Originally Posted by nitemagi
I actually agree. But here's the devil's advocate approach -- if you're a family med doc, do you fire a diabetic pt. that doesn't take his meds, refuses to check his BG's, gets irritable at insistence to change his diet?
I recognize whopper's case is more extreme (violent, risk of harm). Panic button needs to be handy.
That's a good question.
Typically my patients are well behaved in this sort of setting. When I counsel them that high sugars result in diabetic retinopathy (blindness), nephropathy ( kidney failure / dialysis), and MI ( heart attacks) they tend to get with the program.
If not... well. I just might be tempted to fire such a patient. If they don't want to follow my advice
: what the heck is their reason
for coming to see me?
The advantage here is that I have a concrete marker for compliance: the HgbA1C.