First off— I have been meaning to get on here and just say a huge thank you to all you wonderful people who have given me hope, support, encouragement and knowledge. My stomach was so beat up from the dexcom I was devastated. Following the tricks and tips many of you provided, my stomach is almost 100% normal again so THANK YOU.
Second— I had an appointment with my endo today, and all was good a1c is 6.2, blood pressure is fine etc etc. he continues to speak to me about getting on an ace inhibitor to prevent kidney damage. Any knowledge with this? I am a 32 year old woman and I don’t understand why he keeps talking about this. All bloodwork, lab tests, blood pressure etc is totally normal. Sometimes I feel pressured to get on meds for no reason and it bothers me.
@Mlp1124. Michelle, you have fallen in a rabbit hole. Remember Alice in Wonderland?
There are two schools for thought for doctors to follow.
First, is a combination of “do not harm” and “individualized healthcare to meet the needs of the individual”, like yourself.
The second, and much more prevalent is to follow medical journals and medical society protocol recommendations. The recommendations, adopted as good by insurance companies & Medicare, are every patient with a diagnosis of XYZ need to be on medications 1, 2, & 3 because research has shown XYZ has a complication of QRS & meds 1, 2, & 3 have been shown by peer-reviewed, academic research to prevent the complications of QRS, save lives, save money for insurance companies, patients, & aggravation to families.
Hi @Mlp1124 There is data that suggests that ACE helps prevent kidney damage, and improves kidney function for things like when protein is detected in urine.
In my limited opinion I think preventing kidney disease and preserving kidney function is very important for the long game.
In my late 40’s my blood pressure started creeping up. There were occasional trace protein showing up in my 6 month tests. So I started an older ACE and it took a couple months to stabilize and not feel any side effects.
It’s been good now for more than 10 years. No kidney damage. No protein. And continued normal range blood pressure. I guess when it’s time it’s time. I think the protection is real. Starting too early can stink, but starting too late is worse. Also, since we go to the doctor way more than normal people, at least were under nearly constant surveillance. Get a couple of opinions and your decision is the best one. Cheers and good luck
Hi Michelle @Mlp1124 . First, I’m really pleased to hear that some of our wonderful members of this Forum were able to help you along with tips and diabetes wisdom.
And, Second, I urge you to listen to what @Joe wrote - it sounds as if his “Ace Inhibitor” experience, and positive result, is very similar to my experience. kidney damage, especially with long-term diabetes, is very prevalent and NEVER pleasant; I’ve witnessed it close-up.
All lab test results can be “within-range”, but that does not tell the entire story. About 25+ years ago, the doctor I was seeing [a wonderful teacher and researcher] noticed that one of my “kidney-function tests” had been creeping up slowly during a 20 year period - it was still “in-range” but but at the upper limit, and he was concerned about the subtle change. I began using an Ace-Inhibitor, and still take a tablet every morning; within 3 months, my test result had dropped to mid-range and has stayed there ever since.
While trying to decide if this treatment plan is suitable for you, gather together all your lab results for several years and follow all your kidney-function results and see if you notice a trend; it might have been to your benefit if your doctor had given you this information - if it exists.
Thanks so much for the insight. I just get confused as I feel I am still very young? It’s strange bc he’s a type one diabetic too (yes my doctor) but sometimes I feel oddly pressured to take/ use meds I don’t want. Maybe it’s my perception, I tend to think people are out to scam in the medical field, just my view. I will research myself and see what turns Up.
Thanks so much for the response. Can I just ask what are the tests I should be looking for in particular regarding the ace inhibitors? I want to look back on my blood work like you mentioned and start to do some research. Thank you!
Michelle, you and your doctor [I’m not a licensed Medical doctor], should look at more than just blood results. When assessing kidney health/function, urinalyses provides a pretty good picture. Follow the results of the 14 factors in the Comprehensive Metabolic Panel.
Three items in this Panel that come to mind, 1) Protein in Urine; 2) BUN; 3) Creatinine. But know that numbers alone can be misleading; each of what I listed can be affected by hydration/dehydration as well as other conditions. Leave the interpretation to the experts - your doctor.
That said, before each doctor visit, I very strongly suggest that you write down questions for your doctor and demand answers on language you understand. For instance, if I see something on my lab report that concerns me, I will send the question to my doctor BEFORE my appointment.
A crew of smart T1’s I knew were on ACE’s as a preventative measure, meaning there wasn’t any kidney damage to treat, yet their provider chose the med to help keep them healthy for the long haul. When I asked my endo for an ACE, he didn’t think the data supported the decision for me. Of the dozens of different kinds of blood pressure medications, and their sites of action, ACE’s are always given to T2’s early with high blood pressure to help preserve kidney function. They can give you a cough, yet healthcare providers seem to love them. Good luck. I don’t think you are being duped, or too aggressively medicated–over a decade ago I was hearing about those T1’s on ACE’s. Hope that helps ease some thoughts and pressure.
