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Medical Forum / Diseases and Disorders / Diabetes / October 2006Not getting control as fast as I want
Had a call from my PCP today with my lab results. He rattled them off very rapidly so I didn't get everything but gather that all had improved over the last 4 months. I did catch this much. A1C was 6.8 now 6.5 Chol was 190 now 171 LDL is down HDL is holding Trig is down bunches He's doing handstands and seems to consider me in control but I'm not terribly happy. I've been over a year and a half getting an A1C of 7.2 at dx down to 6.5 now and that's only been because of the things I have learned from this group. To make a long story short, this afternoon I called some offices and asked questions until I found an Endocrinology group whose staff did NOT think 6.5 was all that good. I have an appointment on Monday. My insurance won't cover very much of the cost but I spend as much on a fishing trip so I must be able to afford it and I'm darn well worth it. In case no one noticed, patience is not my strong point and I've pretty much run out of what little I had. I've changed my eating habits to multiple low carb snacks instead of 3 meals. I'm dropping 2 or 3 pound a month. My blood pressure is down and I'm trying to get more exercise but I'm still seeing bg over 140 at least 17% of the time although the over 160 readings are gone now. I've been taking Metformin (500mg) once a day but cannot talk my PCP into making it twice a day as long as I have my numbers continuing to inch downward. Anyway, I want to thank this group for the education I'm getting on how to reduce my numbers and what I needed to look for in medical care. Buying more test strips than my medical would pay for has also really helped me to learn the foods I can and can't eat and is the primary reason for the reduction I have seen in my A1C. - Jewel T2, metformin 500mg, diet, exercise and education > I've been > taking Metformin (500mg) once a day but cannot talk my PCP into making > it twice a day as long as I have my numbers continuing to inch > downward. When my PCP ignored the research about the benefits of metformin despite tight control of BG, I fired her a.s. If she'd allowed me only a sub-therapeutic dose as yours did, I'd have fired her a.s then, too. I found an endocrinologist who knew more about diabetes than I did. I'm glad you're recognizing your own worth and are "going fishing" for some actual help! :-) Priscilla > I found an endocrinologist who knew more about diabetes than I did. That is a trick! I'm generally happy if I can find a doctor who will listen to me about what I do know. > When my PCP ignored the research about the benefits of metformin despite > tight control of BG, I fired her a.s. If she'd allowed me only a [quoted text clipped - 5 lines] > > Priscilla Boy, Priscilla, I wish I had your luck! I have been shopping doctors all over the place, trying to get metformin despite tight control of BG, because I believe it is much more useful than any doctor around here, including the Endo I used to see who wanted to get into a "philosophical discussion" about whether I still have diabetes because I manage a 4.2 A1c for over a year (Darn the luck, he agrees that I'm still diabetic) ;) I am in "Carb Hell" as Old Al coined it, but the doctors don't care. My endo DID agree that I will need metformin and then additional pills, and finally insulin, as diabetes is progressive. I wanted to strangle him! I said "I'M TRYING TO PREVENT IT FROM PROGRESSING" I told him I achieve my numbers by eating between 10 and 90 grams of carbs, and I am tired of never having any carbs, and his advice was "eat more carbs" Actually, ALL the doctors tell me "Eat more carbs" and after I raise my A1c they will reward me with a prescription to metformin which might have saved the beta cells they are asking me to kill! Of course, the lowered cholesterol and other PROVEN benefits of metformin are what I want it for, but they don't care. I even faxed my new doctor the ACE / AACE guidelines that recommend metformin for preventing diabetes in insulin resistant people, and still no prescription! OK. off rant. Karl > > When my PCP ignored the research about the benefits of metformin despite > > tight control of BG, I fired her a.s. If she'd allowed me only a [quoted text clipped - 39 lines] > > Karl I feel your pain, Karl! You aren't in Minnesota by any chance, are you? That's where my wonderful endo moved to. *sniff* Priscilla >> > When my PCP ignored the research about the benefits of metformin >> > despite [quoted text clipped - 53 lines] > > Priscilla Priscilla; Nope, I'm in Washington Karl > I told him I achieve my numbers by eating between 10 and 90 grams of > carbs, and I am tired of never having any carbs, and his advice was "eat [quoted