BEARCATJER

Q:

I have had type 2 diabetes for 4 years now. I am not on medication and control my diabetes with diet and exercise. Initially when i first learned of my disease my A1c test score was 6.5%. I immediately changed my eating habits and lost 25 lbs very quickly. Until about a year ago i maintained that weight but in the past year have regained 15 lbs to my current 185...5ft9 tall. I am very active and over the last couple of years my A1c test scores have been under 6%. My last score was 5.6%. I do not actively see a doctor for my diabetes,but instead communicate with my family doc from my home town in Cincinnati. I live in South Carolina. I am concerned about my weight gain in spite of my good A1c scores and i continue to test my BS twice a day. My average BS runs about 110 and I rest before breakfast and after dinner every day. I dont know if my average BS scores are good, just ok or what,but I am guided by my quarterly A1c scores as indications that I am doing well. I used to eat all kinds of bad food...candy, donuts etc in large quantities but i very rarely eat any of those items any more. Im sort of an all or nothing type! I am wondering if the time has come for me to create a relationship down in SC where i live with an Endocrinologist and have periodic checkups . I havent done so because my scores have been tracking so well, but im now almost 72 and am worried that I am being foolhardy in not having a diabetes doc in my area. I know of one who is highly thought of down here and Im sure i could go to him. Any thoughts you have on this would be appreciated very much. Thanks!doc ahmeget s rarelyefui

Patty Bonsignore

A:

First of all let me congratulate you on how well you are managing your diabetes. To answer your first question about weight gain, it is normal as we get older to gain some weight. This can be due to changes in metabolism, less physical activity and loss of muscle mass. The best professional to see for this problem is a dietitian. Dietitians can review what you are currently eating and determine whether simple changes could be made to help you lose weight or not continue to gain. Research has shown that seeing a nutritionist is effective at helping to manage diabetes -- so much so that Medicare covers medical nutrition therapy for diabetes. Find out about diabetes programs in your area, as they will likely have a nutritionist on staff to help you. The second answer to your question about whether it is a good idea to have a doctor near where you are currently living is definitely yes. This is true whether you have diabetes or not. It is very important to have a doctor close by who is familiar with your health conditions. This is particularly important if you ever need to be hospitalized. In your situation, because your diabetes is so well controlled, there is no medical reason that you would need to see an endocrinologist, though you could certainly choose to do so. A primary care provider should be able to manage it quite effectively.

January 2, 2012 at 9:13 am

1 reply

BEARCATJER
BEARCATJER 2012-01-06 19:06:51 -0600 Report

thank you , patty. i dont need to see a dietician to know where i can go much better on my diet. i think that my test scores having been so good i'm getting a little "cocky"…which is not good. i just have been eating too large portions , too much ice cream…even though not a lot..and worst of all..late night eating. Now if i can just muster the self control to ratchet it back I should be ok. I am frustrated that in spite of maintaing i high level of physical activity I am still gaining weight. I guess old age is part of it,but I dont exercise any less rigorously than when i was younger…definitely frustrating!
Guess i will get a local family doctor down here where i live..i know it is the smart thing to do…just have so much confidence in the one i have back in my home town it is very hard to change.

Thanks for your encouragement. I really appreciate it.