My PCP is about to be replaced. I have been with him for about 10-12 years, but as I get progressively worse, he seems to be less inclined to do anything. Who supervises your diabetes treatment?

Example: 1-7-11 blood and urine tests at lab indicate:
glucose 65-99 normal I am 106
A1C 5.7
Mean Plasma Glucose 126

Dec 10, 2010 labs:
glucose 65-99 normal I was 131

On Dec 10th testing, I was told I did not need to fast, since then one doctor says the results don't always change that much with fasting.

What would you do?

Infections raise blood glucose for most people. So when you have active infection, it might be higher then.

Ask for a fasting INSULIN level. If this is higher than normal then you are insulin resistant. The most common intervention for this is tight diet control...following a metabolic syndrome diet which is higher in fat and lower in carbs with alot of protein. Watch portion sizes too.

The most effective drug for this is metformin.
Stress and steroids also raise blood glucose levels.

It might be a good idea to get a glucometer (there are some mini's now that are less than $20 and often free online).

Testing yourself during the day may reveal more. But your A1C is still in the normal range. If you are becoming insulin resistant however, glucose is not getting into your cells well, and you then feel weak, tired and shakey. (worse in between meals). This can lead to carb craving which help in the short run but create more problems in the long run.

In regards to your sleeping problems... there have been new reports that the H1N1 vaccine is causing narcolepsy in Europe. Their vaccine was a little different than US however.

http://blogs.nature.com/news/thegrea..._cases_sp.html

I seem to be getting a lot of infections, not sure why. I avoid people who have a cold or who might be ill, etc.

I will ask for the Fasting Insulin Level test today. I just lost approx. 30 pounds and my portion sizes are about half of what I used to eat.

Depending on the test results, I will keep Merformin in mind. I have had a lot of stress and as you may remember, I am on steroids a lot (lungs).

Glucometer? I don't know much about them, but will start looking. It seems like I heard of one that does not require a skin prick. I am not sure how good they work.

A1C, according to Quest Diagnostics info, was borderline diabetic. Another website said 5.7 is normal. I think I am borderline diabetic and I need to watch my diet closely.

As to Narcolepsy, I looked it up and I don't fit most of their criteria. That said, not much about my situation is normal. I got the H1N1 shot a few months ago.

Thanks again, Dave

I just got a One Touch Ultra mini. It takes a little droplet of blood.
The new lancets that came with it, called Delica, are virtually painless. If you use the side of the finger between the tip and 1st knuckle you can't even feel it!

I got my meter free, but the strips are expensive! My insurance pays about 80% of them. I've been insulin resistant most of my adult life, but just recently my fastings are going up. I've been testing during the day, and my levels are more normal then.
It is only the first one of the day that is elevated.
This is called the Dawn Phenomenon.

This is a very good link to look at:
http://www.phlaunt.com/diabetes/16422495.php

One Touch and Abbott (Freestyle mini) are offering free meters now. Both have TV commercials.

I've just crossed that line myself. All these years with conservative food and habits. My mother was diabetic and her aunt too. So I guess genetically I am doomed. My mother started in her early 40's tho, and I am 64... so I did well I guess considering.

I am using a new form of metformin called Glumetza...which has much less GI upset. So far so good with me.

My PCP told me they ran the tests last month and there is no reason to run any tests again this soon. I hope he is right.

I wish we could pay the medicare rate for some of these tests. I am sitting here waiting to see what my PSA will be after the CIPRO was used. It really wears me down. Stress. I asked this PCP one time if his job was to relieve stress or create it. He did not appreciate my comment, but he understood what I meant. Another time (years ago) I was in such pain I took around ten Vicodin in one day. He accused me of abusing the drug and I told him he is the doctor. Had he prescribed the correct level of pain killer to begin with, I would not have needed all the Vicodin. BTW, Vicodin is nothing to me. Does zero good with pain.

I respect a doctor who says he cannot do anything else at this time, but on the other side of the coin, I need a doctor who can think outside of the box. As my wife said, "We have checked all the horses, maybe we should check the Zebra's now...."

That kit sounds good. I will print this out and go look for it. Costco or Walmart may have them.

thanks again for the info....Dave

The Freestyle light comes from Abbott... You have to fill out a form on their site. Abbott does NOT require an RX for the meter. They mail it to your home, and it takes about 2 weeks to come.
But to join their discount plan for the strips you do need an RX.
The Freestyle comes with 10 free strips to get you started. (I think they want to steal One Touch customers)

The One Touch is similar, but they do not send the unit to you...
only an Email coupon. The email coupon took 3 weeks to come to me! You take this with an RX from your doctor to the pharmacy for the free unit. (kit)
The One Touch DOES NOT have free strips with it.

