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September 1, 2001


Question from Kendal, English Lake District, United Kingdom:

I am female, aged 48, about 20 pounds overweight, and this has been one of the worst weeks of my life. I'm gradually gaining more confidence, but this is after a lot of tears, and panic, and fear for the future. I saw my optician six weeks ago, and he said something about my eyes. I can't remember the exact terms, but he told me to go and see my doctor, and gave me a letter to take with me. My doctor did a random blood sugar, which was okay. Then, a week later, I went back with a bladder infection and was asked to give a urine specimen which was positive for sugar and protein. You'll guess the rest. A lab sugar was 8.9 mmol/L [160 mg/dl], and I was given a glucose meter to use at home. My highest blood sugar levels are at night and have been up to 16.2 mmol/L [292 mg/dl], but these have never been 'witnessed'. I had another blood test last week, to find out more about my blood glucose over time and it is 5.5% which the doctor says that is okay. My doctor told me that sticking strictly to a diet should bring my sugar under control. I have also been asked to go to the diabetes clinic once a month, with my sugar charts. What bothers me is that the optician found something wrong with my eyes, but I haven't been treated for that. Should I remind my doctor, or just go back to the optician?


With the information you provided, you have several options. First, it is reasonable to return to your optician for a follow-up to let him know what has been done. He would readdress his first concern that resulted in the referral and decide if the issue needs to be further pursued. Secondly, you did not mention if the doctor he referred you to was an eye surgical specialist or a primary care medical doctor. If it was your general doctor, it may not be within his scope to pursue an eye issue. If it was an eye care surgical specialist, you may question him concerning the status of your eyes and the presence of any diabetic retinopathy.