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Finally have a Referral to Endocrinology - Any Suggestions for the Visit


MikeO

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Not sure how to go about discussing issues. From a data standpoint is the obvious labile blood sugars and symptoms that comes along with it. So what does a endo all handle or look at?

I am hesitant just to go in to the visit and just saying i don't feel good or even bring up me suspecting dysautonomia as the root of some of my diabetes/GI issues. Use autonomic dysfunction instead? Pyridostigmine does seem to help stabilize my BG/GI just not perfect.

Do i dare bring up that my orthostatics are 10 times worse when my blood sugars are elevated (not sure if diabetes is a actual cause for OH episodes) or suggesting a dysfunctional pancreas causing digestive issues. Any tests that i should be aware?

Just looking to be a bit smarter ahead of the visit

Thanks for reading.     

 

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@MikeO an endocrinologist deals with all the mentioned issues - insulin, neurotransmitters, GI issues .. I would bring a list of everything you want him to address, including how you feel when your sugars are abnormal. I definitely would mention your nOH but likely he will concentrate on the diabetes. Good luck, keep us posted!

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well saw the Doc yesterday (sigh) we did discuss issues. He did go into that autonomic dysfunction can and will mess with one's body functions so in his area meaning the pancreas (bile and insulin) so does he know for sure if the ANS is at fault no there are other reasons just one step at a time. At first he was not onboard that i was diabetic (i was warned that this could happen) as my A1c is 5.6 but after digging thru the MyChart labs and me showing all the data that i collected he changed his mind and ordered additional blood work. he is looking for the type 1 diabetes antibodies as my liable BG swings (said this was messed up) mimic late occurring T1 DM more than T2 DM.

He also did a quick exam and provoke a response when when pressing on the right side of the throat and having me swallow. not sure what this shows but i almost threw up and was not able to comply with swallowing.

we did also discuss GI issues and he recommends going in to see a gastrologist. for now he won't order any DM meds as most are not very GI friendly or had other concerns so he urged to stick with a low carb diet. 

Right now i am stressing a bit waiting to see visit notes and lab results. 

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@MikeO sounds like he is doing the right things. By pressing on the right side of the throat he probably provoked a vagal response. And it is really a good idea to see a gastroenterologist, I am surprised no one referred you yet! Hang in there, stick to your diet ( which you are doing such a great job with ) and be patient! Hugs.

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well antibody labs came back. one is questionable as low positive. no panic for now as my very low carb diet is working. sure i will find out more in september.

Glutamic Acid Decarboxylase Antibody    5.0 IU/mL
IA-2, Autoantibody    5.4 U/mL
Insulin Antibody    0.4 U/mL

 

   
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