This is a type of question better suited to a conversation over coffee or a beer, not in an appointment w your diabetes doctor, imho as a diabetes specialist. As a patient, I don’t separate diabetes goals from life goals because they are intertwined. Expecting a provider to ask in this manner is not realistic.
I really didn’t know how to answer this question. My interpretation is that I won’t have very many life goals if my diabetes goals aren’t met. So, my endo makes it clear that his role is to support my goal to be healthy and active for life. So, yes, his team looks at my diet (vitamins, minerals, etc..) and my BG ranges before and after exercise, and other activities. We review the insulin to carb ratio before, during and after exercise and during rest periods, or illness.
And, if my A1C or ranges are out of line with the goals, then we make adjustments either to the BG goal or basal/bolus.
Mary Ann Sayers
It is an automatic part of the visit–me telling her my concerns are her telling me to be careful. My A1C was 6.1 on Tuesday. The one before that was 6.8. I still want to change insulin life from 5 to 4 hours. The pump “thinks” insulin is still working in my body when I know it really doesn’t last the full 5 hours!
My health care provider does not directly ask me if my overall diabetes goals/priorities are aligned with my life goals. This is a philosophical question. However, our discussion resolves around my blood test results, the condition of my feet, my A1c, my overall health, etc. These practical discussions are all related to my goals to stay healthy and to live as long as I can.
Our medical system is not conducive to asking or answering a question like this. The time allotted is filled with being weighed, having an A1C done, a foot check, a precursory heart check… and a quick as possible answer to any pump questions. Life goals, without question, and diabetes goals beyond getting a better A1C, are way too time consuming to squeeze into whatever’s left of an appointment. Medicare takes care of most of that time with checking off boxes. A lifetime disease deserves way more time for discussion than it’s getting. The system’s broken!
I have no choice in terms of which Endo practice to use (HMO plan). I had a great CDE who understood my T1D goals to have as non-D labs as possible, my aggressive mgt of my T1D etc. Then (boo hoo) she retired. I saw the chair of the dept and was offended by his low opinion of patients (and their capabilities and character!) and switched to another Endo in the practice. It took many appts (mostly tele phone appts) to convince him that I was intelligent, proactive and knew what I was doing. I prefer telephone appts – they last longer so we have great conversations. This Endo understands that I am living iwth a partner with Bipolar 1 (with anger mgt issues) and recognizes that to me T1D is easier than life at home. He has also accepted my tattoo “I>?| V” – I am greater than my highs and lows. Of course the biggest and most successful argument I have in my favor that my A1C’s (5.4- 5.6 for years) is not the result of averaging very high and very low bg’s. Having the T-Connect reports displaying lots of “flatline” time and good TIR. This Endo understands the impact of living with someone with a erious mental illness has on my priorities and goals – understanding that just getting through a day can be a challenge. I truly appreciate his attitude.
I am not asked this question in so many words but he always reassures me that longevity is likely with my history of care and management and family history. I have to bring up goals and changes to management with new technologies. He is accepting to some but not to others. He will come up with other ideas to move forward when what I bring up doesn’t suit him but we are usually on the same page.
I answered I am not asked, but I am not asked directly. However, my doctor does as questions related to these aspects of my diabetes, treatment, and life.
My provider is knowledgeable and aware of my lifetime goal – to be one of the first patients on the cure list without complications from managing my diabetes prior to the cure.
29 years and counting and zero complications!!!
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I work 55 hours per week. My main goal is an Endo close to me that will give me scripts. When I left Baltimore to come home to FLA, I asked my very progressive Endo where I should go for a new Endo. He and I talked about all sorts of things together, including research. He told me to go to Tampa to USF. I live in St Pete and that’s a 30 min drive at 3am and about 1.5 hours during any rush hour, so I can’t afford the time. But when I retire, I will look for another Endo. I won’t say better, because I’m sure my current one works as many hours as I do. He knows I take care of myself and he too just wants to get me in and out.