Part 1 of 3 Parts
Are you ready for your doctor
appointment? The following is some of the questions to ask your
doctor if you have recently received a diagnosis of diabetes, type 2.
Some questions just lead to more questions and can make it difficult
to follow what is and what is not important to know immediately. I
have tried to stay with what is important at the start and good to
learn at the beginning of your journey. Each question tells you
which of my blogs contain an applicable discussion if you wish to
read more or I will refer you to a blog by another writer.
I have tried to sprinkle in the
acronyms that you will learn and see very often. I will also try to
point out terms that you will need to learn. Why? Because you will
see them used by most people that have had diabetes for several years
and once you learn the language, you can learn to read without a
dictionary. You may still want one handy, and there are several
online. I prefer this medical dictionary, but I will also use this
medical dictionary. There are others and you may search for them and
see if you like them.
An example is blood sugar (BS), which I
do not like, but most writers insist on using this term. Correctly,
both scientifically and medically, the term should be blood glucose
(BG). I would urge people new to diabetes to read this by David
Mendosa. One example that I see all too often is the use of the word
glucometer. This is correct only if you are referring to the
meter registered to Bayer as a trademark. Correctly, your meter is
just that, a meter. Also, be careful as most people refer to a meter
and test strip as a unit even though you must change test strips.
The 10 questions are really 14
questions and I have divided them accordingly.
1. Should I
check my blood sugar levels at home with a glucose monitor? How often
should I check them?
2. What are my
goals regarding blood sugar levels?
3. What are
the warning signs or symptoms that my blood sugars are too high? What
do I do if my blood sugars are too high?
4. What are
the warning signs or symptoms that my blood sugars are too low? What
do I do if my blood sugars are too low?
5. How can I
change my lifestyle and diet in a way that will be healthy?
6. What are
the side effects of my medications/insulin?
7. Will I
always need medications/insulin? How will you evaluate whether these
medications are the best treatment for me?
8. What are
the long-term complications of diabetes, and how can I avoid them?
9. How do
other factors such as high cholesterol and high blood pressure affect
me if I have diabetes?
10. How often
should I be seeing my doctor to optimize my diabetes management?
I will list each question and give my
response as a patient to them. They are still questions worth
considering for asking your doctor, but you will not see them
answered this way.
Should I check my blood sugar
levels at home with a glucose meter? Yes, you definitely
should check (test) your blood glucose at home, at work, or where
ever you are when testing is needed or desired. Many doctors
discourage this for various reasons and this is wrong. Many doctors
do not want you to know what they are or do not want you to be
depressed with the high readings. If your doctor does not have a
meter to give you one and a prescription for more strips, then insist
(even demand) on a prescription for a meter, lancet device, lancets,
and test strips before you let the doctor leave the exam room. If
your doctor remains uncooperative, then you have a decision to make
about possible change in doctors. For your diabetes health, the
sooner you make this decision, the healthier you can be.
Testing is the only way you have for
determining how different foods and food quantities affect your blood
glucose (BG – is the acronym). A term you will see in blood
glucose management is self-monitoring of blood glucose (SMBG – is
the acronym). You will also need to test more frequently in the
beginning to learn how long before you reach the high level of your
BG. Many suggest one hour after first bite and for some people this
can be too early. If you are a speedy eater (gobble down your food),
this may work; however, studies have shown that you should eat slower
for greater blood glucose management. Some writers do use the word
control for the same meaning. Some will suggest testing more often
until you are comfortable with when your high level of BG happens. I
suggest starting at the one-hour mark and testing every half hour the
first few times. When the reading is lower than the previous
reading, then you may stop. Your high point has occurred between these two readings.
Having said this, I must warn you that
most, if not all, insurance companies will limit the number of test
strips they will reimburse for your use. Therefore, your budget may
not allow for the testing you should attempt. And, these vital test
strips are expensive.
How often should I check my blood
glucose? This is not an easy question to answer, even for
new people with type 2 diabetes. This will depend to a great extent
on your medication(s), what your insurance will cover, your budget,
and your comfort zone. Many people with type 2 do purchase extra
test strips out of their own pocket because they can afford this.
Those people with a limited budget that are on oral medications
probably will need to use what the insurance will reimburse. People
on sulfonylureas that have had problems with hypoglycemia should
encourage their doctor to write a letter explaining this and asking
for additional test strips. There are other combinations that may
cause use of extra test strips and your doctor should make you aware
of them and request extra test strips. Please read my blog here for
some of the oral medications that can create troublesome
hypoglycemia.
How often you test will depend on your
desire to bring diabetes under good management and your budget. You
will also need to find out how willing your doctor is to go to bat
for you with the insurance company for additional testing supplies.
Some companies will allow some extra test strips in the first few
months, but then want to restrict you thereafter. Other insurance
companies will only allow a set number of test strips per day. I
recommend that you talk with your insurance company to find out what
they are willing to allow. You may need to bargain with them and
attempt to convince them of the need for allowing more test strips
for the first three to five months. Don't be surprised if you are
denied, but it is still worth the effort.
What are my goals regarding blood
glucose levels? This will depend on what you are willing to
tolerate. I suggest reading this for an excellent guide. Some
people set lower goals and do not like being over 125 mg/dl
(milligrams per deciliter) at the high point in BG. For a person
just getting started, my link is a good goal. Try not to have
fasting BG under 80 mg/dl, especially at first. Gain some confidence
in what you are doing before letting the numbers become overly
important. Yes, learn first, and then work toward them. Do not
become discouraged when you cannot achieve them the first few weeks.
Remember you did not develop diabetes overnight, and it can take time
to set goals and achieve them. These are goals you are working to
achieve and you have a lot to learn at first. I have been at this
for over nine years, and there are times when I have difficulty in
maintaining the range of numbers I want to achieve.
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