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Wed, Mar-12-03, 09:18
I just got a call from my doctor. I had requested a circulating insulin test. I wanted this done so I would know if I was actually producing enough insulin. The aim of this test was to help me better determine what meds I should be taking, particulerly glyburide, which I am taking but didnt want to stop until after Ihad this test as it does help my numbers.
He refused saying this test is only done in certain high risk conditions or as part of a study. He repeated the mantra of diet and exercise to control blood glucose...yeh, like I didn't KNOW that already...
It seems diet, exercise, random drugs at varying strengths are all just experiments you are doing on your body and testing for BG is just clues to guess at what is going on...why not just ask your pancrease directly what it is producing and when and go from there to decide what to do? Before you burn it out with drugs you may, or may not, need?
Anyone ever had this test done before? Had problems getting it done?
Wed, Mar-12-03, 19:44
Is your doctor an endocrinologist? If not, you might consider asking for a referral to one or just going to see one on your own. I think an endocrinologist would be much more likely to agree to a circulating insulin test than a GP or internist. An endocrinologist would also be much more likely to be up on all the latest information regarding diabetes (hormones are their specialty, after all) and how all the different hormones work together.
Just something to consider....
Thu, Mar-13-03, 09:58
Yes he is an endocrinologist..which suprised me even more.
I am meeting with him on 3/31 and will have a very "serious" discussion...he is not the only endo. in town......
Thu, Mar-13-03, 15:59
...some docs get irritated when patients suggest what tests should or should not be done. In other words...they like to be the ones calling the shots (sometimes literally! ;) ).
You have the right mindset with "he's not the only endo in town". I firmly believe that the doctor/patient relationship should be a partnership, which means that the two of you work together to attain the best possible health for you, not a dictatorship where the doctor lays down the law and you meekly follow along. I know a lot of doctors prefer the latter style because it saves them time; they don't wind up having to have long discussions with their patients and explain why or why not something is needed but it's really in the best interest of the patient if they understand as much as they can about their disease. Compliance is much greater when the patient has a good understanding of why they need to do what they need to do.
Give him the benefit of a doubt. Perhaps if you discuss this with him face to face and lay out your concerns, he'll be more agreeable to order the test. I don't think any doctor in his right mind would want to knowingly burn out his patient's pancreas or make his condition worse. It might also help if you bring along some literature showing why it would be a good thing to get checked.
Fri, Mar-14-03, 01:41
...But don't hold your breath. Endo or not if he's not at all willing at this point, I doubt you'll be able to convince him. (I had the very same discussion a few times with my doc--I even volunteered to foot the bill for it myself) It seems to me the current thought held by docs concerning burning out the pancreas is that it'll burn out anyway and you'll have to go on insulin eventually so they don't seem to care that the sulfonylureas may hasten the process. It's all part of the mindset that diabetes can only be controlled, not cured, and the patient will only get worse as time goes on. They don't seem to have any thought toward trying to help them heal. Except for folks like Dr. Bernstein, Atkins, Eades', etc. But then, don't we all know what docs think of THEM! (With a *very* few exceptions...)
And while we're on the subject of endos...my pet peeve is the ones who will prescribe insulin only and won't also give the patient Glucophage with it. They don't seem to care what damage the excess insulin will do. To me it's a 'Well DUH' kinda thing. If you prescribe insulin AND Glucophage then your patient can utilize the insulin more efficiently and won't need as much! Geez!
Hey KJ, a question about glucophage. Is it called the same thing here in Canada? I used to take Metformin before put exclusively on insulin.
How does glucophage work? I am due for a blood workup and would like to be able to talk to the doc about using both if it is a good idea.
I still don't have great control over BG's and am soooooo careful. Maybe I should fight for the pancreas test too. My pancreas could still be kicking and not dead like the endo said to assume.
Any help would be great. Thanks, AJ
Fri, Mar-28-03, 09:58
Glucophage is the same as metformin. It works by making your cells less resistant to the insulin in your body so it can be used to lower your BGL. It sure takes a long time to work but does control levels eventually.
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