JayAmerican
Well-Known Member
- Messages
- 80
I go to an office where I will typically see the same doctor but sometimes it's another doctor. I don't know if any of them truly look at me holistically. I haven't posted here in a while and just looking for experience feedback.
I'm 52. 5 years ago I got diagnosed with T2D. Had no idea, since I hadn't had a checkup in a few years, and A1C ended up being 9.8. Doctor wanted me to immediately get on metformin but I insisted diet change first, I went on a keto diet, not 100% strict but definitely disciplined, and my next test 4 months later was 6.2. My cholesterol levels were also high, LDL and particularly the triglycerides, doctor had wanted me on a statin, and after 4 months of strict diet they came down too. Still high but way lower and not in the range of statin seeming necessary, I reasonably maintained with diet alone and mid-2022 my A1C was still controlled without medication at 6.6.
Since 2022 I have been needing to travel a lot, extra focus on work, and not enough time to stay active or be disciplined let alone make it to the doctor's office for almost 2 years and I knew from finger pricks that my glucose levels were going up and decided my next visit I'd have the doctor consider metformin. That was September. My A1C came back 9.4 so definitely not great and I knew I needed metformin help along with trying to be more strict with diet again. My cholesterol numbers were also high again so I know they are correlated but again the doctor wanted me on a statin. I told him we should wait to see what my results are on next A1C check first. He seemed fine with that.
Last week I went back in to get updated blood tests and saw a doctor at the same time. Different doctor. Without even waiting for the test results on that which can take over a week, she was wanting me on an added T2D med named Januvia. I wasn't sure why since the past last visit I've been wearing a CGM and it was indicating my past 90 days estimated at 7.7 and past 30 days even better at 7.2, so why not first wait to get the A1C and cholesterol marker results? She said Januvia was very safe and was only going to prescribe what's considered a low dose 25mg. She also wanted me on a statin. I told her we're waiting on that until the tests come back because of my cholesterol is correlated to my blood sugar then why take more meds than needed if that gets back under control?
Lastly, I had requested a heart test in September and the doctor gave me a referral for a calcium score test. Did that and it came out at 19, which is pretty good for my age (anything under 100 is good for my age) and basically puts me at extremely minimal risk for heart disease. I've never had heart issues, I don't have any other medical conditions at all, my blood pressure is always perfect, almost all my other markers tend to be in normal ranges, etc. I don't eat fried foods, stay away from processed foods as much as possible, am relatively strict on keto with a little flexibility so I don't get stressed about it when I'm busy, and my family does not have any history of heart disease on either side - just diabetes does tend to run in the family. Neither of my parents have diabetes. I also get annual eye checks to compare any differences in eye vessels, etc., no changes ever.
When I called the pharmacy to check the out of pocket cost for the Januvia they said it was $527 USD for a 30-day supply! Yeah... no. I immediately called my doctor's office since there's no way I'm going to spend an additional $6,000 per year on that. I researched the drug and although it's safe it seems that it's primary function is to get the pancreas to generate a little more insulin. I can't see even how that drug would even help me since my issue is insulin RESISTANCE not lack of insulin creation. I know this because outside of my primary doctor's own guidance 5 years ago I went directly to an endocrinologist to get all other aspects of my endocrine system checked and they learned that all my body functions are normal - my body creates a normal amount of insulin, it's just become resistant to it.
I feel that with all of these details, doctors just want to prescribe meds. No matter how safe meds are on paper, there is always risks, and especially when they're combined and taken long term, they could lead to other body issues that then need (guess what?) more meds.
Am I being unreasonable to make the doctors wait on tests and to do more in-depth analysis of my body before they drive me to take drug coctails? It seems that my body reacts best when I simply maintain a strict diet and ensure I am reasonably active. Also, in the US, doctors are given monetary rewards by pharmaceuticals to push drugs, especially ones that don't yet have generic versions. I mean... before prescribing me a DPP-4 inhibitor, shouldn't my doctor verify in tests first that the enzyme it targets is indeed causing my body difficulty creating insulin? How does that even help when the issue is insulin resistance?
