When we started working together, my patient’s HbA1c was 12.5. On top of that, she was experiencing chronic sciatic pain and was extremely frustrated. She was not progressing with physical therapy, nothing seemed to help, and I felt that depression became a factor. It is hard to be motivated to do anything when you’re uncomfortable 24/7.
“Not only is she in a much better place with her diabetes, but she is also on the path to resolving her chronic pain issues, which will hopefully lead to a healthier and happier state overall.”
Hypertension, diabetes, depression, osteoarthritis, degenerative disc disease, chronic kidney disease
from 12.5 to 6.3
We reviewed the significance of HbA1c measurements and how this simple test reveals a lot about her blood glucose levels. We set goals to work toward lowering her HbA1c below 7.0 and reviewed target values for fasting blood glucose levels. I discussed the benefits of changing to a low-carb diet and creative ways to keep it exciting. I also highlighted the importance of consistently following through with her physical therapy and that any exercise would help her in the long term.
She was prescribed a medication for which her insurance company required prior authorization, and that discouraged her from pursuing it. I helped her navigate the prior authorization as well as getting her access to samples from the doctor’s office to keep her on track in the interim. Slowly but surely, she stabilized her blood sugar levels.
Meanwhile, she also was working with her insurance to get approval for an MRI for her sciatic pain. Upon receiving an MRI, doctors discovered disc issues that would require surgical repair; however, the surgeon would not approve her for surgery due to her poorly controlled diabetes. This was her catalyst for taking ownership of her health.
We discussed how she has been taking all the right steps and that she just needed to continue in that direction. Seven months after we started working together, her A1c levels decreased from 12.5 to 6.3, her weight decreased from 174 to 162 pounds, and she was subsequently cleared for spinal surgery. Today she is not only in a much better place with her diabetes, but she is also on the path to resolving her chronic pain issues, which will hopefully lead to a healthier and happier state overall.