Perhaps doctors are far better in whatever country you live in. Here in Canada we get what we’re given and there aren’t enough specialists that you can go shop for another if you’re dissatisfied.
If they should not have any input, why are you going to see them?
My pump + pump supplies are government funded and I’m required to see an endo every 6 months.
Your own personal experience will of course vary.
I would say that is almost identical to my situation. He helped me choose the settings when I got my very first pump, but ever since then, I have been the one doing the tweaking, and he has been very happy with that. If he thinks something looks wrong or has a suggestion at my appointments, he’ll say it, but he never forces me to change anything, we just explain our logic for what we think, and I do whatever I think is best. The people that end up with bad settings are the ones that refuse to listen to their doctors. But just remember, listening & doing are not equivalent. We should listen to their advice & suggestions, but sometimes our choices might be better anyway, and a good doctor knows that. A doctor is an advice giver, not a dictator.
Because I can’t write prescriptions.
I asked the doctor for advice when I first set up the pump, and he said, “how much lantus are you taking? Divide that by 24 and set that as a basal. We can tweak it again in a month.” I thought that was stupid, tried 1 day of her suggestion, and then started tweaking by myself. Now, I adjust every time things aren’t working for me. I only see the endocrinologist to get refills on prescriptions and the only 2 doctors I really rely on are my retina guy for eye scans and eventual treatment and my cde, but she mostly exists for moral support, and admits to knowing less than I do about changing my basal rates. However, a second set of eyes rarely hurts so she looks, congratulates me on my success and talks through potential failures, like a specific type of therapist.
Me, too, Dave. But if I need help, my endo is great.
Fortunately, my endo does nothing but diabetes. He records whatever crazy things I have done to my pump program since the last visit but doesn’t tell me to change anything. He did catch a typo I made in a program once.
I change them, always. Endo acknowledges this, and also fully understands that adjustments to basal dosages / basal rates and to the factors are better done by a well-educated diabetic.
My endo always like to tweak my settings. When I leave her office, I just change them back. She will change my basal by something like 0.05/hr. I don’t think our bodies operate with enough consistency to match the precision that the pumps offer. I do like that she keeps and eye on general things like basal being close to 50% of total insulin daily insulin use.
Really depends on what your basal needs are, YMMV. My 8-yo son’s maximum basal rate is 0.15 U/hr and his minimum rate is 0.1, so a change of 0.05 U/hr would be between 33% and 50%. His basal is nowhere close to 50% of total, despite having a moderately low-carb diet.
My doctor just asks what my basal dose is…
I use Lantus 2x daily. So I tell him my highest dose. It varies throughout my hormone cycle by as much as 4 units per day. I tell him this.
He looks at my clarity report. Says everything looks good. Then he asks if I have any concerns and we focus on those if they exist. He provides recommendations/suggestions/solutions.
If he attempted to override my dosages by telling me what to dose then I’d find another doctor.
My TIR and A1c are great though, so maybe that’s part of it.
I concur with the first two posts. 0.05/Hr basal change is meaningless. I always change mine back to original settings. Our bodies simply do not operate with this level of precision.
I don’t let my endo near my pump. She’s already been told I don’t like anyone else touching it.
My endo knows I’ve got things under control. He doesn’t say anything about my basals unless I ask for help. If he does make a suggestion, it’s entirely up to me whether I act on it.