My Annual Endocrinologist Visit

Each June, I have my annual visit with my endocrinologist. For those who may not know, endocrinologists are the specialist doctors that diabetics typically go to once they are officially diagnosed with the disease.

I thought an interesting blog post would be to describe what my visits are like considering I’m a type 1 diabetic (“T1D”) living medication free for nearly 2.5 years. Obviously this is contrary to what most doctors understand, so this should be interesting, right?

My Personal Routine

I visit with my endocrinologist once per year, and it’s typically in June. Since I’m not on medication, there is no need to visit more frequently unless my fasting blood sugars or A1c readings start climbing to higher levels.

In August, November and February of each year, I only get an A1c test. This is the standard benchmark to test how well a diabetic is controlling their disease. So, for 1Q, 3Q and 4Q, I really only worry about my A1c.

In May of each year (2Q), I typically get my A1c test done along with several other T1D specific blood tests to measure the antibody levels in my body. Since I visit with my doctor in June, we are able to have a more comprehensive discussion about my current state, which is the reason for the extra tests in May.

Other than this annual visit, I really have no other interaction with the medical community in a given year. The annual visits are more of a formality at this point so I can stay registered as a T1D in order to get my testing strips to check my fasting blood sugar each morning.

My Most Recent A1c and Historical Fasting Blood Sugars

As promised in my earlier posts, I will continue to post my most updated A1c results and most recent fasting blood sugar charts each quarter.  As you can see below, my May 2016 A1c was 5.5, which was actually down from 5.6 in February 2016.

Historic Fasting Blood Sugar and A1c Readings Through June 2016

As a refresher, the general guidelines for A1c readings are A1c < 5.7 = non diabetic, A1c > 5.7 but < 6.5 = pre-diabetic and A1c > 6.5 = diabetic. So, according to my A1c, I’m classified as a non-diabetic.

My average fasting blood sugars over the past 30 and 90 days were 109 and 107, respectively. Now, I do fail this test, because non-diabetics have a fasting blood sugar < 100, pre-diabetics > 100 but < 125 and diabetics are > 125.

My Goal

My overall goal each quarter is to keep my A1c reading below 5.7 and have a trailing last 30 day average fasting blood sugar reading below 110. I could get my sugars lower if I really wanted, but that level of dietary strictness and discipline is something that even I find difficult to follow.

Yes, I am Confirmed as Type 1 Diabetic…Again

The other two tests I received were the IA-2 Autoantibody and the GAD-65 Autoantibody. My IA-2 came back at 4.2 and a T1D reading is anything above 1.0. My GAD-65 came back at 9.0 and anything too much greater than 0.0 is a reading of T1D.

I realize some people / doctors out there may think that I’m a Type 2 Diabetic or perhaps the mythical Type 1.5 / LADA diabetic. But these tests prove that I have an auto-immune disease, and I am indeed a T1D.

Progress with My Endocrinologist

I personally like my endocrinologist. He’s a nice guy, and I know that he wants the best for me. That said, he is still the typical medical professional that, from a disease management standpoint, is highly trained from a medication perspective, but nominally trained from a dietary perspective.

1st Visit – 2014 (6 Months Post Diagnosis)

My first visit back in 2014 was about 6 months after I was diagnosed. This was when I was still figuring out the disease. I was off medication, but my blood sugars were rising, and he gave me the typical dooms day scenario that medication was in my near future.

2nd Visit – 2015 (18 Months Post Diagnosis)

My second visit in 2015 was after I was off medication for nearly 1.5 years. This was after I implemented the mostly raw, plant-based diet that caused my blood sugars to rapidly drop. I explained to him in decent detail about the documentaries I watched and the teachings of Dr. Gabriel Cousins.

He was happy for me, but my general impression of our interactions were 1) he thought my diet was weird and unrealistic and 2) that this was only temporarily helping and my body would fail and require medication soon. He did not say any of this, but it was just the general vibe I got from our visit.

3rd Visit – 2016 (30 Months Post Diagnosis) – Now I Have Your Attention

Fast forward to June 2016 for our 3rd meeting. At this point, I felt like now I had his attention. We had our typical conversations, but this time he actually pulled up the internet in the room, and we briefly looked at Gabriel Cousins website together. He also jotted down the name Kirt Tyson, who was the first T1D that I identified that has been off medication for an extended period of time.

My doctor openly admitted that he does not have any other, nor knew of any other, T1D patients that have been able to avoid medication for the length of time that I have while still maintaining non-diabetic readings. To me, this was major progress.

Light Bulb Going Off

We both agreed that my diet is not realistic for most people, and that not all T1Ds could achieve my blood sugar levels with this diet. However, I could tell I was starting to change his thinking about the different strategies at managing this disease. He openly admits that there is still alot of unknowns about the disease, and people like me are perfect examples of that.

As I mentioned in other blog posts, I think a majority of doctors are truly out there to help people and give them the best advice possible. My grudge is with the medical schools and even the pharmaceutical companies and why they do not educate doctors about people like me.

Apparently Novo Nordisk is the largest manufacturer of insulin in the world. I bet their executives know all about people like me, however, what is their incentive to educate doctors on how diet can potentially allow thousands of T1Ds to live medication free? This would only decrease their profit.

Final Thoughts at my Appointment

We ended our meeting with a couple things. I first wanted to re-confirm that I am indeed a T1D, and he said yes with absolute certainty.

Potential Cures On the Horizon?

I then asked him whether there were any cures on the horizon for T1Ds. He’s been pretty consistent over the years on this one saying that strides are being made, but it’s most like 10-20 years away until we see something that could truly be considered a cure.

I’m really not overly concerned about a cure at this point because I don’t believe I would change my diet much if I was cured anyhow. However, my fasting blood sugars are definitely at levels that are adversely impacting my body, so I would like to find a way to get these down lower without me having to eat a 100% raw vegan diet.

We always part ways with him saying that he hopes we don’t see each other for another year, because that means I’m still off of medication and managing the disease well.

Conclusion

In conclusion, it’s been a tough 2.5 years dealing with this disease, but I’ve settled into a groove with my diet. I’ve been able to put some weight back on, and I’ve started to enjoy a greater variety of healthy foods now that I understand my body better.

I realize my blood sugars aren’t perfect, but I believe they are better than most T1Ds managing the disease with medication. If I can keep my A1c below 5.7, I feel like that is a win in my book, and I’m content with my management of the disease.

In the News (New this Blog)

I also wanted to start something new with each blog by putting in any interesting articles I read over the course of the last month. This post is from CNN that talks about Green Bay Packers quarterback Aaron Rodgers shifting towards a mostly plant-based diet. He was educated by his trainers about how this diet can extend his career by making his body healthier and reducing inflammation.

He also notes that other QBs in the NFL follow a similar diet like Tom Brady. Kind of makes you think there is something to this diet if some of the wealthiest, top athletes in the world are shifting away from an animal based diet and towards a plant-based diet.

Aaron Rodgers Comments on Changes to Diet, Impact on His Health