when to see an endo

My GP called this morning to have me fax over the last three
months of glucose logs to him. As I expected, he wasn't happy
with the multiple fasting numbers of 150 or higher (one as high as
338) and the post-meal numbers over 180. This is with metformin,
glyburide, Byetta, Lantus, and diet & exercise. Before we add any
rapid-acting insulin or change my meds (he's talking about DC'ing
the metformin and glyburide and switching me over to Janumet - I
didn't realize you could take Januvia/Metformin and Byetta at the
same time) but wants me to see an endocronologist first to get
their advise. The only problem is that of the seven endos in this
town, only two are currently taking new patients and both are
booking six-months out. I see my GP next Saturday and will get
the referral and necessary charts from him at that time but I'm
wondering if they have the pull to get you in to a specialist
sooner? I can't believe I was unable to get in with one until
after June 1!

--Michael

I had to pull strings to get into see the endo I see now. They were all booked up around here as well. There are only two in the town nearest to me.

Maybe increase the Lantus? Ask you present guy what he or she thinks about that idea. I shoot Lantus and fast acting, amd the strategy was to titrate the Lantus dose up until the morning fasting numbers were acceptable. I really like Lantus since it gives an additional cushion when the fast acting dose is a bit low.

----- Original Message -----
From: Michael

Yes, a GP can help try to speed things along to get a patient in to the Endocrinologist sooner than the scheduled wait time.

Unfortunately there is a shortage of endocrinologists around the country. My area of the country it is the same thing of having to wait several months to get in to an endocrinologist. The one Primary Care Physician she had tried to get her to go to an endocrinologist and the wait time to get in with one where we could have gotten her in within a week would have required her to go to the other side of town. To get for the side of town closest to our house it would have been about 4 months.

However, in my mom's case as I explained in another post going to an endocrinologist will not help her. She almost went to one up at Mayo Clinic but cancelled the appointment not only because she found a Primary Care Physician who can take care of her but they would not be able to help her with her Diabetes. We know this from prior experience with regard to her.

Daughter of Type 2 Insulin Dependent Diabetic,

Kristy :)

Not everyone who is on insulin are able to benefit from the services of an endocrinologist, but I agree if one can and if necessary to at least consult one.

My mom has tried to use the services of an endocrinologist over the past nearly 10 years after initially being put on insulin by an endocrinologist (who she no longer goes to and will explain why in a minute) to see if going to one would help her. Unfortunately, going to one did not help her. The reason is because she can't tolerate the side effects of the medicines that are used by Endocrinologists to treat Diabetics, especially those with Type 2. They would want to try and put her back on the Levemir or Lantus to help with controlling her sugars at night and while it's good that these medicines can help with some of that she can't handle the side effects that she got with them.

So the Primary Care Physician she has now who is not only a Diabetic himself but treats patients who are Diabetic found a different way to try and handle this issue. They are trying to find the right dosage of the second insulin she's on (which is not the Levemir or Lantus) but so far this other insulin (the Novolog 70/30-I would have to double check for sure on this one but I know it's different from the fast acting one she takes which is the one like for meals: Novolog-again would have to double check on this as her list of medicines is now growing in general) is doing good as far as no side effects.

Daughter of Type 2 Insulin Dependent Diabetic,

Kristy :)