text clipped - 10 lines] > metformin for preventing diabetes in insulin resistant people, and still > no prescription! You're tired of not eating carbs, so you want metformin. Is metformin supposed to counteract eating increased carbs? That's not my understanding of what it does, so would somebody explain it to me? bj > > I told him I achieve my numbers by eating between 10 and 90 grams of > > carbs, and I am tired of never having any carbs, and his advice was "eat [quoted text clipped - 16 lines] > me? > bj While it's not its major benefit, it can reduce post-prandial spikes, giving one more wiggle room in what they eat. Priscilla >> I told him I achieve my numbers by eating between 10 and 90 grams of >> carbs, and I am tired of never having any carbs, and his advice was "eat [quoted text clipped - 16 lines] > to me? > bj bj; One of the benefits of metformin, as I understand it, is that it lowers insulin resistance. Thus, in my mind, that would mean I could eat more carbs, and my current insulin would be able to work better to lower spikes. If only I was allowed to test my theory ;) Karl > One of the benefits of metformin, as I understand it, is that it lowers > insulin resistance. Thus, in my mind, that would mean I could eat more > carbs, and my current insulin would be able to work better to lower > spikes. Exercise helps a lot with this too. bj >> One of the benefits of metformin, as I understand it, is that it lowers >> insulin resistance. Thus, in my mind, that would mean I could eat more [quoted text clipped - 3 lines] > Exercise helps a lot with this too. > bj Yes, bj, I'd love to exercise more. My main reasons for wanting metformin have nothing to do with glucose control though. I just resent the fact that my doctors ignore all metformin's benefits based solely on my A1c and ignore my fasting glucose which is trending upwards, and post meal tests which I can easily send over 180 (IF I follow ADA advice) Karl 500mg wasn't enough for me. I went to (3) 250's a day (Glucovance) and that really brought me in control. I take one with each meal so I don't forget. Of course, everybody is different but that's my experience. ed > Had a call from my PCP today with my lab results. He rattled them off > very rapidly so I didn't get everything but gather that all had [quoted text clipped - 34 lines] > - Jewel > T2, metformin 500mg, diet, exercise and education . My blood pressure is down and I'm trying to > get more exercise but I'm still seeing bg over 140 at least 17% of > the time although the over 160 readings are gone now. I've been > taking Metformin (500mg) once a day but cannot talk my PCP into making > it twice a day as long as I have my numbers continuing to inch > downward. That seems like a really low dose to me...my doc has put me on 2000 mg per day and I only weigh 112lbs... and my latest A1c was 5.1. I just could not keep my pp numbers out of the high 6's even with ultra low carb (5-10-10) What happens if you just insist? I have found my Doc is pretty responsive to my ideas when I just flat out say " I want this"... My understanding is tht gastric merriment apart, Metformin is a pretty benign drug for most people. What gives with this Doc? ss > . My blood pressure is down and I'm trying to > > get more exercise but I'm still seeing bg over 140 at least 17% of [quoted text clipped - 11 lines] > a pretty benign drug for most people. What gives with this Doc? > ss Military medicine. I don't get a doctor for a PCP. I get a nurse-practioner and Tricare or the Army hospital really dictate what they can prescribe. My numbers are within their parameters so as far as they are concerned, I'm good. I went to the civilian sector for an ophthamalogist because there was never an appointment available for me; I went to the civilian sector for a podiatrist because I didn't rate one if I didn't have foot ulcers (they don't have the doctors to cover the load); and now I'm going to the civilian sector for an endocrinologist because the Army is still in the high carb mode. - Jewel Jewel wrote in message <1161762712.833492.44270@i3g2000cwc.googlegroups.com>... >> . My blood pressure is down and I'm trying to >> > get more exercise but I'm still seeing bg over 140 at least 17% of [quoted text clipped - 23 lines] > >- Jewel Metformin is a really cheap me. I wonder if you can talk somebody into raising your metformin dose based on the Physicians' Drug Reference, i.e. http://www.pdrhealth.com/drug_info/rxdrugprofiles/drugs/glu1188.shtml ". . .The usual starting dose is one 500-milligram tablet twice a day, taken with morning and evening meals. Your doctor may increase your daily dose by 500 milligrams at weekly intervals, based on your response up to a total of 2,000 milligrams. An alternative starting dose is one 850-milligram tablet a day, taken with