I'm 52. 5 years ago I got diagnosed with T2D. Had no idea, since I hadn't had a checkup in a few years, and A1C ended up being 9.8. Doctor wanted me to immediately get on metformin but I insisted diet change first, I went on a keto diet, not 100% strict but definitely disciplined, and my next test 4 months later was 6.2. My cholesterol levels were also high, LDL and particularly the triglycerides, doctor had wanted me on a statin, and after 4 months of strict diet they came down too. Still high but way lower and not in the range of statin seeming necessary, I reasonably maintained with diet alone and mid-2022 my A1C was still controlled without medication at 6.6.
Since 2022 I have been needing to travel a lot, extra focus on work, and not enough time to stay active or be disciplined let alone make it to the doctor's office for almost 2 years and I knew from finger pricks that my glucose levels were going up and decided my next visit I'd have the doctor consider metformin. That was September. My A1C came back 9.4 so definitely not great and I knew I needed metformin help along with trying to be more strict with diet again. My cholesterol numbers were also high again so I know they are correlated but again the doctor wanted me on a statin. I told him we should wait to see what my results are on next A1C check first. He seemed fine with that.
Last week I went back in to get updated blood tests and saw a doctor at the same time. Different doctor. Without even waiting for the test results on that which can take over a week, she was wanting me on an added T2D med named Januvia. I wasn't sure why since the past last visit I've been wearing a CGM and it was indicating my past 90 days estimated at 7.7 and past 30 days even better at 7.2, so why not first wait to get the A1C and cholesterol marker results? She said Januvia was very safe and was only going to prescribe what's considered a low dose 25mg. She also wanted me on a statin. I told her we're waiting on that until the tests come back because of my cholesterol is correlated to my blood sugar then why take more meds than needed if that gets back under control?
Lastly, I had requested a heart test in September and the doctor gave me a referral for a calcium score test. Did that and it came out at 19, which is pretty good for my age (anything under 100 is good for my age) and basically puts me at extremely minimal risk for heart disease. I've never had heart issues, I don't have any other medical conditions at all, my blood pressure is always perfect, almost all my other markers tend to be in normal ranges, etc. I don't eat fried foods, stay away from processed foods as much as possible, am relatively strict on keto with a little flexibility so I don't get stressed about it when I'm busy, and my family does not have any history of heart disease on either side - just diabetes does tend to run in the family. Neither of my parents have diabetes. I also get annual eye checks to compare any differences in eye vessels, etc., no changes ever.
When I called the pharmacy to check the out of pocket cost for the Januvia they said it was $527 USD for a 30-day supply! Yeah... no. I immediately called my doctor's office since there's no way I'm going to spend an additional $6,000 per year on that. I researched the drug and although it's safe it seems that it's primary function is to get the pancreas to generate a little more insulin. I can't see even how that drug would even help me since my issue is insulin RESISTANCE not lack of insulin creation. I know this because outside of my primary doctor's own guidance 5 years ago I went directly to an endocrinologist to get all other aspects of my endocrine system checked and they learned that all my body functions are normal - my body creates a normal amount of insulin, it's just become resistant to it.
I feel that with all of these details, doctors just want to prescribe meds. No matter how safe meds are on paper, there is always risks, and especially when they're combined and taken long term, they could lead to other body issues that then need (guess what?) more meds.
Am I being unreasonable to make the doctors wait on tests and to do more in-depth analysis of my body before they drive me to take drug coctails? It seems that my body reacts best when I simply maintain a strict diet and ensure I am reasonably active. Also, in the US, doctors are given monetary rewards by pharmaceuticals to push drugs, especially ones that don't yet have generic versions. I mean... before prescribing me a DPP-4 inhibitor, shouldn't my doctor verify in tests first that the enzyme it targets is indeed causing my body difficulty creating insulin? How does that even help when the issue is insulin resistance?
. So I believe in any case. Some of the lit in Aotearoa/NZ destined for doctors with regards diabetes care is along those lines, but we can be awfully good at pretty presentation, without practice, or genuine adherance, as I believe, also, in any case.
