Dr. Appt. Today - Disappointed

Pegsy
By Pegsy Latest Reply 2015-02-13 14:05:04 -0600
Started 2015-02-05 16:58:25 -0600

I saw my doctor today and I am so disappointed. First of all, she didn't test my cholesterol, after making such a big deal about it 3 months ago. So it will be another 3 months before I find out if it has gone down.

My A1c was 6.4. Up .1 from last time. I have been keeping careful track of it at home and I estimated that it would be 6.1. She says this is about what my liver is doing at night and started talking about adding another medication. NO! I'll live with this and work on my diet some more.

Following her diet advice for the last 6 months has sent things in the wrong direction. I'm going back to what I was doing before with a few changes that I have picked up from my more experienced friends. We'll see how I do in 3 more months. :~(

I've decided not to test so much during the day. It just doesn't match up with the A1c labs. I feel my most important reading is the morning fasting number. From there in comes down during the day with proper eating and exercise.

Now I am back to the decision of whether to have a bedtime snack or not. SO frustrating!


50 replies

Dr Gary
Dr GaryCA 2015-02-11 17:42:10 -0600 Report

Hi Pegsy, sorry to hear about the disappointing news. I know it's frustrating to be doing what you are told is all the right things and not get the results you had hoped for. Just want to give you some encouragement. Hang in there, keep taking really good care of yourself. Keep us posted on how you're doing, my friend!

Pegsy
Pegsy 2015-02-11 18:21:28 -0600 Report

Thank you so much! I've returned to my "old" plan that was working for me before all this advice from my doctor and her dietitian. My numbers are already coming down. :~)

Dr Gary
Dr GaryCA 2015-02-12 22:39:16 -0600 Report

Hey Pegsy, sounds like you know what you are doing here. I am glad to hear you are already seeing results. Excellent!

allied gardens
allied gardens 2015-02-08 18:51:36 -0600 Report

Hang in there and check your sugar about 6 times a day. Before meals and 2 hours later.Write down the sugars also. Before you go back to the doctor check the cholesterol. Seems like we need our lists when we go to the doctor and reminders on tests!

Health snacks
Health snacks 2015-02-06 21:32:15 -0600 Report

THANK YOU SUPERCHEF MR.CHARLES MATTOCKS FOR ALL OF YOUR HEALTHY RECIPES FOR ALL AS WE ARE VERY LUCKY FOR HAVING YOUR LOVE TO US ALL!!!

tcandeyman
tcandeyman 2015-02-06 13:40:03 -0600 Report

well gd mrn what i found is that i have a some fruit before bed this seems to help my sugar reading my sugars are a little high the va changed my dozeage so gd luck with your sugars

handmashed
handmashed 2015-02-06 11:23:48 -0600 Report

Pegsy,
My morning bg is always lower if I have that last snack. BUT… I have to keep it on a time schedule… if I wait too late, or have it too early, My bg is not right in the morning. The night snack I always have is a chocolate protein shake made with Calfia almond milk!! It keeps my liver from making trouble, and gives me a delicious treat!! I sure wish there was a cut and dried answer to bg problems… one day there might be.
Be well!!

Pegsy
Pegsy 2015-02-06 12:28:50 -0600 Report

What time do you usually go to bed and what time do you usually have this snack? I took a snack last night at 9:30 and went to bed at 10:00. I had a pretty high number this morning so I am thinking this may not be the thing to do.

Sopies Grandma
Sopies Grandma 2015-02-06 08:00:27 -0600 Report

I'm sorry to hear that your having such a difficult time. sounds like maybe you should consider seeing a different doctor. Is the doctor you are talking about a PCP or an Endo? For me I have to eat a snack before bedtime. My numbers crash at night. Every night! I have the alarm set to wake me up at 2 am and 5 am and again at 7 am. Last night however at 2 am my sugar went from 95 to 245 in less than an hour. Not to sure just what happened but I feel sort of shaky right now and my vision is really bad. If this doesn't clear up right soon I will be calling my doctor.

JeanM
JeanM 2015-02-13 14:04:05 -0600 Report

Your liver dumped sugar into the blood stream to make up for the low sugars. Somewhere your Blood sugar must have gone lower to the point where the liver went to starvation mode.

Pegsy
Pegsy 2015-02-06 12:30:55 -0600 Report

She is an MD claiming to specialize in diabetes care but she is not an Endocrinologist. I am thinking seriously of finding one. I don't even know where to begin.

