Do any Doc's look at the data? I've been doing intense data collection for 3 months!! Its frustrating to do so much work for three months and then have somebody not even turn the page. I don't know if this is how its supposed to work. She just looked at the A1c and was like, "this is bad." I'm having a low blood sugar/post appointment freak out. I think I'm gonna try to schedule with the Mayo. Don't know where else to turn. She is running a diagnostic sensor at the weeks end and testing for adrenal disorder and hypothyroidism...again. ahhhh!!! I feel myself becoming non-compliant as we speak.
My endo spends 45 minutes with me at each appointment, at least half of which is spent going through my blood sugar trends in detail looking for patterns, which he still usually can't find.
But my endo has Type 1 himself and is on a pump and Dexcom. I am never, ever giving him up unless I am forced to.
I've never had any detailed conversations with any doc. My current doc looks at the numbers and goes "these look pretty good..." and asks if I have questions, which I don't and it's pretty brisk through that. The last appointment he got my A1C wrong, didn't tell me so I had to ask [THAT'S THE WHOLE POINT OF THE APPOINTMENT!!!!] and then he got it wrong but the nurse piped up with the right number. I was pissed and am thinking of firing him but still have a couple months to jack around with it...
ahhhhhhhhhhhhhhh!!!!!!!!!! This is impossible. God help us all. : )
This is definitely progress, right? Progress from Dec to Feb? I think the distribution looks more like it should.
I've only had 2 appointments with my endo so far as a new Type 1, but I handed him a detailed food log along with my blood sugar readings, with notes, and he looked at it for all of 2 seconds, and about my food logs he said, "well this is useless". Really? Really.
My endo doesn't usually look at numbers at an appointment but he does spend a lot of time answering questions. I usually have a list of questions at each appointment. I think he does actually read the numbers because he said he did, I was printing them and giving them to someone each time. Now I'm on the pump things are monitored more closely and I'm emailing the numbers to my CDE as well as uploading pump data once per week to t-connect so she can see them and now probably dex data too at diasend.
Bad typing last night, I meant "I feel myself becoming non-compliant." Should I trust my Doc to make dosage changes? I've been desperately trying to determine an accurate basal dosage. I collected data, for three months, at a variety of basal rates and nobody looked at them. I had evidence and reasoning for the basal I was on. She said its too much, which it probably is, but the system becomes somewhat predictable at the higher basal - I can see patterns and it softens the extreme highs so that all I have to treat are mostly lows. The system is manageable at this basal because I don't hit 400, unless I exercise.
The 2nd distribution looks more like there's a process of control and not just a bunch of random events.
I used to go over this with my Nurse Practitioner and she would recommend changes. My new Endo does not - and I do not want her to. I have a pretty good handle on my diabetes and tweak as necessary. If I am having a problem, then I expect her to chime in and offer suggestions. I pin point the problem and then support it with the data. I give them a two week snapshot for my medical record and that is it.
My last ( and I do mean last) appointment with my endo, he said my A1c was 7. I knew the result was 6.3 and I told him so. He said “6.3 or 7 it’s all the same”. Among other things I couldn’t quite accept. Don’t see him anymore.
I know my endo DOES NOT look at my records, probably because he's a type 1 himself and also finds that kinda uncomfortable but also because my a1c is in the 5% range and I promise him that I don't go low all that often, 1-2 times a month at most unless I'm having like surgery and not eating solid food much that's really the only exception I know of?
But I would agree, if you're having a problem and your doctor doesn't read through your data to help understand your concerns? DO look elsewhere. I wouldn't go to a doctor that ignored my concerns. I feel like your doctor shouldn't change your doses without looking at your data and seeing trends to what kind of dosage change is necessary. Mine usually checks mine then has me talk to my cde to talk it over further IF I need something changed.
OK, so its been suggested to me that the Doc's don't look at the data because they really have no way to analyse it. I guess that sounds about right. You have to do a certain, difficult type of analysis to make any sense out of it, I guess. I hope thats what a diagnostic sensor does. It altered the basal and the system hasn't fallen completely out of control, like I expected it to. Whew!
Yes indeed! Great work.
Have you found it gets easier and more routine as you get a better "sense" of what to do, how much, and when?
That was my experience. I got the subQ stuff down to a science (well, still plenty of "art" :-)), so that's why I ventured off into the intramuscular frontier... Never tight enough for the obsessive!
Typical (bad) endo. Unfortunately, that seems to be most of them. However, there are gems out there... I'm lucky enough to have one.
It's worth looking around if this is representative of the interest your endo takes in treating and managing your diabetes heath.
I don't know. I think its more luck than anything I have done. I think a bunch of the chaotic morning behavior has fallen away for some reason. I honestly have no idea why its stabilizing, but I like it.
In general, I would say any meeting, with anyone where you dump a bunch of data on them and expect an instant analysis is a set up for failure.
I never bring data with me to an endo appointment unless I can send it beforehand, and unless there is going to be adequate time to discuss the data. I might add that neither of these have ever happened, so my endo appointments are essentially data free zones (except for report on an A1c, if I have had one close to the appointment).
Regardless, for virtually every appointment, I bring a written list of what I would like to accomplish and I discuss that first thing to get agreement. I don't leave until I have checked off the items on the list.
IMO, if your endo is beating you up for "bad" numbers, as opposed to saying things like, "Your A1C seems high (or extremely high, or higher than last time, etc), what do you think is causing that?" Or, "do you think we should try tweaking (basal/bolus/timing/etc)?", then you might want to look for a different endo.
I think I see her perspective today. I think she is advocating hard on behalf of eliminating the lows because I naturally come in swinging at the highs. She's right. I need to decrease the basal. I've been using more of a medicinal candy approach to shifting the system up y-axis. Thats stupid. It doesn't work very well.
She is wrong, though, in that she thinks I'm about to take a dirt nap. There was a dramatic increase in system stability. The A1c decreased to 5.5, so with my usual about of system variability, I would be about to die, but I double checked the data. Its stable. Real stable. Terry phenomenon stable. Flatlining.
usually she wants A data set, just for her records. And, I think, to prove I'm checking my BG. IDK. I didn't get the chance to ask about a 40/60 split because she thinks I'm gonna bite the dust, or something. IDK. Waiting until after they run the diagnostic sensor to make requests. They want their data. I don't have much faith in three days worth of data. I have 3 months worth of data and it isn't all that helpful.