Quote:
Originally Posted by Idiopathic PN
I just want to share with you what happened to my doctor's visit yesterday.
1. He discussed with my earlier 2-hour glucose test, which was a spike of 157 (I think) at 30 mins and 72 at 2-hour post prandial -- he said NORMAL.
2. I showed numbers of my home monitoring which are punctuated with spikes at 1 hour and generally normal after 2 hours (except on few occasions).
3. He said accdg to the criteria of the American Diabetes Assoc, my "official" results are not diabetes, not even pre-diabetes. While my home numbers are high, he does not want to recommend medication at this point....
4. I asked if the spikes, even a short while, can damage nerves. His answer, "yes to some, no to some". But since i already have the nerve problems, will it further damage mine, he said "maybe".
5. i mentioned treatment, e.g. ER Metformin.
The doctor was really hesitant to give me treatment but i said to give it try because the numbers are freaking me out. I need to gain some weight but i cant eat because i am scared of elevating the sugar!
So, he gave me a prescription. its not metformin but, Tradjenta. When i went home, i checked on the drug interaction website. It has contraindication with one of my antibiotics. I called the clinic and am waiting for the callback.
Thank you for letting me share.
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I do NOT understand his reluctance to prescribe Metformin. Docs do it ALL the time for people with your blood sugars, LONG before they are "official".
Maybe you could/should discuss it with your PCP or even your pulmonologist. I doubt your pulmonologist would prescribe since it is outside his specialty, but PCP's would not have a problem prescribing it. MANY PCP's actually treat diabetics rather than send them to an endocrinologist. Diabetes is well within the scope of a PCP when not contraindicated.
I am not familiar with the drug prescribed but I will look it up.
I realize you are NOT diabetic but I am also darn sure your blood sugars need attention. They are NOT normal. I am not saying you are pre-diabetic, you have something going on that is causing your spikes. Someone needs to find the cause of your spikes. I would keep seeking answers. Do not accept that you do not fall withing the guidelines of the ADA. I know and have heard THAT response. As long as my A1C stays below 7.0 (the ADA guideline for diabetics) my doc is satisfied. I am NOT. When I get post-prandials in the 300's, I am NOT satisfied because it takes dropping into the 50's to get my AlC's below 7.0 Only after explaining to him that I did not want to go blind, lose limbs, have renal failure, etc. because that was OK with the ADA, did I get a different response. I said that the ADA was not the one that was going to suffer the consequences of my spikes and I needed something to deal with them. He then took my swings under consideration and has worked with me to help control them.
OK, I need to retract some of my prior comment. I looked up the drug prescribed which is a DPP-4, one of the newer classes of drugs for diabetes. I also looked up Metformin which is considered first line treatment after diet, BUT, and here is the clincher that would explain your endo....... Metformin has lung disease listed as a contraindication. Ah, that is why I am not a doctor, just an ignorant patient.
When will you see your PCP again?