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Interesting Appt With Endocrinologist

F

Flora123

Well-Known Member
Messages
1,078
Type of diabetes
Type 2
Treatment type
Tablets (oral)
First time seeing a specialist. He started asking me what meds I was on etc. Was surprised I wasn’t and then told me it wouldn’t stay that way and I may eventually need insulin. Ok I thought. He’s the expert but we will see and stop being so negative. Was a bit negative about my maintenance until he saw the figures. Now a bit perplexed took history. Said I was really slim, fit, well and still not sure what type I am!! I am a medical anomaly and he thinks I am a strange type 2 but still not ruling out type 1. Was told to carry on as I am until my next HbA1c which he said would be very unlikely to be good! Hmmmm.
Anyway I asked what caused me to get this and He categorically said no one can eat their way to diabetes. He said genes, predisposition but in my case just extremely bad luck. This did make me feel better. Got to have a scan to see what my pancreas is doing. It’s all very interesting/strange.
 
"A strange Type 2" because you are not overweight, not on meds but will end up on insulin. Well there's logic!
Perhaps he/she hasn't any Asian patients (higher proportion of TOFIs) or hasn't come across the term 'Diet managed' but still maintains the chronic, progressive disease pathway is the only outcome. Ah well...
 
Maybe he's related to the Endocrinologist my GP consulted about my "results" who advised her to prescribe me 500mg of Metformin a day "just in case" my HbA1c got worse in the future :banghead:
 
Some Endos are better than others of course. I have seen a couple, although not about diabetes. The second being very interested in me because of a few things that astonished him.

He didn't spend a lot of time on my personal diabetes, but was very interested in my family history, littered with diabetes of all sorts, and even further crammed with auto-immune conditions. During my time seeing him, he tested be for around 30 separate auto-immune issues, as he was emphatic I'd have something. Well, I didn't.

When I was last leaving his consulting room, just replaying the consultation in my head, his parting shot was something along the lines of "Watch out for that LADA. It's a sneaky b*****."

It's good to have something to look forward to. Non?

Of course, me being me, I'm not planning on going down that road, but none of us know what the future holds. Time will tell us how well our LCing efforts have really served us, but for now, I'll just crack on. :)
 
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Just like my first endocrinologist who thought it was my fatty liver causing my weight gain and prediabetes, didn't have a clue, what to ask and told me that I would have severe diabetic problems if I didn't eat and drink to the NHS guidelines. If I remember correctly.
Under his direction, I was told to eat porridge for breakfast, baked potato with a filling such as tuna, cheese et al, and pasta for my evening meal!
I was dismissed six months later because he believed that he thought I was better off with my GPs and dsn care!
 
bulkbiker said:
Sounds like he's a prehistoric endocrinologist... possibly trained a while ago and not kept up with his CPD?
Click to expand...

I don’t think so. I just think I got the ‘talk’ that they usually give. I think he is genuinely flummoxed by me :)

I was pleased he ordered a scan etc. Kept going through every test I’ve had and was amazed everything was normal.

I think it’s because there are none of the usual things wrong with me that they might normally find. We shall see but at least I wasn’t told to see a dietician!
 
Guzzler said:
"A strange Type 2" because you are not overweight, not on meds but will end up on insulin. Well there's logic!
Perhaps he/she hasn't any Asian patients (higher proportion of TOFIs) or hasn't come across the term 'Diet managed' but still maintains the chronic, progressive disease pathway is the only outcome. Ah well...
Click to expand...

Maybe but he said there are many sub divisions of type 2 that are still being discovered...?! I didn’t feel he was ‘old school’ and I don’t live in a multi cultural area. Who knows. Doesn’t want to see me again and said GP capable of managing my case.
 
Flora123 said:
Maybe but he said there are many sub divisions of type 2 that are still being discovered...?! I didn’t feel he was ‘old school’ and I don’t live in a multi cultural area. Who knows. Doesn’t want to see me again and said GP capable of managing my case.
Click to expand...

Hi there.
I have a rare type of hypoglycaemia, I am not diabetic, but I have the same symptoms and intolerance to certain foods. My problem is not high glucose but my pancreas creates too much insulin.
Having normal hba1c and fasting glucose levels is not asymptomatic of a type or sub type of diabetes. There are many types of metabolic conditions, hormonal imbalance and intestinal problems that can become health issues.
I do believe that this endocrinologist cannot understand the symptoms you are showing and has no knowledge of rarer types of metabolic conditions.
Be interesting what your pancreas scan shows!

Best wishes
 
DCUKMod said:
Some Endos are better than others of course. I have seen a couple, although not about diabetes. The second being very interested in me because of a few things that astonished him.

He didn't spend a lot of time on my personal diabetes, but was very interested in my family history, littered with diabetes of all sorts, and even further crammed with auto-immune conditions. During my time seeing him, he tested be for around 30 separate auto-immune issues, as he was emphatic I'd have something. Well, I didn't.

When I was last leaving his consulting room, just replaaying the consultation in my head, his parting shot was something along the lines of "Whatch out for that LADA. It's a sneaky b*****."

It's good to have something to look forward to. Non?

Of course, me being me, I'm not planning on going down that road, but none of us know what the future holds. Time will tell us how well our LCing efforts have really served us, but for now, I'll just crack on. :)
Click to expand...

