I’ve been a diabetic for almost three years. I was diagnosed and started on medication by a Certified Nurse Practioner in the practice I go to. I liked her a lot and she seemed to understand how I felt about managing my diabetes. Unfortunately, she left the practice to pursue a career in mental health about six months into my journey so I had to choose a new primary physician.
The doctor I chose is pretty good, I don’t like her as much as the CNP I started with, but she doesn’t hound me about stuff too much. The one thing she has gotten on me about trying is to get me to cut back on my medications. I take 2000mg of metformin (1000 in the morning and 1000 in the evening) and 25mg of Jardiance (usually in the evening). I have taken this since right before the CNP left the practice. When she left, I had lowered my A1c from 12.5 to 5.9 (yep, you read that right). Since then, it’s crept down a little lower to 5.6 and then 5.5 for my last one in January this year. My new primary care has been hounding me to cut back on my medication. I told her I don’t understand why because my A1c is not too low. It’s pretty much right in the middle of what’s considered “normal.” I don’t have problems with my glucose being too low. I’ve never had a fasting level below 83. My post prandials at one hour are pretty consistently below 145. Occasionally if I’m not as careful about what I eat it gets up to 165-170 but that’s pretty rare (maybe once every couple of weeks. Anyway, she said she felt like I was being overmedicated. I really couldn’t follow her reasoning because I felt like I was the model patient and all my numbers were exactly where a doctor would want their diabetic patients to be. I wondered if she had a bunch of diabetic patients who just take a pill and don’t really test at home or modify their diets so they don’t get the results that I got. I told her I felt like she was trying to punish me for having “normal” readings. Isn’t that where she wants all of her diabetic patients to be? If someone comes with high blood pressure, you don’t just start them on the lowest dose and say it’s okay if it doesn’t bring their readings down to the normal range, you up their dosage or try a different medication until their readings are “normal”. Is it that unusual for diabetics to get their numbers back down into the normal range?
Finally, she said she would send me to an endocrinologist for a second opinion since she only deals with a handful of diabetic patients each day. So off I went to the endocrinologist. I sent her lab results, food diaries, and home fingerstick results. She looked at my medications and the amount I exercise (karate twice a week and tai chi twice a week). She complimented me on my glycemic control and said that she did not think I was overmedicated. None of the medications I take will make glucose levels dip too low. She said just to keep doing what I’ve been doing and she would tell my primary not to worry.
I was just wondering, has anyone else had differing opinions from their primary doctor about what is considered acceptable glucose and A1c levels. Do you feel your doctor is treating your diabetes aggressively enough? Do you think all diabetics should try to lower their numbers to “normal” levels or is just lowering them a little good enough?
Sorry this was late being posted.
Lynne