Yes, I said this and I know this
happens. Why, you ask. Because the doctor is in a hurry to see the
patient and only half listens and decides quickly what is best for
the patient to be able to move on to the next patient. It is rare to
find a doctor today that listens or even asks questions for their
understanding.
Most doctors will not even consider
insulin as a first line treatment, but do consider it as a treatment
of last resort. They often use the threat of insulin as a way to
force their patients into working harder to manage diabetes using
oral medicines. Instead, they prescribe regular metformin or one of
the Sulfonylureas. Then the doctors are upset when patients
complain if nausea from metformin prevents them from eating and they
stop taking it. Then for those on a sulfonylurea the patient suffers
an episode of hypoglycemia and this scares them into stopping this
medication. They then label these patients as non-compliant.
Instead of prescribing metformin ER
(extended release) that often is better tolerated, they tell the
patient to take their medicine or find another doctor. When this
happens, the patient might be better served to find another doctor,
but the search could be futile because many doctors are the same and
would rather label a patient non-compliant than do what might be of
help for the patient.
The other issue is of food plans. Most
doctors tell patients to eat more carefully or hand them a food plan
with no explanation. These doctors will not refer the patient to
someone that can work with them in designing a food plan that will
help manage diabetes and explain the reason for the changes needed.
In addition, they can help direct the patient to finding the needed
foods that aren't always expensive.
Most doctors will not refer patients
for diabetes education or to work with other professions that might
provide assistance. They also will not do anything to find out about
family, work schedule, or even lifestyle that can be changed. Many
doctors prescribe one or more medications and have them scheduled for
another appointment. No instructions are given for times when
medications cause problems and no instructions about calling if there
are problems. In other words, the attitude is here are your
prescriptions and don't bother me until your next appointment.
This is why I will continue to support
doctors in several states that are training peer mentors for
education of diabetes patients they serve. Several of the doctors
have agreements with a few nutritionists that are not registered
dietitians or members of the Academy of Nutrition and Dietetics
(AND). They also work with the diabetes patients to educate them
about food and work with them in areas of nutrition for levels of
carbohydrates they wish to consume.
I have heard from two of the peer
mentors that I correspond with and they are very happy that the
patients are gaining a benefit and most are doing quite well in
managing their diabetes. I have even had correspondence from two of
the doctors thanking me for finding two nutritionists, which led to
three others. One of the doctors has found a CDE that will work with
them and not against them like so many have in the past.
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