So I had my appointment with the diabetes doc. He's one of only two docs in the whole city (population around 580,000!) who are certified to run the insurance company's type 1 diabetes program, and, well, I would not pick him as my doc if I had a real choice. He's just not the type you feel could be your buddy or your partner with treatment. I don't know what it is, but he just doesn't make me feel comfortable at all.
Well, I presented him with my findings and then got the expected speech about how meters are never 100% accurate and one meter varies compared to the next, blah, blah. No kidding. I got the impression he thinks I'm just lying and trying to make excuses for high blood sugars. I'm not!!! I really want to get to the bottom of why my meter says everything is better than it's been for 3 years and yet my a1cs are much higher! Something doesn't compute. Something (my hemoglobin, the lab or the meter) is messed up!
Here's the kicker. He wants me to come in at 8am for a new a1c (good) and also a finger stick to compare the lab's glucose value to my Ascensia Contour. THEN... he wants me to do the same every two hours for the rest of the day. Lab to meter comparisons. So, at 8, at 10, at noon, at 3, at 5. I've never even heard of anything like this just to see if a meter is accurate! That's a lot of lab work, isn't it?! And that's an entire day off, hanging around in a neighborhood where there's nothing to see or do for 8 hours or more. (We don't have a car and his office is so far out of the way that I couldn't get anywhere and back with pub trans in time.) Agh! This couldn't be worked into my schedule until September 6th.
The problem is, I don't know how to take this. What's the motivation? Why wouldn't he have just said, "ok, so you think the Ascensia is junk. Well, I seriously doubt it, but sure... we can give you Accu-Check strips next time instead." What's the big deal? Why the 5 lab tests? I figure it's one or more of the following:
1) He has a contract or deal with Bayer (a German company, after all), the maker of Ascensia meters, and wants to prove that I'm crazy, not the meter
2) The insurance company has an exclusive deal with Bayer and he would need to prove something's wrong in order to get me something else
3) He doesn't believe me and thinks this is a convienient way to catch me with bad blood sugars all day (plus prove that the great Bayer is to be trusted)
If I felt like I could actually talk with him, yes, I would have asked further. However, I felt more judged and under suspicion than warm and fuzzy. I had a better relationship with my docs in America than with any here. I have found that in Germany there tends to be a more "I'm the doctor, you're the patient, so just do what I say and don't ask questions" attitude. It's frustrating. (Other expats have mentioned this phenomena, too, so it must not just be me.)
And now there's a dilemma. The Ascensia reads only 10 to 20 points lower at good numbers, but up to 50 points lower when it gets over 180. If I go in and do everything I can to keep my glucose levels in the 80 to 120 range all day to show what a good job I can do, the variance might be too small to say there's anything much wrong with the meter. The only way to see how much of a difference there really is is to test over a larger range of sugars. So, I want to see what it says when I'm at 200, not just at 100. My plan is to under-bolus at lunch or drink a little Pepsi or something to insure a couple of 180+ readings. This is risky (if #3.... trying to catch me with bad numbers... is true), but how else will we see how accurate the meter really is? I plan to do this and make it very very clear to them all that I purposefully went high because I wanted to see what the meter would say. I don't see what else I can really do. It feels like this is some kind of a game that I'm doomed to lose. Has anyone else ever had a doc do testing like this just to see how your meter compares to the lab?!
Of course, I'll post updates later for my own record and for any others who actually read my long-winded complaining, lol. Just don't have anywhere else to bitch about this sort of thing, you know!