May 1, 2016

Insulin Use for Type 2

Many people with type 2 diabetes fight to avoid insulin. Yet, others cannot get their doctors to prescribe them insulin. What are the problems for these people? The first group may feel like they have failed and that the doctor is disappointed with them or a few may have a real fear of needles. Chances are they are victims of their doctor that used fear of insulin to keep them on oral medications.

The second group is battling to manage their diabetes in spite of their doctors who follow the ADA and believe they should rely on their A1c only. These patients are forced to seek out other doctors once they know that their doctor will not refer them, so they can start insulin.

Both groups are dealing with doctors that do not believe in patient centered care and may or may not have adequate knowledge of how to treat type 2 diabetes. Unfortunately, this is a fact of life for those of us with type 2 diabetes. Many of us constantly find ourselves forced to change doctors because of what the doctor says or doesn't tell us about diabetes.

A minority of doctors is willing to admit they don't know everything and do work for what is best for their patients. They refer their patients to other caring doctors if they can. If they are unable, they apply themselves and obtain advice from knowledgeable physicians and work to help their type 2 diabetes patients.

The majority of doctors bully their patients and think they are all that the patient needs. Yes, I said bully their patients. I have had a few of these doctors and will never deal with them again. They are more interested in their schedule and were determined to change my medications to what they could profit from and when I refused to take the prescription slips, told them I would not change medications or the dosage, they told me I would. I told them that I would not and walked out the door. Only one tried to get me back into his exam room, but I continued to leave and am happy I did.

On the way out, another of his patients was being taken to another exam room and he recognized me and made the signal to call him without the nurse knowing. We had a good conversation later when he asked me why I saw his doctor. He agreed the doctor was a bully and had increased the dosage of two of his medications that day. I asked him if he had a copy of his lab results and he said he never received a copy even when he asked. After some more discussion, he agreed with me and said he would change doctors.

A week later, he called and said he had changed doctors and the doctor had given him a copy of his lab results and reduced the dosage of several of his medications. When he asked the doctor why, the doctor said that the tests indicate that he was being overdosed and did not need that large a dose. The doctor continued that the next time should confirm the dosage or if it was still too large. He said the doctor showed him the test results and what the ranges were for each medication and how the lab results compared. He said this was when he was given a copy without being asked.

I told him it sounded like he made a great choice. He said he was going to ask for the lab results, but was happy that he did not need to. He said he thanked the doctor profusely, but the doctor just said he does this for all patients and he feels that he has better and more proactive patients as a result. He said that this was an eye opener for him and he is setting up a database to record each lab result and in the future to do analysis to track how he was progressing.

I said this is great and I wished him well.

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