Most of you know I live in a really small town. The closest endo to me is almost an hour away. I travel over 2 hours to get to my current endo. In my town there are basically no specialists; only general practitioners.
Being in a small town can had it's advantages. But when it comes to having diabetes, it can be a huge disadvantage. I have heard from people in my town more times than I'd care to admit, being diagnosed with diabetes and being offered no follow up support at all. Mostly the "change your diet/take this pill/test once a day" stuff. That in and of itself is very frustrating for me. These people have no diabetes education whatsoever and are left with no answers and no questions to ask (because they don't even know WHAT to ask).
Several days ago I ran into a girl that I used to know when I was in school. She was diagnosed by a local doctor about 5 years ago as a diabetic. When I asked her what type she said that they told her she was type 1. And that they had first put her on Novolog 70/30. When she complained to her general practitioner that her blood sugars were all out of whack, instead of changing her medicine, he simply upped her dosage of 70/30.
Due to health reasons (among other things), she lost her job and hasn't been able to work because of wildly swinging blood sugars. She's frustrated and at the end of her rope. She finally went to a different doctor in a different town and that doctor was smart enough to get her on Lantus and Novolog and refer her to an endo. She's still waiting on her appointment now.
When I say that she was given no diabetes education, I mean NONE. She's on a sliding scale and has no idea how to count carbs. She's basically on an exchange system.
I tried to refer her to the D-OC, but she doesn't have internet and has very limited resources. I did suggest that she go to the public library and do some of her own research though.
This incompetance of medical professionals frustrates me to no end. I don't understand how or WHY a general practitioner wouldn't know that 70/30 insulin is not appropriate for a type 1 diabetic or refer them to some basic diabetes education classes.
How do we fix this problem? How do we get help to people in rural areas? I could teach her things like carb counting and insulin to carb ratios, but I'm not a medical professional. She needs more help than I could even begin to give her. I know there is a lack of diabetes education classes in my town. I know there's a lack of general knowledge by medical professionals in my town. But how do I fix it??