the morning meal. Your doctor may increase this by 850 milligrams at 14-day intervals, to a maximum of 2,550 milligrams a day. The usual maintenance dose ranges from 1,500 to 2,550 milligrams daily. If you take more than 2,000 milligrams a day, your doctor may recommend that Glucophage be divided into three doses, taken with each meal. . ." Regards Old Al > To make a long story short, > this afternoon I called some offices and asked questions until I found > an Endocrinology group whose staff did NOT think 6.5 was all that good. > I have an appointment on Monday. My insurance won't cover very much > of the cost but I spend as much on a fishing trip so I must be able to > afford it and I'm darn well worth it. Yup. Good for you. Could you stretch to more metformin on your budget? (Is it possible to buy it OTC where you are?) Nicky.  SignatureA1c 10.5/5.5/<6 T2 DX 05/2004 100ug Thyroxine 95/72/72Kg : > To make a long story short, : > this afternoon I called some offices and asked questions until I found : > an Endocrinology group whose staff did NOT think 6.5 was all that good. : > I have an appointment on Monday. My insurance won't cover very much : > of the cost but I spend as much on a fishing trip so I must be able to : > afford it and I'm darn well worth it. : Yup. Good for you. : Could you stretch to more metformin on your budget? (Is it possible to buy : it OTC where you are?) : Nicky. If the poster is in the US metformin and oher generics should be soon available at Wal-Mart for $5 for a 30 day supply. No idea if the price applies to all atrengths or quantities 9IE 1X OR 2 X PER DAY), but it is still cheap. Wendy > Could you stretch to more metformin on your budget? (Is it possible to buy > it OTC where you are?) [quoted text clipped - 5 lines] > 100ug Thyroxine > 95/72/72Kg If it's prescribed I can get it on my Tricare. I just couldn't get him to prescribe it. Jewel Metformin is not OTC here in the States. However, I do know of a place we can order in Great Britain without a prescription. SignatureMichelle, T2 diet & exercise >> To make a long story short, >> this afternoon I called some offices and asked questions until I found [quoted text clipped - 9 lines] > > Nicky. > Metformin is not OTC here in the States. However, I do know of a place we > can order in Great Britain without a prescription. Some drugs are not over the counter for reasons - they need medical advice ans supervision! This is true. However, some medications are OTC in some countries but by prescription in others. Some medications apparently fall in the gray area, which warrants the different rules? SignatureMichelle in NV http://community.webshots.com/user/desert_quilter >> Metformin is not OTC here in the States. However, I do know of a place >> we can order in Great Britain without a prescription. > > Some drugs are not over the counter for reasons - they need medical advice > ans supervision! > Michelle in NV > http://community.webshots.com/user/desert_quilter >>> Metformin is not OTC here in the States. However, I do know of a place >>> we can order in Great Britain without a prescription. >> Some drugs are not over the counter for reasons - they need medical advice >> ans supervision! > This is true. However, some medications are OTC in some countries but by > prescription in others. Some medications apparently fall in the gray area, > which warrants the different rules? The rules of prescriptive authorities are not rational. They're a safety net invented by committees for people who can't think. If you try to understand them you will go mad :-) SignatureChris Malcolm cam@infirmatics.ed.ac.uk DoD #205 IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK [http://www.dai.ed.ac.uk/homes/cam/] >> Michelle in NV >> http://community.webshots.com/user/desert_quilter [quoted text clipped - 14 lines] > safety net invented by committees for people who can't think. If you > try to understand them you will go mad :-) I kind of suspected something or other like this, but had no experience from which to speak. In any case, I won't waste my time trying to make sense of it. ;-) SignatureMichelle, T2 diet & exercise Jewel, I pesonally think you are going in the right direction. I do believe that the pcp is in not in the loop about your diabetes and that you deciding to go to an endo is the best thing. I was a diabetic going to a pcp for 1 1/2 and I was not in control no matter what I ate. I went to the endo and within three months my numbers were down and I was losing lots of weight. Unfortunately diabetes is forever so having a little more patience is to your benefit. Loretta -- In tribute to the United States of America and the State of Israel, two bastions of strength in a world filled with strife and terrorism. |
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