Diabetes? Just lose weight, it will go away.

TL writes:

I still cannot believe this happened to me.

I caught my diabetes early – so early that I was first diagnosed with “pre-diabetes” at 27 by my excellent GP. He thought it didn’t make sense, so he sent me to an endocrinologist to “try to figure out what’s really going on.” It was a 4-5 month wait to see an endo as a new patient. I chose one, Dr. Z, that was highly recommended, but unbeknownst to me, the staff made my appointment with Dr. A, another doctor at the practice, instead.

After waiting two hours past my appointment time, I finally saw Dr. A. He came in, informed me I was a typical Type 2 diabetic (with no labwork), and asked me if I ever got any exercise. I told him I exercised 3-4 hours a day – and I know he heard me, because I have copies of his reports, and it’s in there right before what he said next – “recommended patient exercise 30 min. 3 x week to get levels down.” I also told him I’d been on a low carb diet for several years. He told me I needed to eat [about twice the amount of carbs I’d been eating] to treat my diabetes.

Then he addressed the true source of the problem…fat! “You just need to get some of that weight off and your diabetes will go away. Lose 10 lbs, minimum,” he said. I asked if he didn’t think I should start on medication. “No, you just need to lose some weight!” he barked. Then, he left. He’d been in the room 5 whole minutes. Since I didn’t know any better, I continued seeing Dr. A for a year, during which he told me to lose weight, do more exercise, and start eating better – although I had been the entire time – and insisted that he would not prescribe any medication for me. I just needed to work harder! Finally, I realized something – he was telling me to exercise a lot less than I did, and to eat more carbs to get my blood sugar down, and that if I just lost some weight my diabetes would go away. That made no sense! I had continued exercising and eating fewer carbs until I was almost at 0, but I just got worse. I finally got a brain and went to a different endo.

You see, I was 5’5″ and 110 lbs when I first saw Dr. A. My GP had been after me for years to gain weight. Dr. A took one look at my diagnosis, and decided it must be because I was fat! The fact that I was sitting there right in front of him had no effect. As it turned out, I didn’t have Type 2 diabetes…I have Type 1 diabetes. What galls me, about as much as the myth of what causes Type 2 and the bs “treatment” of people with Type 2 by medical professionals, is that if I had been…god forbid, an actual overweight person with new onset Type 1 (and yes, it happens), I would probably be dead now. Fatphobic doctors can kill.

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  1. TL, I’m so sorry. Dr. A sounds like an idiot (I can actually think of much worse things to say). I have had really good experiences with endocrinologists, overall, but that is pure luck. A fatphobic endocrinologist is a very bad thing, indeed.
    I hope you have only excellent doctors from now on.

  2. Jerry

     /  July 24, 2009

    If you haven’t done this already, I would report this guy (to the AMA?) before he really does kill somebody. Yikes.

  3. Holy guacamole.

  4. Meems

     /  July 24, 2009

    What responsible doctor tells someone who is 5’5″ 110 lbs to lose weight?!

  5. Entangled

     /  July 24, 2009

    It’s like he heard diabetes and instead of actually being a doctor working with a patient, he started saying the same stuff you see in the health section of womens magazines. Besides being rude, making you wait two hours, and giving terrible medical advice (seriously, I generally think telling people to lose weight is lousy, unhelpful advice, but in the case of people who are already don’t have much weight on them, it’s even worse). Seriously, in any size person, untreated type I diabetes is very dangerous. I’m glad you found someone who was actually a doctor and not just reading from the teleprompter in his head.

  6. Oh good God. I think you have EXCELLENT grounds for a complaint to the state medical board (assuming you live in the states) or equivalent, given that:
    1) He totally missed that you had type 1 diabetes
    2) You had a BMI of 18.3, which is officially UNDERWEIGHT, and were being told to lose weight.
    2) He was said to exercise MORE – and told you to exercise less than you already were!

  7. ( um, there was supposed to be a 3 there. oops. )

  8. Lili

     /  July 24, 2009

    OP here. This happened 4 years ago, so I’ve had some time to think about it. Here are my theories as to how this happened:
    1. The man I met was not Dr. A, but someone who stole his identity, and possibly wasn’t even a real doctor (which is totally plausible, as far as I know).
    2. He was Dr. A, but something happened to him after he got his impeccable credentials, like a stroke or brain injury.

    Those are the most charitable conclusions I could come up with.

    – Lili from Tucson

    • Lili:

      I have a third theory about Dr. A.:

      Credentials look good on the wall, but do not necessarily mean that the doctor is competent. All the credentials indicate is…he could pass some exam and/or made it through a certain program.

      It’s no guarantee the doctor actually could put the alleged skills into practice…or wanted to.

    • cicadasinmay

       /  July 25, 2009

      Yeah, I kind of figured he was an alien impersonating the doctor, but not being human at all he didn’t know a thing about Earth medicine and could only repeat things he just read in the magazines in the waiting room!

