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Question:

From Cozad, Nebraska, USA:

I had written to you before with a question about whether or not I have diabetes [see the previous question], and, as you suggested, I consulted with the doctor, and gave him a copy of my blood sugars with a home monitor for the last three days. My fasting sugars have been 149-167 mg/dl [8.3-9.3 mmol/L], I have had some just over 200 mg/dl [11.1 mmol/L] after meals, and my bedtime blood sugars have been 155 to 212 mg/dl [8.6-11.8 mmol/L]. I know that you cannot tell a lot from these, but I am concerned because his nurse called me back and said these are irrelevant because the HbA1c was normal, and the doctor he says since there is nothing wrong, no treatment is necessary.

I was treated very rudely by this nurse, and am unsure where to turn. We live in a small town, and have only one clinic with five doctors. I am confused as they are treating me like a hypochondriac, and your initial answer said I should consult him. Please help.

Answer:

I am sorry you are having such a difficult time. I still believe you have type 2 diabetes and need treatment. My general recommendation to you is that you need to see another physician.

With a service like this, I do not think the replying health professionals can make critical decisions without knowing whether all the information has been provided. Your description of your situation is fairly obvious. Our literature in the area of diabetes medicine contains several references which suggest the oral glucose challenge test is more sensitive than the hemoglobin A1c. This sounds like this is the situation you are in. It also may be the case that the physician's reference laboratory does not have a good lab test.

JTL

[Editor's comment: You might bring this answer with you and consult with the doctor again, or perhaps ask to be seen by another physician in that clinic (if you haven't already seen all of them). Another alternative would be to go to a nearby town and see a physician there or ask for a referral to the closest endocrinologist for a second opinion. SS]

DTQ-20010904174505
Original posting 12 Sep 2001
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:09:26
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