Sleep is so important for me. If I had to wake up so many times during the night it would have a very negative effect on my health. I don't know how you it!

lilleyheidi
lilleyheidi 2015-02-06 00:13:49 -0600 Report

In my opinion your doing the right things. The margin of error on A1c is … well, i don't remember the exact number but I know there is a margin of error on them, so I wouldn't worry too much about a few points. 6.4 is not bad at all. Keep doing what your doing. Best of health to you. Don't be discouraged or at least try not to be. Praying for you. heidi

mslaird
mslaird 2015-02-05 23:35:37 -0600 Report

I know what you mean, I go for my lab work on tomorrow. I like my doctor he make sure every 6 months he does my lab work. I do have to admit last year between July and December I pretty much gave up I just stop doing all of it I went in a depression. The 5th of January I went on a 21 day fast and snapped out that rut I was in and got back on track. I always tell my doctor the truth he thinks I'm a little out there Lol. I let him know up front my lab work gonna be bad when it come back, he told me not to beat myself up about it we all are human and to learn from our mistake sometimes we gonna go backwards. So here I go again I'm gonna try my best to stay looking forward and not to go backward this year.. Its a hurdle to jump but with God help I'm gonna make it. Keep your head up don't beat yourself up and follow your heart its gonna be alright…

Pegsy
Pegsy 2015-02-06 12:35:26 -0600 Report

Thank you so much for your encouragement. I really need it. I am such a perfectionist and I am pretty hard on myself. I need to get with reality and accept that I have diabetes for the rest of my life and I just need to deal with it the best I can.

mslaird
mslaird 2015-02-06 15:10:51 -0600 Report

Yes by accepting it will only make it easier believe me when I say by easier.. I'm here for you we can help each other and believe me I'm not gonna beat you up or let you stress yourself over thy is diabetes life… Be encourage and know God got us no matter what..

Jibber Jabber
Jibber Jabber 2015-02-05 23:13:26 -0600 Report

A .1 change is really no change at all…none of these test we take are exact..not the test we take at home and not the A1cs at the doctors office…as far as the weight is concerned..there is always a range on what is considered to be a healthy weight and doctors drive me flipping insane with them…one doctor told me my ideal weight was 112 (excuse me while I laugh) and another told me 140…I am going with the 140 because when I was 140 I looked good and was a nice size 6…take all the weight talk with a grain of salt…and chin up…in the grand scheme of things holding steady in your A1C range is a good thing…

Pegsy
Pegsy 2015-02-06 12:40:42 -0600 Report

Thanks for the encouragement, I really need it! I am not quite 5'2" and at about 122, I think I could stand to lose a little more. It's in the belly area. I am not dieting to lose weight, I am just eating sensibly and exercising as I should for my health, If more pounds come off, so be it. I'm not going to worry about it either way, so long as I don't start gaining it back.

BB42
BB42 2015-02-05 21:08:08 -0600 Report

Forget the snack! A 0.1 increase is not significant. Might I ask is you physician an endocrinologist who specializes diabetes? If not, consider changing. This is such a weird disease. Stay the course. I call my doctor whenever things don't go a I expect. He is encouraging and keep me on course. So should yours

Pegsy
Pegsy 2015-02-06 12:43:45 -0600 Report

She is not an Endocrinologist. She's telling me that I am doing everything right. Then one appointment she scolds me about my cholesterol and wants to put me on medication and then the next appointment she doesn't even test my cholesterol and states that it's only a little bit elevated. Which is it?!? Her advice is inconsistent which really gets on my nerves.

sweetslover
sweetslover 2015-02-05 21:02:56 -0600 Report

Hi, Pegsy
I am so sorry you are disappointed in your results. The good news, though, is that your A1c is still in the good range. Do what you know works for you. That's what I have to do.

