more pills isn't always the answer.

Myself, I'd rather treat the BG more aggressively

If you are unhappy with your A1C (which isn't the worst it could be, by far) then take a look at the kinds of food you are eating and the quantities too.
Additionally, look at the amount of activity and exercise you take - is it daily?

Be aggressive with your portion size and exercise!
Then, if that doesn't help, perhaps other meds might be the answer.

Diabetes may well be a progressive disease BUT I believe we can do a lot ourselves to manage and control that progress.

[georgepds]

Thank you all for your comments

My diet is radically different from the one I used to eat, but, like anything, there is room for improvement.

I'd been doing well on exercise (well for me, ~1-2 miles/day walk). But I've got a knee injury that gets progressively worse, especially after a steady walk. Well, I've got to find something else to do. My understanding is exercise can reduce the a1c by up to 1 %, and I'd like to try that route.

[rzrbks]

All but one of the Endos in this area are "Personally Related to God."

The CDEs in this area, small metropolitan region (5 million + people in a 60 sq. mile area) all say the same thing--if you're doing well with your GP or PCP stick with them, you'll be happier.

I did go to Endo, once, a number of years ago, he did indeed confirm he was related to God, I haven't been back since.

[mzteacher]

hi...for me by adding glipazide to the met dropped numbers the next day...
there may be more things you can try!

[georgepds]

Originally Posted by mzteacher

hi...for me by adding glipazide to the met dropped numbers the next day...
there may be more things you can try!

Yes.. that's what I'm thinking. I know that diet and exercise will ultimately help, but in the meantime I'm doing myself serious harm by not lowering my BG. My feeling is treat the problem, simultaneously institute life changes, and then, when you've lost the weight to the point it takes care of the problem, drop the meds

[georgepds]

Originally Posted by princesslinda

...
That being said, my doctor writes my prescription...the rest is up to me. The "education" I was given was eat between 45 and 60 carbs/meal and test once a day...I soon found out that this way of eating and testing had no positive effect on my blood sugars, so I took matters into my own hands and read a lot and made up a plan that works for me...

Thanks Linda. May I ask what plan worked for you? How many carbs, how much exercise, how long did it take to kick in?

--george

[princesslinda]

Originally Posted by georgepds

Thanks Linda. May I ask what plan worked for you? How many carbs, how much exercise, how long did it take to kick in?

--george

Keep in mind that everyone is different, and your results may vary based on a lot of external factors (weight, age, general overall health, length of time you've had diabetes, etc).

Before diagnosis, I lived a VERY UNHEALTHY lifestyle. I didn't exercise and ate really badly. When I got my wake-up call, I was so scared that I immediately did a complete turnaround. I ate extremely low carb the first 3 months, lost quite a bit of weight and my A1c went from 9.6 to 6.2. Since I ate so many bad foods, just eating a healthier diet helped me a great deal. I was quite overweight at diagnosis and after I got rid of my first 30 lbs, I could tell a BIG difference blood sugar wise. Now i'm working hard to keep the A1C in the 5 range.

As for exercise, I was extremely overweight at diagnosis and have a "sit-down" job...I had to find ways of getting in extra steps. I bought a pedometer and kept track of my steps daily and made sure I increased them daily. I have a treadmill and stationery bike at home at, at first, could only ride/walk for 5 minutes at a time....I'd do my 5 minutes, take a break and breathe, then get back on...Now I do at least 30 minutes each night, more if I have time. I park a long way from the doors at work, at the mall and at the grocery store, and I take the steps instead of the elevator (i'm on the 6th floor). I recently starting doing Pilates a couple days a week which breaks the monotony of the bike and treadmill. Our docs recommend it to our older patients, so I figured it would be something I could easily do...it's more challenging than I thought, but I like it (as much as a basically lazy person can like exercise)! I've lost around 72 lbs so far...still have quite a bit more to go.

Most days, I eat between 50-100 carbs per day during the week and a little more on the weekends as we go out to eat then and it's harder for me to judge. I check my blood sugar
4-5 times a day, more if its up, and if I see a food that makes me spike, I avoid it. For me, my motivation comes from the memory of all the problems my mom had with her uncontrolled diabetes, culminating in her death from renal failure at age 54, as well as the fact that I feel better now at 43 than I did at
30. Hope some of this info helps.

[Peggy]

After my PC tried for 9 months to adjust my oral meds enough to get good results, he recommended an endo. My husband has been diabetic for about 20 years so we've met most of the endos in town and, as rzrbks said, most of them have a God complex. So I wasn't thrilled about seeing an endo but gave it a try. My endo is GREAT!! Has a wonderful attitude and considers himself to be a PART of my healthcare team, with me as team captain. He changed my oral meds and got me started on a low dose of insulin. My A1c came under control remarkably fast and has stayed that way in spite of me not doing very well with my diet. I hope you can find one as good as mine.

[Harold]

Not yet! I would probably call the CDE first to get their opinion. We have some really good CDEs' here and none of the Endo's will see you if you do not have a recommendation by a Doc or CDE.