I'm concerned about my friend A1C

[nawchem]

My friend going back 30 yrs was diagnosed with diabetes and high blood pressure. He takes metformin and high blood pressure pills. He had a one month follow up. He recently told me he only sees his dr once a year now. But hes put off going to the dr 2 months (so far), because he didn't eat well during christmas and doesn't want the blood test to show the effects.

I'm worried, his uncle was my neighbor. Also a diabetic and he had a heart attack and died at 50. My friend is 45. His dad was a diabetic too.

Is he getting very good medical care? I thought they would be monitoring him more then this.

[Charran]

It sounds as if your friend is suffering from alot of denial. Not knowing about something, doesn't make it go away or get any better. I don't think he's monitoring his health enough, but he is an adult and has to take that responsibility for himself. You can only get blood tests done when you actually show up for doctors appointments. I don't think the fault lies with the medical community here, it lies with your friend. There is nothing stopping him from going to the doctor and demanding to be checked for everything. I personally go every 4 months to the doctor and have the complete workup done. That way any small changes can be dealt with immediately. Now on the flip side, if it was his doctor that told him to only come once a year for a checkup then I would seek out another doctor. I don't know if things in the States are as easy as that though. Also, is your friend doing his own testing with a meter at home? That would also give him a good indication of what is going on BG wise with himself. I'm sorry to sound so abrupt here, but I really do feel that every person is responsible for their own health and medical treatments. We need to stay informed about our health and take a proactive stance in dealing with health issues. We can't rely on the medical community to do it for us.

[nawchem]

Charran you're right. Its so frustrating to be his friend right now. He is on state medical care for the poor, so he doesn't have a lot of medical options, it is their plan that he gets an annual checkup. Since he was diagnosed a little over a year ago, I told him in the early stages he could do really well with lowcarb and possibly get off medication. His dr gave him the you can eat carbs but don't eat a lot of sweets diet, he doesn't even follow that. He is a minister and spends a lot of time socializing as his job, I know its rough for him. Last week I had a dream that he died.

Since hes motivated to get a good result on his A1C I thought if they did the test more often he would be a better patient year round.

[Charran]

I won't pretend to know anything about State Medical Care because I have no clue how that works, but even if your friend can't get the treatment he should be having, you're right in thinking that there are things he could do on his own that would greatly improve his condition. The first of course would be diet. Following a low carb eating plan would greatly improve his BG, even if he did nothing else. If he could then add in some exercise daily, that would improve it even more. The point is though, that you have to be self motivated to do those things for yourself. No one can do them for you. We've all had experiences with doctors and dieticians who have put us on a "diabetic diet". It's too bad the medical community can't catch up to the fact that that doesn't work! That's why we have to take the situation into our own hands. I really hope for his sake that your friend can find the motivation to take care of his health, to ensure himself a long and healthy life, before it's too late. You are a good friend to be so concerned about him.

[nawchem]

Maybe if he gets a bad A1c that will increase his self motivation. He is overwt but carries it well at 6'4" and has never exercised. I gave him the Dr. Bernstein site and have told his wife about the recipes I make that are LC and as good as regular for bread and desserts. Sigh. I think after seeing so many family members get sick and die young they feel like its a hopeless situation. I won't get religious on him about LC but I think I'll keep working it into the conversation here and there.

[Markm]

I think the real issue here is summarised by the old adage "what gets measured gets managed". And it doesn't sound like your friend is getting enough input on his glyceamic control to get a handle on how well he is doing. Could he arrange to have an HBA1c done quarterly? Has he got a meter and does he test his BG every day? Without doing this, he will never achieve the sense of control and empowerment needed to drive favourable treatment outcomes.

Mark

[nawchem]

Markm you worded it perfectly. I don't know the details of his care, just his wives frustration that he won't go to the dr even once a year. He does have a meter and 2 test strips/day. I just emailed him about it, but I can't butt in too much without getting him irritated with me.

In the US with a 2 income family, they are considered lucky to get any help with their medical bills. The church doesn't pay well or offer insurance for their family. As a diabetic it would cost you an arm and a leg to buy your own insurance.