[davef]

Hi all,

I'm looking for some advice in relation to who should be in my care team.

At present my care team is me, my GP (family Doctor) and of course my DF Family. I really like my GP, he takes the time that is needed with me, he is willing to listen to me about what works and doesn't work. He was great in monitoring me in the early days and as I progressed (and learned) he did start "weaning" me of regular visits. After DX I saw him 3 days later, then a week later and week after that, then it went to two weeks and then a month, then 6 weeks and now it's at seeing him every 3 months.

I feel I have done very well in the past 5 months and he has done well by me, I don't feel my care is lacking in anyway. I believe my BGs are well under control, my 14 & 30 day average is 97.2.

I know there is a diabetes clinic in a local hospital, but from what I have heard, they are working from the old text books, so I haven't been inclined to go along there.

I'm not attending an Endo and what I'm wondering is, should I be seeing one? I'm sure if I ask my Doctor for a referral he'll be happy to give me one, I'm just not sure that I need to be seeing one at this stage.

What do you guys think?

[princesslinda]

Dave, i've never seen an Endo either, as I feel my internist listens to my concerns and has been very supportive in helping me get the test strips I feel I need, etc.

If/when I feel my control starts slipping or the meds aren't controlling my blood sugars....or if I were to have to start insulin, i'd see an endocrinologist. Otherwise, i'm of the mindset "if it ain't broke, don't fix it." Just my 2 cents worth.

[fgummett]

Hey David, my initial reaction is usually that a GP is just that, a General Practitioner (why do they call it Practice?) and I don't see how they can possibly keep up with the latest on every medical condition BUT having said that it sounds like you are under good control and every 3 month check-ups is better than the every 6 months I see my specialist. Also if, as you hear, the specialists in your area are not that up to date they could do more harm than good... well
I'd still see about getting time with a dietitian and CDE Nurse in case they have some additional tips but it sounds like you are already doing really well.
You say, "at this stage" this may be all you need, but you already know, D is chronic and progressive so I wouldn't discount a specialist in the long haul
Maybe someone to help you stop smoking?
~ Frank

[Chappo]

My care team is:
-Family
-My colleagues
-My endocrinologist
-Myself

[morrisma]

Dave,
As Frank said, what you miss with a GP over an endo is the latest medical info and up to the minute new procedures.

Additionally, an endo's practice probably includes a diabetes educator and maybe a pump specialist both of whom specialize in providing the detailed care within their specialties. This means you get access to food & diet info, goal setting, and possibly help with insurance claims and justification all in one office.

That said, not all endos are created equal and your local options might not provide a significant advantage over your gp. I'd explain your concerns to your gp and see if he can recommend an endo that might add something to your care.

Cheers,

[davef]

Originally Posted by princesslinda

If/when I feel my control starts slipping or the meds aren't controlling my blood sugars....or if I were to have to start insulin, i'd see an endocrinologist. Otherwise, i'm of the mindset "if it ain't broke, don't fix it." Just my 2 cents worth.

That's my thinking at the moment, if/when something changes then I'll look further.

Originally Posted by fgummett

Hey David, my initial reaction is usually that a GP is just that, a General Practitioner (why do they call it Practice?) and I don't see how they can possibly keep up with the latest on every medical condition BUT having said that it sounds like you are under good control and every 3 month check-ups is better than the every 6 months I see my specialist. Also if, as you hear, the specialists in your area are not that up to date they could do more harm than good... well

And if they have to practice, why practice on us!

One thing I do know about my Doctor, after I told him about the Gretchen Becker book .... he went an got one, I take that as a good sign, somebody is open to continued learning and new ideas, is a good one in my book.

