I like my doctor. He’s a little quirky, but a very good doctor. Although I visit him only once every three months, he seems to remember a lot about my health and seems to actually care.
The one thing that drives me crazy about my doctor, however, (and most doctors I’ve seen since being diagnosed with type 1 diabetes) is the fact that he doesn’t seem to strive for excellence as far as my diabetes management is concerned.
My approach is that my numbers should be the same as those of someone who doesn’t have diabetes. I’m far from getting there, but I believe that should be the goal. Diet, exercise, medication, pump or injection should all be determined with that goal in mind.
Achieving the goal – having a normal HbA1c level (below 6%)– with very few lows or highs, will probably mean, at least as far as diabetes is concerned, a long and healthy life with very few complications.
However, this “goal” does not seem to be the common approach of family doctors or diabetes specialists. Extreme sports and very strict diets are usually considered crazy, if not unhealthy, by most of the doctors I’ve met, my doctor included.
So, I went to my doctor today to get new prescriptions and paper work for blood tests. While there I decided to ask him what he thought of the idea of me getting an insulin pump. His reaction was “Why? Your HbA1c is under 7”.
I can understand why he didn’t ask about my highs and lows, or about how the pump would affect my running or diet. What I cannot understand is why “less than 7” is considered healthy when you have diabetes, but not if you don’t. I understand why doctors need a minimal measure for people with diabetes to strive for but, if that measure isn’t really normal, should they stop there? Shouldn’t doctors say “maybe you can do better?” Especially if they know their patient is the kind of patient that can drive himself to do better?