carterjp <[email hidden]> quoth:
Quoted message said:Priscilla,
Quoted message said:Quoted message said:I know. And I agree. And so does the doc really. The doc basically says "Your fasting is 89,
HbA1C is 5.6, your 2-hr OGTT is 116. Based on that you are IGT. HOWEVER, your meter shows you
cross 200, and that is clearly T2. Be labeled IGT for insurance purposes for now, but you are
T2. No meds for now. Diet and exercise like the T2 you are, or else you will face the
consequences a T2 faces when they don't diet and exercise."
That sounds almost exactly like my endo, except he prescribed metformin for cardiac protection.
Quoted message said:It's GREAT to have some company. How was your t2 dx'd? Also on a random pp test on a home-meter?
How did you weigh your options in terms of getting officially classified as a t2 in the insurance
system versus staying an official IGT and actual t2 under your PCP's care?
Not my PCP, my endocrinologist. Whole different kettle of fish! ;-)
Last January, my regular internist (PCP) was out on maternity leave, and the physician assistant
filling in for her did my annual checkup. She ordered the first fasting BG test I'd ever had. (I'd
had a GTT years ago and been told I was "borderline diabetic" but no-one ever followed up with me
about it, and I didn't know anything at that time.) The fasting test came in at 130, and the
letter in which I was told this said my "sugar was a little high," and they wanted me in for a
retest. They seemed more interested in my triglycerides of 248 and my cholesterol (total just
under 200, HDL low).
It was the FBG that I focussed on, though, since I knew type 2 diabetes ran in my family. I got
really scared and started educating myself. Luckily, a poster in this newsgroup, Susan Fein, was a
poster in another newsgroup I inhabited, and she clued me into carbohydrates and blood glucose and
pointed me to some resources. I read up and started low-carbing. I waited two weeks to go in for the
second FBG (which I knew by then would be the one that would confirm a diagnosis of diabetes -- or
not). When I got it, I was at 103! At that time, 103 was within the normal range. Woo hoo! As far as
I was concerned, that proved out low-carbing as the treatment for my diabetes. That was just over a
year ago. (Oh, and the low-carbing fixed up my triglycerides and raised my HDL, too.)
Unfortunately, my internist, when she returned, and her physician assistant decided that the 103
meant I didn't have diabetes, despite my telling them over and over again how stringently I was low-
carbing and how high my BG would go when I indulged. I'd learned here that metformin was important
for cardiac protection, since insulin resistance can do a lot of damage regardless of how tightly
one controls one's BG, and I explained that to my internist, but she refused to prescribe it for me.
So I found an endocrinologist. I got an appointment with the endo of a woman I knew, but that MD
moved out of the country before the time of my appointment came along, and I was given some dude I'd
never heard of before. Turns out he is exactly the right doctor for me. He thinks that how I treat
my diabetes is exactly how he wishes all his patients did and says that in 10 years low-carbing will
be the established recommended treatment. (It probably didn't hurt my case that I'd written out a
time line of lab results and how I'd been treating my condition with diet, etc.) This guy's also
very personable and has nice crisp boundaries, while also being touchy-feely. A difficult
combination to maintain, but he seems to do so.
This endo was very clear when he typed his notes into the computer. He said that he was officially
diagnosing me with "impaired glucose tolerance" because of how difficult a diagnosis of DM can be
when trying to get insurance in the future (and because I'd never had a confirmatory high number
needed technically for the diagnosis), but he then turned to me, looked me in the eye and said, "I
need you to be very clear that I *do* understand that you have diabetes!" Finally! I was understood!
He was also aware of the same information I was about metformin and prescribed it for me. I'm still
ramping up on dosage and strugging with side-effects at 1500mg/day.
It does feel a little odd, but it's a deception made necessary by problems not of my making. I keep
good control and am in better general health than I was 1.5 years ago. Denial of coverage because of
a diagnosis is unfair. I'm probably in better health than many people who've never been identified
as diabetic but who may well be, people who would be taken on for insurance. I've been at my current
employer for 23 years, and anticipate remaining here until I retire in 15 years, so I don't expect
I'd need to apply for health insurance before I switch to Medicare, but since anything can happen,
my doctor's "innocent deception" may end up being necessary.
Hope this helps.
Priscilla