Pegsy
Pegsy 2015-02-06 12:44:50 -0600 Report

I'm starting to lose confidence in what I thought was working for me. I think that's really what my problem is, LOL.

valentine lady
valentine lady 2015-02-05 19:19:00 -0600 Report

Hi Pegsy
So sorry to hear you are so disappointed about your numbers. Not to worry things will turn around for you in the next 3 mo I just feel it.
I'll keep you in my prayers. Hugs, VL

Pegsy
Pegsy 2015-02-05 18:18:11 -0600 Report

OK…I'm trying to look on the bright side.
1/14/2014 fasting glucose 174, A1c 7.3
1/28/2015 fasting glucose 151, A1c 6.4
Even though my expectations were not met today, it is still progress in the right direction. I'll quit complaining now. LOL

Pegsy
Pegsy 2015-02-05 18:12:08 -0600 Report

She also told me not to lose any more weight (according to her "chart") and I still have a belly roll! That tells me there is still too much fat on my body. I am going to continue to eat and exercise sensibly and if more weight comes off, so be it.

RosalieM
RosalieM 2015-02-05 17:46:36 -0600 Report

Hi Pegsy,
I like your attitude, 6.1 or 6.4 close enough. The monitors have a 30% error rate allowed. You get better diet advice right here. Diabetics soon become experts
on what raises blood sugar. It is much more accurate than diabetic educators.
Remember here you get the benefit of many people testing their blood.
People are all a little different in how they react to carbohydrates they eat and they take different medications which also affects how their body reacts.
There is no question though that carbohydrates raise blood sugar for every one,
protein a little and fat not at all. The other thing that is for sure, you get all the carbohydrates your body needs from fruits and vegetables. even if you never ate another slice of bread or potato. That is really all the diet information you need
to stay healthy..

Pegsy
Pegsy 2015-02-05 18:08:43 -0600 Report

Thanks Rosalie, I know you're right. I wonder if my "goal" for my A1c is unreasonable. Perhaps still entertaining a fantasy, that I can make this diabetes go away. I just so want to control it through diet and exercise alone, and get off the Metformin. This feels like such a setback that it actually went up a little and not down. Not much, I realize, but still.

RosalieM
RosalieM 2015-02-06 06:27:55 -0600 Report

Pegsy,
A1c's are different for everyone to. The number they select is arbitrary. No one ever questions that. My A1c has ben 7 for years and years. I take no drugs and only enough insulin to make up for what I am short. I am normal weight. If I lowered my blood sugar any lower by diet I would become mal nourished.

The role around my middle is excess skin from losing weight.
When you age, the skin doesn't bounce back as it did when I was younger. If you can have an A1c.where it is now and you do not need to take metformin to get it there, You have your diet,
and exercise right. That would be a god goal for you.

jigsaw
jigsaw 2015-02-05 17:31:57 -0600 Report

I believe that it makes sense to go for the numbers that you are most comfortable with. That of course is with the caveat, that it is an informed decision, and goal.

I have maintained an A1c between 6.0 and 6.2 for 21 years. I feel good in general, and have no diabetes complications at all. As far as I'm concerned, that is a number that I am comfortable with. That means that for now, I will not change my diet or exercise routine.

Food plan, exercise, and meds are the three areas that impact many PWDS the most. Adjusting any one of these can frequently make a big difference. Sounds like you're on the right path. By the way, I have yet to meet a doctor that knew much about proper food plans, and nutrition in general. They are hardly ever educated or trained in that area ! A registered dietician with experience in diabetes would most likely be your best bet.

Pegsy
Pegsy 2015-02-05 18:20:44 -0600 Report

21 years without complications is awesome Jigsaw! I hope I can achieve similar results.

Pegsy
Pegsy 2015-02-05 17:37:01 -0600 Report

It was the dietician(s) she sent me to that steered me in the wrong direction. I need to go back to what I was doing before. She told me to stop the bedtime snack. I think that was bad advice. If I can get it down to 6.0 or lower, I will be a happy camper. Back to the drawing board! Thank you for your sympathy and encouragement. :~)

suecsdy
suecsdy 2015-02-05 17:23:27 -0600 Report

So sorry it didn't go the way you wanted. I totally understand. 6.4 is pretty good…that's where I am as of last Dec Compare it to where you were when you started this journey. My Dr. doesn't really give me diet advice other than to low carb it. I will say she was thorough with my tests though and even though I am not crazy about the results, I am grateful she was on top of things and referred me to the nephrologist. I guess ultimately, we all have to figure out what is best for us. If you don't feel like her advice is working for you, don't use it. How often do you test? I do 4 per day..before meals and at bedtime. Occassionally, if I feel "off" I will test, but I can't really afford to test more. As long as my pre-meal numbers are good, I'm usually happy.

