Once weekly long-acting insulin?

Sounds horrible. Glad you now have it under control, but man that is a tough list of symptoms. Kind of makes diabetes seem like a walk in the park.

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My experience has been the exact opposite. In my early years before insulin it was difficult or impossible to find an endo to treat a T2 patient. T2 is a metabolic disease and is outside of the scope of endocrinology. It was only after I was on MDI, started by my GP that I found an endo willing to accept me as a patient. My GP still won’t support my insulin pump.

That was almost ten years ago and things have changed somewhat as more T2 are starting insulin earlier but for the most part it is the GP that treats most T2’s.

A once weekly insulin might be a excellent resource for a T2 just beginning insulin where the idea is not to provide total insulin coverage but to provide some relief to stressed beta cells.

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An insulin that doesn’t last 4 hours… umm Afrezza comes to kind

Many endos don’t treat diabetes at all. They also treat a lot of hormonal issues like low-T and women’s issues, pituitary and growth issues, puberty issues etc

Imo an endocrinologist doesn’t add much to the equation for treating diabetes that a well organized PC doc or NP doesn’t particularly if they work with CDEs for the new patients … its basically a game of routine follow ups, being organized and on the ball to make sure their rx needs are met, and referrals to appropriate specialists as needed… wheras if I had a condition that required more active medical management than self management I think they might provide more value

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@Sam I think one variable that an Endo can bring, assuming they are current on evolving treatment, technologies, etc is a pathway for T2s who need to navigate insurance denials. A good PC no matter how knowledgeable isn’t going to be able to push through with insurance companies what a Endo can. Many T2s are denied access to tech like pumps, cgms and such because once the insurer opens those floodgates, the medical system will collapse financially. So deny deny deny.

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That has been the exact opposite of my own experience… my pc doc has always been willing to go to bat to argue with insurance,

And my endo who was actually even a personal acquantaince and worked with my wife couldn’t seem to be bothered with it at all

Though now that I’ve moved to a new area where I’m not a known person in the community I don’t think my pc doc would lift a finger for me either but I suspect my Diabetes NP would go to war with insurance if it became necessary

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My PC can’t get me out of the office fast enough and generally says to run it by me Endo. My Endo is more up to date on research and tech than I am, and has no issue going off label

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I share this experience with you. I changed from an older endo to a younger one, and my experience thus far has been that the younger one is much more up-to-date than my former. (that’s not to say that older doctors can’t keep up with the latest in technology, etc, bc they certainly can; it was just my experience that my elder endo didn’t care to. a shame for him and his remaining patients :grimacing:)

But I do think that my endo is spectacular. My PC is phenomenal, and is also the head of Gastroenterology at NYU Hospital (so this is great for me, bc I have many D-related GI problems), but my PC commented during my last visit that he thought that my A1c was a little “too low” (5.2%). I found that very odd for such an educated man to say.

You never know. I think we all can have the opportunity to experience medical professionals differently. Also, I have found, IMHO, that those of us who use communities like ours (FUD) are much more likely to self-advocate than the many who don’t have the opportunity to self-educate. I think also that we here at FUD can learn to really develop a spine and not allow others to tell them what is “the best thing for them.”

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My guess is that they are worried you might be having hypos which can/would have a negative impact on your care.

I definitely think this is true. I’m definitely no expert, but my last Endo spent 1/2 of all our sessions asking me about the latest tech and open source software/systems. Apparently I was better informed that most of her patients. Fortunately my use of software like XDrip, NIghtScout and hacking G5 transmitters to extend them made her a believer.

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One of the things I really enjoy about visiting my endo is our layered discussions on the latest tech and the most current ways that I am employing my knowledge of YDMV. My endo is a very strong advocate of YDMV and does not EVER try and push a “formula” at me. He is always recommending that I. "experiment, " bc we are all different. I LOVE that he is so open minded and worry-free about how I choose to try out new activities and new foods, etc. He seems to even get excited (at least I like to think so) about our visits bc I am (most likely) so different than his other patients.

our visits usually last about 1 hour. And he also engages my husband in our conversations as well, and I find this wonderful. As Hillary Clinton once said: “It takes a Village.”

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The first pc doc I saw when I moved here absolutely disparaged me… scolded me viciously before even talking to me for having an a1c of 5.1…No idea what my control was like, no idea how involved I was, if I was capable or not… that was BS didn’t see him again…

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I would have done exactly the same thing; in fact, that was why I left my previous endo. (and he, himself, was a T1D who wore a pump.) Go figure.

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