January 15, 2015

Learning to Manage Diabetes by Yourself

If it were not for doctors and that fact that we need them for prescriptions, many of us with type 2 diabetes could do well without them. Considering that many with type 2 diabetes only see their doctor twice a year or for about half an hour, and all they do then is check your A1c to see how you are managing your diabetes. Often they do not have certified diabetes educators or registered dietitians to refer you to, which may be to your benefit.

Why would I say something like this? Read my blog here from June 25, 2012 for some of my reasoning. Granted doctors vary in how often they see patients with diabetes. For well managed diabetes, they will only see the patient two times per year. For people not managing their diabetes, they are most often seen four times per year. Most patients using insulin, if the doctor even sees them, (most are sent to other specialists) want to see patients four times per year or more often. It is more often for patients with well managed diabetes and the doctors are very concerned about hypoglycemia. When this happens, these doctors obtain a program to download the meter and they do look at the readings or they have one of the office staff to this and red circle anything below 75 mg/dl.

I feel fortunate that the person I see at the VA feels very much like I do. While she is concerned about hypoglycemia, she does not view my heart problems, cholesterol problems, and blood pressure problems as something that cannot be managed and is very satisfied with the test results. She also thinks for my abilities I should be below 6.5% for an A1c and encourages me to stay there, until such time as my tests indicate otherwise or I have cognitive problems.

Diabetes self-management is important for people with diabetes. We are covering this in our support group meetings and I may cover some of it here after some of the meetings if there is more information I want my readers have. The other important part of this is Self-monitoring of Blood Glucose (SMBG). For more on this, please read my blog from May 25, 2011.

I had several emails saying the study did not accomplish anything and that once the study ended, glycemic management stopped and glycemic management waned. This can happen because participants are no longer supplied with testing supplies and often cannot afford the extra supplies on their own. Yet people want it known that these people do not need the extra testing supplies. They want people to be managing their diabetes in the blind without the added information testing can help them. More doctors are at least giving new patients the chance by requesting the insurance companies to reimburse for extra testing supplies during the first four to six months. A few doctors are helping patients every other year, but these are not as many.

The biggest problem with testing is that many patients believe they are testing for their doctor. It is hard to convince them that they can learn from their testing and use the information to help them manage their diabetes. I have talked to a couple of doctors about this since I knew the doctor that the person was seeing. Then I am told by the patient that whom they test for was none of my business and of course, I tell them that if they want to lie to me, I don't care, but to lie to their doctor is not a good practice.

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