Pegsy
Pegsy 2015-02-05 17:32:49 -0600 Report

I test at least 5 times a day but I no longer see the point of that. I have great control during the day. Usually in the 110's two hours after a meal. I am pretty satisfied with that but with those numbers, my A1c should be lower. What's happening is that my liver is dumping glucose like crazy at night. I don't want to add another medication. I need to find a natural way to get that under control. So frustrating.

RosalieM
RosalieM 2015-02-06 06:32:41 -0600 Report

Pegsy,
You are eating to much carbohydrate during the day. It is loaded in your liver probably by the metformin and is let go at night.
If you cut your carbs during the day for a few days, you should see the fasting number go down.

Pegsy
Pegsy 2015-02-06 12:53:55 -0600 Report

It is my understanding that this is what the liver does, and what it is supposed to do, regardless of taking Metformin. My glucose has come down considerably on Metformin. Before starting it, my morning numbers were even higher. I was on a diet for quite some time that eliminated ALL starchy foods and I felt terrible on it. I seem to need some starchy foods in my diet. I consume just one serving (11-20 gr) per meal or snack. I don't know how to reduce that without causing my liver to dump even more into my system.

RosalieM
RosalieM 2015-02-07 09:02:32 -0600 Report

Does Metformin take the sugar from your blood and put it in your liver? I am not sure, but will research that. Metformin has to put the sugar it removes from your blood somewhere. I am guessing it goes to your muscles and liver. If I eat too much carbohydrate, my fasting blood sugar goes up for a couple of days after.
It may be the metformin that makes you not feel well without starch? The metformin has no starch to work on. If you ate only fruits and vegetables along with protein and fat, you probably will not need the metformin. That is unless you do not make enough insulin. That is true in my case. I have to take a small amount of long acting insulin once a day.
Most type two diabetics make too much insulin, but not all some make some but not enough.

Pegsy
Pegsy 2015-02-07 09:12:51 -0600 Report

Thank you doctor Rose for you medical advice, LOL! I was on that diet for over a year BEFORE starting Metformin. I felt horrible and I had extremely high morning glucose and could not get my glucose low enough during the day while on this diet that you recommend. My body produces plenty of insulin per my lab work. I appear to have two issues going on. 1) my body's cells are resistant to the glucose in my blood and 2) my liver just won't give it a rest.

Here is where you can learn more about what Metformin does. I'm sure there are many more sources online that can provide the information you seek.
http://en.wikipedia.org/wiki/Metformin

RosalieM
RosalieM 2015-02-07 11:51:47 -0600 Report

Peg,
I did look up the link. It said "Type 2 diabetics have three times the glucogenesis of normal people. That is the liver puts this much out. Metformin reduces it by 1/3. Grandma Rose got that one wrong. That leaves two possibilities, either you are putting too much glucose in your liver ( eating too many carbs) or your pancreas does not make enough insulin. I think you said your weight is normal. If your weight is normal you should not be insulin resistant as that is linked to weight. I have that problem myself, my pancreas does not make enough insulin. The metformin I took did not lower my blood sugar. I had to figure it out myself as my doctor didn't.
I ask for insulin and in time figured out how much to take. He now agrees with me. Doctors don't always catch it mine didn't.

Pegsy
Pegsy 2015-02-07 11:57:01 -0600 Report

My doctor says that I do produce enough insulin but that my body doesn't use it efficiently, thus the Metformin. I am still hopeful that in time, with proper eating and exercise that I will be able to eliminate the Metformin. If not, well, there could be worse things. Stress and sleep have a big effect on me as well and those are both improving, so we'll see.

RosalieM
RosalieM 2015-02-07 11:29:23 -0600 Report

Peg
Thanks for the link. I would have liked to become a doctor, but before women's lib, that was not an option. Calling me doctor Rose is a compliment.
How is your energy level? If you body's cells are resistant to glucose, you would not have enough energy. Thanks for the link, I will look into it. I suspect that your understanding of which foods are high in carbohydrates may be the problem. Stay tuned.

suecsdy
suecsdy 2015-02-05 21:05:31 -0600 Report

I always have a bedtime snack…somewhere between 10 and 11 PM. and my fasting numbers are usualyy below 100 and sometimes even in the 80s, but I am on insulin and don't see me getting off it anytime soon. Counting my blessings though, I am on low doses of both fast insulin and the longer lasting.

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