We just had the first 6 month check-up here in France.  It was with a different doctor than he had in hospital, although the attitude was much the same. 
It was a terrible meeting, we had so many questions and wanted some help with a few issues and all she focused on was that he took Lantus twice a day.
She said: No one, ever, takes Lantus twice a day.  It is only for the nighttime.  It has no purpose for the daytime.
And then she said: If the BS is between .80 and 1.00 when you wake up, that is all you need to worry about.
Is this typical of doctors in France?  Europe?  Do they not pay attention to what is going on elsewhere?  Or have I been reading too much...
So, V is following her orders (she IS the doc) for the next few days - It should be interesting.  She cut his daily Lantus in half, only 1 injection at night and told him to increase it by 20% every night until he had one morning reading of 100.  Then to stay with that. 
If this is a typical doctor, how do you handle it?

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Wow. I agree that this is unacceptable. Can you try to find a different doctor?

I have good experiences with the doctors in Hungary (in the capital city) knowing about most of the latest treatments even if their attitudes are sometimes a little "old-fashioned".
We're going to try, but as this is a teaching hosptial, I'm guessing that they are all taught the same. He has to have another surgery, to repair the muscles that didn't heal right after the pancreas was removed, and that is going to be next summer at the same hospital, so I don't see us making a major change until after that. In the meantime from V's standpoint, who does he listen too - his doctor or his wife?
His wife :) Always!!!

I'm surprised that she thinks Lantus is only for the nighttime. She if she will join TuDiabetes!
Most doctors just trust the describtion by the manufacturer. The manufacturers state that Lantus and Levemir will last for 24 hours. But this is a dangerous twist of the truth. Yes, it will last that long. But not in its effectiveness.

This means that Lantus will fall rapidly in its effectiveness after 21 hours. Levemir will degrade in its effectiveness after 14 hours. German diabetologists are not surprised by these facts. They will recommend to try different approaches until the patient will reach good control. They are not sure - they try because everyone is different!

I think it is very easy to get along with your doctor. Try his recommendation for 3 days. Then go back to your usual regime. Your numbers will support your claim. But offer him another opinion: tell him that you are unsure about the Lantus too. You would like to switch to Levemir and to apply that twice a day. He will also recommend to apply that once a day but you should insist that it is not comparable to Lantus. From knowing your numbers I am convinced that this can make a difference for V.

As you see I am not convinced that your doctor will give you the correct advice. It is not their life but your husbands life. It is hard to stand against a doctor. But you can beat him because he has to show that his advise is right and you can proof him wrong very quickly.

The best thing is not to wait for a miracle to happen. Try things out - even the ideas of your doctor. Step by step you will learn within a few weeks what works. I am sure at the end your doc will stick to the solution that works.
It was so frustrating that she wouldn't even look at the numbers I had or listen to the reasons for changing from the once a day routine. You're right, all we can do is try for a few days then get back to what works.
I like Holger's idea of following their advice and showing them whether it works or not. Don't they want to see his blood sugar logs when you come in? I get scolded for not bringing enough logs (I usually only log 2 weeks before my appointment).
I had 6 months worth of logs and she only looked at the last day of the last week - saw that he took Lantus twice a day and wouldn't look any anything else. I tried to show her the logs when we made the change to twice a day, she saw one high number on the 2 week spreadsheet and said: See? that's what happens when you take it twice a day. When I asked about the lows that taking a higher dose once a day were causing she said: must be too much rapid.
Hi Katie,
So welcome in the world of French doctors... I can try to explain something about them.
First they are in France, a country of type 2 diabetics. They know there's Lantus because Sanofi Aventis gave them informations, meeting in nice hotels...But they don't want to know how others countries treat the diabetics. My Endo knows that some diabetics took Lantus twice a day, but she doesn't want to know about low diet carbs, Levemir, pumps...And of course she doesn't understand a word of English. She doesn't want to learn the new treatments. A friend of TuDiabetes who has a small boy with type 1 told her Endo about the Omnipod : the answer was there's no pump like this!!!!!!!!!!! I think all Endos must know from each other, no frontiers . I really can't understand that they don't want to know!
It's crazy to increase Lantus by 20 % every night. I used Lantus (type 1 and only 8 units of Lantus/day) and in july I switched to Levemir because of what I read about it. I used to make the shot in the morning when I woke up. You must believe me: I discovered a new world and a new life with what I learn with TuDiabetes. Have a nice day.
I asked about a pump and got a blank stare. I just tell V that's it's up to him (us) to manage his blood sugar. But he's had his regular doc and now the endo tell him the same thing about the Lantus - why he thinks the GP would know much I don't understand. But, we have to see if there right, don't we. But the statement about only the morning reading being important was really wrong, in my opinion.... And very confusing.
Hey guys, I can feel a certain empathy towards Katie and the attitudes shown by the medics. I live in Spain and have the admit that the Endo I visit is great and very open to new ideas and suggestions and I try and respond likewise with his.

I have come across certain doctors that are very "old school" and to them it is a case of "my way or hit the highway" scenario. This is upset me and me must all remember that the doctors are providing us with a service!

With regards to Endo's, can I say this is there defense. Many are endocrinologist's which means then specialise in the endocrine system an therefore they simply can not be 100% up to date on all things cool with Diabetes. If however you Endo is a Diabetes Specialist then I say that there is no excuse as this is what they do day in and day out..
When I was on Lantus I tried to use a amall amount of NPH insulin before dinner time. I had Lantus before bedtime. But It was not a very good experience. I had lows frequently. I only had Lantus one time in 24 hours. My lows when caused by Lantus were very difficult to control. Once I had to go to the hospital... I was constantly below 60 mg/dl and I had more than 50g of pure sugar. I remember myself entering in the ER without passing throw the reception desk. Who saw me then should had said that I was drunk :) I aproach a nurse and just tell her that I was about to fall in the floor. I don't remember much then... until the glicose kicked in.

Oh Katie I am so sorry for you two. We don't expect too much of doctors, but many live in the dark lazy day's of 'Job's for your friends' Here in Spain I moved a year ago from Malaga Province to Granada Province. I found my new doctor was an alcoholic. He changed my heart tablets without listening for my chest and never gave me a follow up appointment. He said " "If you have a problem. Go the the Emergency Department at the Hospital !". It's 40 kilometres away! He just waved his hand at me when I told him (In Spanish) about my D2. So we live in Granada but registered back at my old address so I can see my original doc. BUT! He never sent me to an endo, and I never heard of one here in 10 years. My D2 is crazy, burning legs, blurry vision 125kilos. After 2 H/attacks I am scared witless but try to live normally! I pray you both get the correct support you need. I think Europe is quite 3rd world still when you get inland !

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