new and some questions

iVillage Member
Registered: 03-10-2008
new and some questions
51
Mon, 05-05-2008 - 12:20pm

Hello everyone,


I am new to this board and have had diabetes for ten years now.


I take Metformin 1000 mg twice daily .  I am curious as to what other diabetics doctors recommend for  preventive care.


I have a CBC and a A1C test once yearly and that is all that my pcp thinks is needed.


I also have high blood pressure , kidney damage, am a heart attack survivor.


I have chronic uti's and was scheduled to take iv antibotics but that was cancelled this morning although I have no idea why.


I certainly don't want to sound like a hypochondraic but should I be having more than a blood test once a year with no other screening done?


Does the A1c eliminate the need for testing daily?


Why do they stop recommending mamagrams  and other screening tests when you have diabetes?


Does anyone have chronic uti's ?


Thanks for reading this,


Have a wonderful day !


 


 


 

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iVillage Member
Registered: 04-03-2003
Mon, 05-05-2008 - 12:44pm

"Why do they stop recommending mamagrams and other screening tests when you have diabetes?" I have never heard this - in fact, both my GP and my endo asked specifically if I'd had my mammo last fall (I was dx'd Jan 2007) and my GP (who also does ob/gyn) did the usual pap at my physical last fall.

"Does the A1c eliminate the need for testing daily?" NO WAY! The A1C is an average of the last 3 months but regular daily testing is how you know what things are good choices and what things aren't. If your numbers are way high, damage is happening NOW, why would you want to wait a couple months to find out that you're doing damage to yourself when you can change it right away (by changing what you eat, exercising, discussing medication adjustments). From the ADA website "The A1C test alone is not enough to measure good blood sugar control. But it is good resource to use along with your daily blood sugar checks, to work for the best possible control. " Also from the ADA site "To watch your overall glucose control, your doctor should measure your A1C level at least twice a year. " My endo checked it quarterly last year and it was always good (<6.0) I've got an appointment today and she didn't check that I should have the A1C done in this round of lab work so she might be going to a twice a year plan (or she might just be planning to do it in the office as she's done once or twice - she has a machine right there and takes the sample and we discuss other issues while the machine calculates the result).

Chronic UTIs and yeast infections are often a side effect of diabetes. The downside is that the standard treatment/prevention for UTIs (aside from antibiotics) is lots of acidic juices like cranberry juice BUT fruit juices are not usually a good choice for diabetics. If you can, eating plain yogurt can help (after the antibiotics are done with) or at least taking acidopholus pills (found in most health food stores and some grocery store vitamin sections).

Why did they not tell you WHY they cancelled the IV appointment? Did you ask? Did you ask why they are not recommending the standard gyn screenings? (there might be something specific to your situation about that) I'd think, given your situation, that they'd also be doing regularly scheduled (once a year or more) lipid panels to check cholesterol and triglycerides - you're a diabetic who has already had a heart attack, I'm pretty sure they'd want to be tracking ANYTHING that puts you at risk for another heart attack.

You might consider getting a referral to someone who specifically works with diabetics (an endocrinologist or at least a diabetes educator who can tell you what's what and give you information to take back to your pcp)

--Deb

Avatar for cl_coldfingers
iVillage Member
Registered: 03-19-2003
Mon, 05-05-2008 - 1:04pm

Hi and welcome to the board.


iVillage Member
Registered: 03-10-2008
Mon, 05-05-2008 - 8:19pm

Thank you for responding to my post.


I was told I don't need any Gyn exams because I have had a hysterectomy .


I was told my heart 'sounds good' so nothing more is needed

Avatar for cl_coldfingers
iVillage Member
Registered: 03-19-2003
Mon, 05-05-2008 - 8:51pm

Well, just because you had a hysterectomy doesn't mean that you should not see your gyn....


iVillage Member
Registered: 03-10-2008
Mon, 05-05-2008 - 9:25pm

Hello again ,


In answer to your question,


My PCP is the one who made the quality of life comment and has made it more than once.


I notice I start sweating and feel a horrible sick to my stomach and start shaking when I do this if I eat something or drink a ounce or two of juice in ten to fifteen minutes I feel alright . I have tested a few times when I did this and my sugar was between 60-70 each time.


Avatar for cl_coldfingers
iVillage Member
Registered: 03-19-2003
Mon, 05-05-2008 - 9:57pm

I wish you luck finding another pcp.


Avatar for cl_maryfrances40
iVillage Member
Registered: 03-25-2003
Tue, 05-06-2008 - 12:20am

Hi There!