We don't. I was diagnosed in my early thirties, and have managed my condition well until aged 59 it went haywire. Hashimoto’s thyroiditis, kidney disease not related to diabetes, high blood pressure (poss stress) de pruytens syndrome and last year at 63 a heart attack I didn’t even notice and dilated cardiomyopathy. No cardiovascular disease. Now I’m on insulin because it’s better for my health. You never know. Personally think there is an auto immune thing going on. But noone has suggested tests.
 
Roseanne01 said:
We don't. I was diagnosed in my early thirties, and have managed my condition well until aged 59 it went haywire. Hashimoto’s thyroiditis, kidney disease not related to diabetes, high blood pressure (poss stress) de pruytens syndrome and last year at 63 a heart attack I didn’t even notice and dilated cardiomyopathy. No cardiovascular disease. Now I’m on insulin because it’s better for my health. You never know. Personally think there is an auto immune thing going on. But noone has suggested tests.
Click to expand...

Have you considered building your case of the AI testing?
 
Not really. At this stage I’m very focused on my heart health and my worsening kidney issues. I know my niece inherited an auto immune gene from both her parents. But I will look into it. It’s not something you hear much about here.
 
Flora123 said:
First time seeing a specialist. He started asking me what meds I was on etc. Was surprised I wasn’t and then told me it wouldn’t stay that way and I may eventually need insulin. Ok I thought. He’s the expert but we will see and stop being so negative. Was a bit negative about my maintenance until he saw the figures. Now a bit perplexed took history. Said I was really slim, fit, well and still not sure what type I am!! I am a medical anomaly and he thinks I am a strange type 2 but still not ruling out type 1. Was told to carry on as I am until my next HbA1c which he said would be very unlikely to be good! Hmmmm.
Anyway I asked what caused me to get this and He categorically said no one can eat their way to diabetes. He said genes, predisposition but in my case just extremely bad luck. This did make me feel better. Got to have a scan to see what my pancreas is doing. It’s all very interesting/strange.
Click to expand...
What prompted your referral to him?
 
Flora123 said:
Maybe but he said there are many sub divisions of type 2 that are still being discovered...?! I didn’t feel he was ‘old school’ and I don’t live in a multi cultural area. Who knows. Doesn’t want to see me again and said GP capable of managing my case.
Click to expand...
I'm astonished GP referred you. Did you insist? Your GP must have been flummuxed too?
 
Flora123 said:
First time seeing a specialist. He started asking me what meds I was on etc. Was surprised I wasn’t and then told me it wouldn’t stay that way and I may eventually need insulin. Ok I thought. He’s the expert but we will see and stop being so negative. Was a bit negative about my maintenance until he saw the figures. Now a bit perplexed took history. Said I was really slim, fit, well and still not sure what type I am!! I am a medical anomaly and he thinks I am a strange type 2 but still not ruling out type 1. Was told to carry on as I am until my next HbA1c which he said would be very unlikely to be good! Hmmmm.
Anyway I asked what caused me to get this and He categorically said no one can eat their way to diabetes. He said genes, predisposition but in my case just extremely bad luck. This did make me feel better. Got to have a scan to see what my pancreas is doing. It’s all very interesting/strange.
Click to expand...
First saw an endocrinologist last November after he cut my Metformin in half and stopped the Invokana completely because of possible kidney complications in August. My weight was 165 lbs (10 stone 5 lbs) and my A1c was 6.3 at the end of August and up to 9.3 in November. I wonder why.
Had on operation in February to put right the supposed kidney problem and he started me on insulin, back to the previous dose (4x500 gm per day) of Metformin and cut all other diabetic drugs. Over the next few months my insulin dosage more than doubled and I gained over 10 lbs. His last comment when I saw him was, "I can't do any more for you. You are on your own."! He is young and an associate professor at a medical school. Also he probably didn't like me saying that diabetic treatment was barbaric and medieval and probably classed as cruel and unusual punishment! The latter because many medical practitioners still think that it is obesity and lack of exercise that has caused the diabetes. That is: self-inflicted so must be punished.
Just had another operation (gall bladder removed following pancreatisis) and my insulin dose was reduced whilst in hospital. The last couple of weeks I have reduced my carbs to almost zero and maybe the illness improved my own insulin production. I have been able to reduce my insulin dose to several units less than originally prescribed in February. After all 'I am on my own' so I can decide what I do. At the current rate I could be off insulin in a couple of months as I still get low glucose levels.
So the age, experience, knowledge, good bedside manner (which my endo. had) etc. have no meaning. Some doctors want to categorize people so the patient then fits into a predetermined treatment protocol making the job easier.
Recent research has shown that there are several types of diabetes most of which are not lifestyle induced. I suspect like many other recently researched medical issues diabetes will be seen as a continuum that is not a progression that a patient will have to move through. Treatment including diet will be geared to maintaining the status quo. I am convinced that there are many medications (including insulin) that either reduce our need to produce insulin and/or cause the pancreas to stimulate the production of glucogens by the liver. Both of which will increase glucose levels and A1Cs. When I asked the endocrinologist said, "No er yes, the first, no the second. My pharmacist siad the pancreas works in a continuing feed back loop. Like a sound system feedback, reduce the input until the system levels.
My suggestion: Do all the research you can, experiment with different levels of input (carbs, medications, exercise) and figure out what works best for you. This way you can create the protocol that works for you. As Shakespeare put it, "Know thyself."
 
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