But both are available now free.

In the store I priced One Touch and CVS, Target and WalMart all had them under $20. The mini types now are quick and easy to use. The more expensive meters have computer hook up to send results to the doctor directly or to help you log them.
I am logging in a notebook. Severe diabetics or those with an insulin pump who have to adjust insulin at mealtimes, do better with the more elaborate meter.

For type II's the mini's should be adequate.

My son had an attack of prostatitis and his doctor said doxycyline is enough for most, because it reduces inflammation.

Doctors vary in their approach to treating type II. My doctor has been watching me for 3 years more closely, and since I am very strict with sugar and carbs, she's held off with treatment.
But now she has become more aggressive with it. When I hit 140 fasting, that was IT.

Sometimes when patients have so many problems, doctors can become numb to an emerging other one. So watch for this.
Your alternative is to see an endocrinologist who monitors diabetics all the time, and has more experience with it.

Your doctor may think your infections are contributing. And maybe they are. Or not? I can see already on the new medication I "feel" more energetic. So those mild elevated sugars were wearing me down.

I am in the Abbot website now, filled out their questions as to which type of meter I need and it came out to be the Freestyle Lite

Precision Xtra® has Blood Glucose and β-Ketone Monitoring System. I don't know if I need the Ketone monitoring or not. Since I have not heard of that, I probably don't need it.

So many options, quite confusing.

I got into a form, but it appears they want me to give them my insurance information, etc.
Nothing mentioned about Freestyle Lite yet, will keep looking.

I just read your post again. I can read your posts and learn more from you than most of my doctors. They are simply too busy to take the time. All but a couple of them. I feel sorry for them sometimes, like they are on a treadmill, going faster just to stay in place. I will ask my Pulmonologist for a referral to an endocrinologist.

Wanna muddy the waters a little more? If I fast, I feel better. No food, just water. Give me a few hours (maybe 6 hours) and I start feeling better. Go figure...take care, Dave

I think this is the site I used:

https://www.myfreestyle.com/dtc-land...le%2520Branded

Feeling better from a fast, suggests something you eat is bothering or affecting you.

Have you ever tried going gluten free?
I myself cannot eat nightshade veggies ... they cause neuropathy burning in my feet! And now all the peppers I love -- green, yellow and red...upset my stomach! That is really a bummer. But potatoes I found strangely were the worst!

I don't think you need the ketone feature. That is for type I diabetics prone to diabetic lactic ketoacidosis...which happens when sugars get really high for a prolonged time, and the body starts making ketones and lactic acid. This causes the blood to become acidic and in serious cases causes death. It happens when sugars are very uncontrolled, and diabetics don't inject enough insulin.

https://www.myfreestyle.com/dtc-land...le%2520Branded

My wife cheered when I read your post to her. She has been saying this for awhile. So starting last night we are going to start a "glutten free" diet. I don't particularly like bread type items anyway.

I have been a "meat and potatoes" type person all of my life.

My worst sin in eating may be M&Ms with peanuts. They have been making me feel worse. So I tried some plain old Hershey's milk chocolate yesterday. About 1/4 cup full. No reaction of any kind. I will try another small amount today to see if it upsets my system and if it doesn't, I thought I would try 1/4 cup of the M&Ms. Maybe I have developed a problem with peanuts? Who knows, but I am willing to try to work on it.

This "feeling sick" is leaving me feeling weak. Listless. BTW, I am on the probiotics and have been for around ten days, so they should be working soon. My problem is dairy products. I loved dairy products all my life, but about five years ago my allergist noted after drinking milk I had ...... hard to describe it. Like a thick mucus forming in my throat and of course, that made it harder to breathe, especially at night. So I quit most dairy products.

I miss the milk a lot. I take the supplements you recommended and have done so for at least a couple of years. Thanks again for your patience and support.

Still Gluten free, will work hard at staying that way for enough time to see if it helps my system.

Changing Gastroenterologist and Neurologists. Seeing new Gast. Dr. today. Hope he has some answers.

I have been thinking about some comments I received about doctors and how they handle the stress of difficult patients such as myself. If I were a very, very successful doctor and I had one patient who was not responding to my suggested treatments, I might find that very frustrating. Add that to the heavy patient load and I can see where this doctor might want me to go elsewhere. Remembering that most of my doctors were rated as the best in our area by their peer group. (Google "Sacramento Magazine" and TopDocs if you want to know what I am referring to.....)

I have had three specialists tell me they can't do anything more for me. I thank them for their efforts and move on. Today I move on again. Please wish me luck.

Thanks again for your patience and great information mrsD.