I am glad you took me up on my invitation to come over here. (You won't believe this but I have a UTI now and am on Levaquin. It does seem to be helping.)


Your treatment isn't meeting national goals and I too, wonder if your diabetes is playing a larger role in what is going on with you. You need to have an A1C performed every three to four months. Not testing your blood sugar is like driving a car without a speedometer. You can never tell when you are speeding or going too slow.


Metformin doesn't cause hypoglycemia which is what your 60-70 blood sugar reading. And you need to report to your doctor any blood sugars below 80 as he or she may need to readjust your mediation.


I have been diabetic 17 years and I have a good quality of life so I don't understand the remark either. I have a number of health issues popping up right now but that doesn't mean that I am going to give up and I wouldn't expect that you would either. Of course you can't do the things that you did when you were in your 20's but look at all the things that wisdom and time has given you. This is just another stage in what we all hope to be a very long and enjoyable life.


Does your insurance pay for your test strips? Even Medicare pays for the person to test twice per day.


I am not aware that they don't recommend mammograms for diabetics. I had one last year and will have one as soon as I see my gyn. I too had a total hysterectomy but I continue to have pap smears because I developed a cancer of the vaginal wall which would have been found if I didn't have pap smears done. I think there is a decreased in the yearly pap smears recommended for post menopausal women but certainly not mammogram as the incidence of breast cancer goes up with age.


I am hopeful that you can get a new PCP in your insurance plan as it sounds like you are being taken well care of in my humble opinion.


Please pull up a chair and join our conversation. We are here to help you in anyway that we can.


follow me


iVillage Member
Registered: 03-10-2008
Tue, 05-06-2008 - 11:22am

Thank you Cheryl ,


I will bookmark that site and see if I can learn a little more.


I have never had much luck with doctors treating my diabetes. They just gave me the metformin. No literature or advice .


I tested my sugar almost 2 hours post meal and it was 179.

iVillage Member
Registered: 03-10-2008
Tue, 05-06-2008 - 11:35am

Thank you Mary Frances, for inviting me .


I am glad I came over here also!


I am sorry you have a UTI they are so miserable!

iVillage Member
Registered: 04-03-2003
Tue, 05-06-2008 - 12:15pm

Feet need to be checked because peripheral neuropathy (loss of nerve function/feeling) in the feet can allow damage to occur without you knowing it and next thing you know you've got a nasty infection and possibly amputation. A coworker's husband has been diabetic for years (ignores what he should do, poor control). Last summer, he was in the back yard barefoot and stepped on a nail. He didn't even KNOW about it until he went back in the house and noticed a tap tap sound when he walked on the linoleum floor! Fortunately, they were able to address it with antibiotics and such but the dr told him to prepare mentally for a possible amputation of part of his foot. Also, diabetes can 'assist' in fungal and yeast growth (we're just too sweet lol) so checking between toes for stuff growing is also important before it gets too widespread.

You definitely need to be having your kidney function monitored because prolonged high sugar will cause more damage. A friend lost her eyesight and kidneys to diabetes.

You need to be having annual dilated eye exams to check for signs of damage to the retina. If it is detected early, there are things that can slow the damage. But, again, the best way to postpone/slow eye damage is to closely control your blood sugar.

A1C checks the level of what's called glycated hemoglobin in your bloodstream, averaged over the last 3 months. What that means is that sugar/glucose has stuck itself onto the red blood cells. Picture a healthy red blood cell as a nice smooth donut (no chocolate glaze!lol) It slips through the blood vessels slick as a whistle. The excess glucose roaming around in your system sticks onto the outside like colored sugar crystals on cookies. Thus, that smooth outside is now bumpy and rough. As the bumpy rough donuts go through the blood vessels, they cause little bits of damage. One or two little bits isn't a huge big problem, the body is amazingly self-repairing. BUT when you get LOTS of bumpy rough donuts, it's like dragging sandpaper through your arteries and veins. Eye damage due to diabetes is usually a result of the blood vessels in the retina starting to 'leak' blood from these little bits of damage. Small amounts self-repair. But, without care and control, you get bigger and bigger areas of leaking blood which damages the retina until there's no vision left.

You might want to consider carrying a pack of glucose (tablets or gel pouches) rather than lifesavers - readily available in most pharmacies (no Rx needed) - comes in assorted flavors and is designed specifically to quickly raise blood sugar for diabetics. Lifesavers is good but it's not as well calibrated as the glucose packs/tabs.

--Deb

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