Wisdom right there, that is
Thank you SO MUCH, smile&nod.:) I haven't seen you on line too much lately and was wondering how you were doing and if you still love your pod. Glad to hear you're doing well, it's encouraging. I know...I know I'll have better 'control' on pump, it's just getting past the start and transition (I become so insulin sensitive pumping, probably like many, and feel initially like i have less control). I saw my CDE this morning, we've agreed on the POD and I'll start on Monday. Have to stick with this cause, like you, it just keeps getting worse. And...that's exactly my pattern too, drop then huge rise, again this AM woke to 196, then went low at 7AM, sitting in CDE's office 3 hours later and CGM arrow RISING going straight up to 212+ with no food. So frustrating.
You have a good point though, actually, well you and Brian. Gotta have things coded for insurance.
I think I understand what you mean here, I just started onto a pump and I'm super sensitive to insulin and I'm using so little I barely fill up the reservoir (I was first told 80 units for 3 days but now it's looking like 60 units for 3 days, and if I try the sure t sets and like them , around 40 for 2 days? maybe 50? ), but I feel like in the end it'll give me better control. I'm hammering out my basal rate, and I'm getting there too! Now I can precisely dose everything and that will likely lead to less hypos from insulin overdoses...once I get my basal right at least lol.
well, maybe...however, i don't see endo for neuropathy. i see a neurologist and didn't even discuss it with her, really. I was diagnosed a year+ so ago and neurologist said neuropathy probably started way before I was even diagnosed Type 1 because I had a very slow onset..well,until it wasn't and I went DKA. so uncontrolled and neuropathy shouldn't have anything to do with each other..but IDK? I've had many other visits, A1C's, etc...since diagnosed with neuropathy and never has it been coded this way..so, it's confusing. She, the Endo, can clear it up I suppose.
You can still have a good or okay A1C but also have major highs and lows - after all it is just an average. When I was on MDI, I split my Lantus (levemir - it depended on insurancfe0 into 2 injections for better coverage. Have you tried that?
I'll also insert here that sometimes, the "uncontrolled" is added because some insurers will only cover pumps, CGMs, even adequate test strips if the PWD is "uncontrolled" It is almost like a punishment for those who do a good job. "So...I see that you are doing a great job, your numbers are good - great A1C small standard deviation. Looks to me like you don't need all those test strips, pumps etc...any more. Come back when things start to go sour." Says Mr Insurance Mogul.
Your overnight BG goals are doable. Start with not dropping low at 12 a.m. and work through it.
These things are sometimes not quickly fixed. I've been struggling recently with overnight highs followed by waking up lows. I finally, after more than a week of this pattern, cut out all snacks after 7 p.m. and have two very good, in range nights. I know better, but it took me about a week to make that assessment and take action.
Preventing the low at midnight will go a long way towards a more normal wakeup number. Lows of any sustained duration (for me > 20 or 30 minutes) affect my BGs for hours afterwards.
I know your struggle, keep up the effort. You will eventually find the right balance.
thanks so much, terry! glad to hear you've gotten your overnights under 'control'. question for ya, so...I increased my levemir to 5.5u am & 5.5u pm, I went to bed at 135 last night, no food after 6:30pm or bolus and woke up to 73. Is that OK or too much levemir? THANKS! :)
I'd venture much depends on how you felt. if normal and not hypo, I'd say it's fine.
The only thing I'd worry about since you have DP is what your BG was doing during the hours before you got up... could have been hypo then.
Thought you had a G4, Sarah?
I hope the pod helps you. I agree with Brian that the code may be just to help you get some treatments. I would ask your doc about this. I thought uncontrolled meant very high bg with someone who wasn't able to control it for whatever reasons. I have a lot of fluctuation also, not as extreme as yours, and I'm labeled controlled, so I would guess it's for insurance purposes.
The official diagnosis comes down to highs and lows. I was uncontrolled according to my doc until I stopped having lows with symptoms.
If you stay under 200 and have no low s under 60 and have now hypo symptoms then he will change it to controlled.
If your a1 c is under 6.5 and no lows and few highs you will get a well controlled diagnosis. It’s one of the few diagnoses that can change at every visit.
I have been well controlled for 2.5 years. It all changed for me with cgm.
You got to be kidding. Under 200 (always?) and no lows under 60? Doesn't sound like too many of Type 1's qualify for "well controlled" by that definition!
I go under 60 and I have gone to 200, not often fortunately but I'm still labeled as controlled. I think each doctor probably has their own criteria and reasons for the various labels.
I think non symptomatic is really the key here.
I know for certain if you tell your doctor that you are having lows that cause you symptoms, he or she will list your as uncontrolled.
As for the glucose data, I suppose there are varying scales.
Interesting. To me having symptoms from lows is a GOOD thing!
I have discussed lows with him at each visit, but I'm labeled type1 controlled. I have symptoms- do you mean lack of symptoms is a problem? As much as I don't like my low symptoms I think it would be dangerous not to have any.
Yes, I agree, lack of symptoms when low is dangerous. While we all try to minimize them, most Type 1's have lows at times and the symptoms are our warning that something is not right and needs to be dealt with. I don't know all this "controlled and uncontrolled" sounds pretty arbitrary to me. I don't see it as black and white, but as more of a continuum from someone who has wildly vacillating numbers, to someone with incredible stability. To me the only one I would call uncontrolled would be someone who never tested, or didn't take their insulin or oral meds if they were on those. The quality of that control for the rest of us is hugely varied. (even for the same person at different times in their D life). It's also dependent on numerous variables many of which we for lack of a better word, control over, some of which we don't.
Your description is really good Zoe, we are all so different and there are so many variables out of our "control" also. I fluctuate a lot sometimes with no reason it seems. Sometimes spike or drop due to exercise/basal etc. Each day is different.
Zoe you summed things up so beautifully. I try not to, but often I interpret "controlled" or "uncontrolled" as either "making an effort" or "not making an effort" And it can be too simple of an explanation to crazy numbers/A1C's. You know, my usual diatribe about blaming the patient without evaluating the treatment.