Attitudes of Healthcare Professionals
Why is it in this day and age we still have physicians that think all diabetics are "non compliant" just because your A1c is not what the ADA thinks it should be?
I am NOT that number, damn it! That's what I always want to scream at them in their face.
I am the person who has had T1 for longer than you have been alive, test 6-8 times a day, wear a pump and a cgm, low carb, exercises everyday I am not at my full time job as a nurse, and pay way more money than you will ever have to pay in medical expenses!
I work my butt off to get an A1c of 7.1-7.3, how dare you judge me!
Hmmmmmmmmmmmmm..... now I feel better :)
This isn't the first time this has happened to me and I have changed physicians several times because of those types of attitudes but this was the experience I had today with a locum physician who was filling in for my retina specialist. Hope my regular doc returns before my next appointment.
Replies to This Discussion
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Permalink Reply by Stemwinder on -
Hi April, I see that you are experiencing the full blown oral T2 treatment which I know is very flustrating. You mentioned that your doctor has started insulin. I hope it helps you it has really helped me. Eventually we reach the end of the road with oral meds and insulin is the right thing to do.
It is flustrating when we can't eat the carb laden food without spiking. I'm T2 also and share your flustrations. I have sort of made peace with it all and have worked hard to become a compliant patient but you know what I still hate that term.
Yes we do get a bad rap for being T2 whether it's deserved or not. I am long past caring what others think of T2's. I find a lot of non-judgemental folks here at TuD and thats why I keep comming back.
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Permalink Reply by Laddie on -
April--Frankly if I were you, I would demand testing to see if you are an undiagnosed Type 1 or LADA.
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Permalink Reply by Stemwinder on
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+1 great point
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Permalink Reply by Marypat on -
I have a great endo now- after I walked away from the first one. My new endo (the go to guy for T1s on pumps) explained to me that sometimes the A1c is not the most accurate measure of blood glucose control. My CGM indicates that I should have an A1c of 5.8, but my A1c comes in at 7.0 if I am lucky. I worked hard too to get my A1c down and I was a bit disappointed with the test results. He reported the test results and his assessment to my PCP and at my last PCP appointment we talked about it. She said she had a number of patients that also fit the same description- a disconnect between the BG average and the A1c. She had not previously heard a medical explanation of the issue. Both my family doctor and my new endo are very supportive. I guess I am lucky.
Some of the other healthcare professionals can have a bit of an attitude, but I think it is because they are not familiar with LADA and it does not make sense to them.
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Permalink Reply by Terry on -
Marypat - The average BG number from CGM data does not match up exactly with the A1c number. CGMs will often not get as low as actual lows and not as high as actual highs. My A1cs usually come in higher than my CGM. If CGMs were lab accurate then the correlation would be very high. As it is, we currently calibrate CGMs with fingerstick meters that are +/- 20% accurate!
I, too, would be puzzled with a CGM predicting a 5.8% A1c and ending up at 7.0%; that's a bit of a stretch. Have you compared the average on your fingerstick meter (90 days) with your A1c?
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Permalink Reply by Clare on -
What kind of CGM do you have ? I have found the new Dexcom G4 is generally very close to what my glucometer reads - at least within a 5% range or so. And I am really happy with it.
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Permalink Reply by Terry on
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Clare - I have the Dexcom G4, too. At times I've had very good correlation with my fingerstick readings, but I've also had some readings that were 15-20% off. My first sensor performed very well. I used it for 16 days and the readings were very close to my fingerstick readings.
I changed my second sensor out after about 10 days due to some data dropouts and poor fingerstick correlation. It worked well for the fist week though. My third sensor has taken two days to settle down and now I'm getting good correlation.
I'm also really happy with the G4. The first sensor especially showed its potential. My comments to Marypat about the Dex averages and A1c's are based on my experience in the past with the Dex 7+ system. I didn't start with the G4 until Novemeber 2. I'm hoping the G4 average will track my A1c numbers better than the 7+ did.
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Permalink Reply by Clare on
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I just got off the phone with them they are sending me a free sensor because the second one has given me some really funky numbers, like 110 Dexcom, 55 meter, and 155 and rising with the Dex and 112 meter. So I called and complained and they are sending me a new sensor.
I did get good numbers from my first sensor as well, only I started on November 12th. It is my first experience with any D device besides my meter so we'll see how it goes. The first 12-24 hours was rocky as hell but it has improved from there.
I will find out next week how my A1C compares because I have my semi-annual endo visit.
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Permalink Reply by Marypat on
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Terry- You are correct. I did not explain myself well- not the first time. I really did not mean the CGM, I should have said the fingerstick BG compared to the A1c. The fingerstick BG data indicates that the A1c should have been closer to 5.8.
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Permalink Reply by PatientX on -
Man, you should go to my endo. I keep telling him I want to tighten up my 7.0 and go lower and he tells me that I am doing just fine. I used to be at a 6.2 and then they started to mess with the cholosteral medicine and my A1C of 6.2 that I had for about 3 years went up to a 7.
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Permalink Reply by Cosumne Jan on -
I have consistently low A1Cs and it's not much better. Everything that happens to me is blamed on diabetes, even though my blood sugar has been in the mid to low 5s for 5 years. The doctor is always trying to get me to take statins "just because" I'm diabetic (my cholesterol levels are also low), and when I refused that I was told to take a baby aspirin every day. The doctor has criticized my obviously successful low carb diet several times. Even though my numbers are great, I'm still called non compliant. So I don't think it's possible to please the docs, you just have to please yourself. I have never been so disappointed in the medical profession, but still it surprises me that as a nurse you can't deal with them either. I'll remember that next time and it will make me smile.
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Permalink Reply by PedsRN on -
Being a nurse with diabetes can be good and bad. Good in the sense that I have a medical background and tend to think I am more of an advocate for myself because of it. The downside is that a lot of docs just don't know a lot about T1 (endo's excluded) and just go with whatever I say. Which is great most of the time, but when I really need some help trying to find out what's wrong they're clueless. I'm still in search of a new endo. At my last visit, I offered my complaints, which I rarely have any of, and he just kinda wrung his hands together and said, "well, you have all the technology, you test, you exercise and you watch what you eat, theres really nothing else I can offer you." Yeah, it's totally frustrating!
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