June 3, 2013

Personal Observations

The last few weeks were somewhat of a blur for me. I was still upset that I could have caused the group to fracture in different directions, which fortunately it did not. I received an invitation to the new group which I politely refused and then pressure to join their group. Since I had politely refused, I did not feel bad about shutting off my cell phone and deleting their emails. It was more difficult avoiding them entirely so I finally asked them to stop, as I would be staying with the group.

For the number of people in our local community with diabetes, both types, and now one with LADA, more that two groups does seem to have a place. This is very good in a way. Plus this puts doctors serving members of our community on notice that they need to become more familiar with diabetes and follow guidelines that are more current. Our group has been approached by the local doctor of the doctor led group about why we are staying outside of the official channels. We did ask the doctor advisor why he opposed our group so vocally and he refused to answer. We clearly told him that we liked being able to read the guidelines of the different medical groups and compare them without worry and that all of us did not wish to be dictated to by other professionals. We did not wish to follow their teachings when we were able to discern for ourselves what worked for us.

When he asked to address our group, emails were rapid and everyone said no. We asked him what the lowest A1c was for his group. He admitted he did not know and we stated that our group had several just above 5.5% and one at 5.2% with the highest one at 6.3%. The doctor said he doubted many of his group was near 6.0% and we said that was the reason most of us would not join his group and that of the 14 current members, 12 were now on insulin. We felt that with this, we would have little in common with the group he led. He agreed that he had not realized so many of us were on insulin, and that the two groups were probably better being separated since we were doing so well on our own.

He did ask if we as a group were having many problems with hypoglycemia. I asked what level he considered us to be in hypoglycemia. The doctor said anything under 80 mg/dl. At this point, the three of us meeting with him laughed and asked if he was aware of the joint group from ADA and The Endocrine Society that declared hypoglycemia at 70 mg/dl and he was not. Tim opened his laptop and this link. He quickly skimmed the article, asked Tim to send him the link, and gave Tim his email address. I answered that most of us did not get too concerned with readings down to 60 mg/dl, but that once it went below 65 mg/dl, we were taking actions to correct the levels, with either glucose tablets or certain foods or drinks from this list.  Tim then opened my blog about the diabetes algorithm and the doctor asked for that link. 

The doctor finally admitted that we probably knew more than many of his group ever would and thanked us for letting him know that as a group we did so much research. We thanked him and told him that someone from our group was always available to speak to his group about insulin and the advantages of insulin over oral medications. He said that he would honestly keep this in mind.

The doctor asked about the two members of our group that were not on insulin and we stated that one had just been diagnosed with prediabetes and was taking metformin ER presently and his wife had type 2 diabetes. She had been encouraged to develop lifestyle habits that got her off all medications and had been for some time now. We said that we are working with him to get off all medications and he is hoping that he can delay diabetes for many years. He was surprised and said that we did not encourage either to go on insulin. Tim said no, as we do with all members, but we discourage anyone from staying on most oral medications other than metformin because of the side effects and problems many are causing.

I gave him the classes of oral medications, those that were under close watch by the FDA and asked him which were acceptable now. He listed them and I said that two of our group was allergic to sulfa and therefore the sulfonylureas were out for them. The remaining class required close monitoring because only glucose tablets were recommended for treating lows because they slowed foods going through the stomach. At that point, the doctor stated that as long as we were teaching each other this information and knew what we did, he was happy that there were two groups. We corrected him that there were now three groups and the third one was as a result of our group splitting. They were all on oral medications and had come from the doctor that did not want his people testing. He made no comments about this, but we could tell this upset him as well.

He thanked us for our time and wished us success. He then stated that he would consider asking us to speak about insulin in the future since we were well versed about it and were meeting as a group. He admitted he had not realized we were so many in number, but that was a good thing. I told him that five of us were using the VA for our medications and this brought him back. He said he thought two of the group he led were or should get their medications from the VA. I quickly told him to have them go to the VA office at the Courthouse lower level and talk to the VA officer and she could get them started if they qualified. He said that maybe he should stay in contact with us and meet with a few of us on a quarterly or semiannual basis. He stated he had learned more than he anticipated and anything that could help his group was welcomed.

After he had left, Allen stated he was surprised we had said so much. Tim stated that he had thought about it and decided that we should and see where it went. He said that with so many opposed to him speaking to our group, we needed to sound him out and exchange ideas. I said it may now be a good thing to have him speak to our group since he knows that so many of us are on insulin and that he was not welcome in his first attempt. Tim said that was also his reason for discussing so much with him and by having his laptop available, we should have impressed him with our knowledge and research. This also let him know why our members were not interested in joining his group.

Tim concluded that he would press him to have as least two of our group address his group and since we now had his email address, he would attempt to stay in contact with him. I told Tim that I agreed and like it or not, we should consider having him as a speaker in the near future. Allen was hesitant, but said he would think about it. He did admit being surprised about his reaction to so many of us being on insulin. I said this would not be something he would want for his group since all were on oral medications. Tim said that was the dividing line and this was a good thing. With that we went our separate ways for the day.

No comments: