new and some questions
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| 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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Deb,
What a wonderful answer you gave Dee. Thank you!
Dee,
Lifesavers really aren't the thing to keep in your purse to treat your hypoglycemia episodes. They will raise your blood sugar too quickly and drop just as quickly. Like Deb told you, glucose tabs have the correct measured amount of glucose that you need. Plus there are other things on the market like Glucerna bars which are specifically made for diabetics and which you can also carry in your purse to use when needed. They have the correct kind of carbs in them to prevent the wild swings of blood sugar.
What kind of blood pressure meds are you on and that will protect your kidneys and stop you spilling the proteins in your urine.
There is so much going on with you, that I think you warrant a referral to an endocrinologist to get all this back into balance. Is there one in your health plan or insurance network?
I will be really interested in how your blood sugar fluctuates. When was the last time that you saw a dietitian for meal planning help? If it has been a long time, see if your insurance will pay for a return visit. There have been many changes in diabetic eating since you were diagnosed.
You do need a dilated eye exam annual. Plus you feet need to be checked by you at home every day and by your doctor every time you get treatment for your diabetes and once per year isn't adequate.
Look in the folder entitled "Hanging ON". There are several articles that you need to read and keep. One is about the Rule of 15 and another is about your feet. There is also one on how to take care of yourself when you are ill. Your doctor really needed to tell you about this but since he hasn't please read what is posted there.
As you learn more here, I hope that you will be a little more assertive with your doctor and tell him you want him to help you more than he currently is to manage your diabetes. Blindness and amputations don't need to happen and I certainly hope they don't happen to you. We know so much more about diabetes and have so many better meds for treating it than when your grandmother was alive. A cure for our type of diabetes is just down the road.
Deb and Mary Francis,
Thank you SO much for all the information you gave me.
I knew my Grandmother died while in a diabetic coma and had lost one leg and was blind. (before I was born)
The way you explained the sugar in the bloodstream was very eye opening. I had no idea.
My PCP says she has NO time for all my problems to limit it to ten minutes.
First off - find a new dr that WILL give you more than 10 minutes of their time
Next, cramping in the legs can be related to electrolyte imbalance, sodium and potassium issues in particular. If you're on a diuretic (which it looks like at a glance but I don't even play a dr on TV), you need to make sure you are getting potassium - my mom was on diuretics for years (heart patient) and the standing rule was to never eat the last banana in the house because mom needed it when she took her medicine. You can also lose sodium. On the flip side, make sure you're drinking enough plain old water. Seems counter intuitive but if you don't drink enough water, you retain water while if you drink plenty of water you don't. An easy measure of whether you're well hydrated or not is to look at your pee - light yellow to clearish is plenty of fluid, if it's darker, you need more fluid (for example, first thing in the morning is usually a dark or bright yellow because it's accumulated overnight, it should get lighter as you drink more fluids during the day). (Caveat: this might not apply 100% with a kidney dysfunction; if you've got specific quantities of fluid per day as medically indicated, go with that but be sure to be meeting those goals to get adequate fluids).
A good PCP -can- help manage diabetes, if you find one who is willing to take more than 10 minutes with you (and given your situation, you need more than that - my PCP doesn't schedule anything less than 20 minute appointments as far as I can tell, maybe 15 minutes for some quick follow ups but I don't think they even book 10 minute slots).
Next eye exam needs to test for glaucoma, cataracts, general vision AND look at the state of the retina - that's standard preventive care for diabetics. If you tell the eye dr you are diabetic, odds are they'll automatically want to include that (and I get my eyes examined at the Sears optical center at the mall - they have regular optometrists doing exams, the hours are more convenient with my work schedule, they take the Sears credit card if necessary, and they accept AAA discounts on the services if you've got AAA).
Blood pressure meds probably don't specifically deal with the protein BUT high blood pressure can cause/increase damage to the kidneys so in that regard, the bp meds would relieve some of the stress on the kidneys which in turn may alleviate some of the other problems.
Check with your local hospital - they usually have FREE diabetes education classes. They figure that it costs way less to have one instructor and a roomful of people for a few hours to prevent hospitalizations due to diabetes than it costs to have to deal with someone in the ER and all like that (particularly uninsured/underinsured people - I worked in a hospital's finance dept for a time and they end up writing off a whole lot of stuff when insurance won't pay and the patient can't pay).
I don't know what you mean by 'generic' meters - most have a brand name on them - but whether you get it at WalMart or at a pharmacy, the same model/brand is the same model/brand.
Testing at 1 hr after a meal (which is basically any time you eat) you'd want your reading to be <180 so 217 is really high. The thing is, you don't know what your blood sugar was before the popcorn and diet soda. It might have been 200 already by then so the snack wasn't all that bad it was everything else prior to that today that set you off -how long was it from lunch to the snack? what was lunch? lots of things like that play into it. I've even found that, for me (YMMV), if I don't stay hydrated, my blood sugar readings can edge higher than they otherwise would for the same meal.
Glad that the illustration helped - I got used to explaining things in pictures for my little sister. I'm a very verbal person (can ya' tell? LOL) and she thinks in pictures (she's a graphic artist). When she was stuck on something when doing schoolwork way back when, I'd give an analogy or description to help her picture the situation so she could frame it in a way that she understood. That kind of stuck and I tend to think/explain things in analogy format as a habit (which is often helpful on message boards like this when I can't SHOW someone something, I only have typed black and white words to convey the message).
--Deb
Deb,
I am trying to find someone to take me that will take my insurance I have VERY few choices.
I am probably overhydrated because I am thirsty all the time. My urine is usually clear almost like water and depending blood /wbc / clouds etc because of the infection.
The urologist said keep slugging down the water. He thought the water pill which I probably spelled wrong the type is so tiny on the bottle I had to wing it :( was not such a great idea.
i would think the insurance would want me to try and prevent problems,
with preventive treatments/tests but they apparently do not.
By generic meters I mean like the brand walmart sells they are only $8.88 for a meter and $46 for 100 strips. The ones like one touch are more than 60 dollars for the meter and they are 50 something for only 50 strips.
I have a wal mart one .
I wish I had this information ten yrs ago I probably would be in better shape health wise but I feel i can start now and improve things to some extent.
your sister is a lucky girl :)
You are very good a painting a picture with words!
Thanks again,
Blessings , Dee
PS because I feel so crummy I checked my BS and it is down to 56....
This bs control may be way harder than I thought .
The meter price really isn't an issue.
Your Walmart meter should be fine.
Deb,
I have the bottom end of Interplan Insurance.
If meds are covered they are 35 dollars for generic and 50 for others . Quite a lot they don't pay. Most I get at WalMart cheaper Not using the insurance.
I will make a spreadsheet listing my fast , before meal, two hours after a meal so I can get a better picture.
My sugar
Dee,
Here is an article which will help you understand diabetic eating better.
http://health.ivillage.com/diabetesthy/di/0,,pz7h,00.html
I think what happened with your blood sugar being elevated after eating the popcorn and then dropping so low was that you didn't have any proteins to smooth out your blood sugar sugar. You can also do this with fats since I know that protein is a problem for you due to your kidney disease.
Lisenopril (I may not have spelled this correctly) that has been perscribed for you is a used to combat protein in urine of diabetics as well as controlling their blood pressures.
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