  9. That idiot only proves that 50% of all doctors graduated in the bottom half of their class…and he was one of them. Not only does he see a bone-thin woman whose own doctor suspects real problems and refuses to do diagnostic tests, but he has the unmitigated gall to:

    1.) Tell you to LOSE weight when you are underweight already?

    2.) Exercise more when you are already exercising enough to qualify as being in training for the Olympics?

    3.) Assuming you are type 2 because you are 28? Dumb; type 1 (autoimmune disease based) diabetes can occur at any age. It’s NOT unusual for a young adult to suddenly show up with it (type 1 is not just for kids).

    4.) Even if you ARE a type 2, being thin is not unheard of; happens a lot.

    5.) Although this is as of yet my own impression based on my research (and is not medical advice) the very treatment protocols for diabetes, IMHO, are deficient and a doctor should at least be aware based on current research that:

    I.) Diet and exercise matter, it appears, only to the extent of determining medication (specifically insulin) dosages for the former (one needs to know how much carbohydrate to compensate for); the latter (exercise) really is for keeping in reasonable everyday physical conditioning. (It need not be hours a day; in fact, too much exercise is more often than not as bad as none at all for the diabetic).

    II.) Neither of those “traditional” treatments “control” blood glucose levels in any special way; all that is triggered using the hypocaloric meal plans and “hamster on a wheel” “exercise” is the same as…starvation and overwork does in anyone. There is nothing special about either.

    III.) Neither diet nor exercise deal with the real problems the diabetic faces, which appear to be: 1.) Lack of sufficient insulin production for the needs of the particular patient;and/or, 2.) Poor metabolic function that affects how well the body uses the glucose supplies it gets.

    The only way to effectively deal with diabetes, IMHO–which is mostly genetic in origin– is to include medication in the regimen from the start, especially in a case like yours. The “diet and exercise only” mantra appears to be of little use by themselves in delaying complications from diabetes (or diabetes itself) and reflects tradition only.

    BTW: I am a type 2 diabetic and I was prescribed medication from the get-go. It was never just “diet and exercise” even though the condition (disease) was caught early on.

    • BTW: I missed the fact that you are a Type 1 and my last comment reflects that (and I can’t edit it to fix it).


  10. Observer and all other posters: I am a T2 diabetic also. I was NOT prescribed medication right away. I began as a gestational diabetic at 28. Then again at 30 and again at 32. I was told to keep my baby weight off, and I would stave off pre-diabetes. So….in my 30s, even while exercising 2 hours a day (I would put my kids in child care just so I could do this) and eating below 100 g of carbs a day, I was able to keep my a1c in the 4s, BUT, at 36, my trigylcerides went up over 300, at 38, I developed high blood pressure, and at 40, when I could no longer keep up that routine, my a1c finally broke 7. I had to BEG for medicine.

    Of course, I was told – just lose weight. Now, I am overweight, however, through my 30s, I kept a BMI of just 26 – with ALL that diet and exercise, just at the outset of my healthy weight. There was no way I was going to get down to my weight in high school! Are you kidding.

    And while now, I could stand to lose another 20 lbs (I have lost 23 already on Byetta), many people when they look at me don’t think I weigh as much as I do.

    If my diabetes had been managed better with medication added to the plan, perhaps I might not have felt as frustrated and let my weight slip.

    I’m trying to get it down now, but I’ll never be under 28-30 in my BMI – it’s not reasonable.

    When my internist started talking to me about a lap band/gastric bypass, I went and found an endocrinologist, who told me at my weight, I wouldn’t even qualify – I wasn’t that overweight.

    With Metformin and Byetta, plus HBP meds and Cholesterol meds and heart pills now, I have regained my energy and controlled my a1c to 5.2 – I am now on the 3rd week of the C25K running program.

    I totally agree that it is genetics – and certainly diet and exercise is part of management – for all types – but I think TOO many internists write people off as overweight and DON’T treat the symptoms, which causes a lot more havoc in our bodies than it should!

    I’m so glad I found this post – it pretty much marvels my frustration as a patient with T2 who is NOT a glutton couch potato who did this to herself (which is what many doctors tell diabetics at a certain age).

  11. MargB

     /  July 26, 2009

    OMG! I am APPALLED. Glad you finally got a proper diagnosis and treatment.

  12. That is some bad experience you got. You should confront him and tell him all these in front of a reliable witness. We should teach people how to be more efficient at their work so that others will not suffer from their inefficiency.

    Evelyn Guzman
    http://www.free-symptoms-of-diabetes-alert.com (If you want to visit, just click but if it doesn’t work, copy and paste it onto your browser.)

  13. Lili

     /  July 27, 2009

    I did review him on several doctor rating sites, and I wasn’t the only negative review, by FAR. I tell everyone I can about him. Unfortunately, it’s difficult to effect any real change unless someone actually dies. It would also be hard to prove, because whoever typed up his reports didn’t clear the template from the last patient – so for example, all my reports say that I’m insulin-resistant and have a first degree relative with Type 2, neither of which is true.

    I agree that credentials aren’t everything, but Dr. A really did some top-level programs. I just can’t reconcile that with the guy I saw, and from what I read on the rating sites, everyone else saw that same guy, too.


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