Originally Posted by fgummett

I'd still see about getting time with a dietitian and CDE Nurse in case they have some additional tips but it sounds like you are already doing really well.
You say, "at this stage" this may be all you need, but you already know, D is chronic and progressive so I wouldn't discount a specialist in the long haul

As you say, it's progressive and my idea is that when it does progress, then I will too and add an endo to "Team David", so long as he is up to the demanding standards of Team David

As it happens a very good friend is a community nurse in the town where I live, she completed a diploma for Diabetes Nursing/Care last year and does check in on me from time to time. Turns out that she was a lurker here on DF when she was doing her diploma and thesis, since she believes it is imperative that those caring for diabetics should listen to and learn from the experiences of diabetics, she got some flack from some lecturers for having that opinion, but stands by it.

In relation to dietitian, I don't actually see one, but the biggest customer for the company I work for is Weight Watchers Ireland. I have worked closely with them for 7 years now and have I learned a lot from them. Now they are beginning to learn from me about diabetes. That's not to say that I won't attend a dietitian if I feel the need, but I'm doing fairly good on weight loss at the moment, I don't feel I'm lacking in nutrition.

Originally Posted by fgummett

Maybe someone to help you stop smoking?

You know that nurse friend, well ..... we have a pact to quit on June 1st. I was going to quit Jan 1st, but decided to tackle one thing at a time. Now I am getting to grips with my diabetes management, I have set a date for quitting. I have cut down since Jan, in May I'll cut back further and then cold turkey from June 1st. We used to be able to buy cigarettes in packs of 10, the government banned them last year, so we can only buy packs of 20. For my mind, it was a foolish step by the government as I know I started smoking more when I couldn't buy 10's. Guess it might have made it harder for kids to buy them, but I really don't it has.

Thanks for the input,

[fgummett]

Cool!

And if you ever need a, "Comfortable Living Specialist"... you'll know where to cal...

[davef]

Love the truck's graphics!

[Scrabblechick]

I'm going to see an endo, mostly because my GP's office is about 40 miles from here. I wanted a woman doctor to do my physicals. I'm just funny that way. Anyway, the endo I'll be seeing specializes in the D, and I know he's a good doctor. He also has an office here in town.

I'm seeing him May 1. I'm a little nervous, even though I know my numbers have been good, lately.

[fgummett]

Originally Posted by Scrabblechick

I'm seeing him May 1. I'm a little nervous, even though I know my numbers have been good, lately.

Good luck..! Make a list of questions (check it twice) make sure you get your feet checked and take ownership of your blood results... don't just settle for, "they're fine..."... what exactly are they?!

[mortis505]

Dave, normally I stress to people that an endo is needed for good care, but each case is different. From what it seems you are one of the lucky ones that has a GP that actually listens to you. I say that if you are comfortable and happy with your current team, then why change it. And good on you for doing so well.

[Funnygrl]

For a type 2 well controlled without insulin- no, there's no reason to see an endo if you trust your GP.

[Janlaton]

Well, Dave, for 39+ years I was comfortable with my Family Practice dr. I did ask her one time if she thought I should see a specialist and she replied that since I was very well controlled with no complications she did not see the need to do so. I will say she is very knowledgable on the subject and I have been thru classes in the Diabetic Center locally. She has also had me see a dietitian.

Last fall when I was diagnosed with Diabetic Neuropathy of the Cardiovascular nerves she did as she had promised and called in 2 specialists: a cardiologist and an endo. For all that was done if I have a new question today I would call my PCP before I would either of the other 2. Then Endo did have me go back thru the classes in the diabetic center. I have not learned anything new BUT IT IS ALWAYS GOOD TO REVIEW!

Janlaton
40years of type 2

[Lulika]

Dave I would tend to agree with the concensus that if you are happy with the care you are getting, dont change it. I am delighted with my GP, she seems very knowledgable, adresses my concerns and takes a real interest. I see her every two weeks and she always remembers exactly what is going on with me; I dont feel the need, at this stage anyhow, to see an Endo. If I was to get god for bid, worse or complications, I might then seek a second opinion, but not for now

[Scrabblechick]

Frank, I have embarrassed family members by grilling the docs on "What does this MEAN? What ARE these numbers?" No worries that I'll settle for "Everything's fine." LOL.