That’s fantastic!
It’s none of their business. CA is so law-happy it drives us nuts.
California just has a box on the renewal form that says if you have things like diabetes etc that could affect your ability to drive check here. It has never affected my ability to drive so I don’t check it. Considering the quantity of people that have diabetes in California, I think they have worded it like that on purpose.
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I do the same thing. I imagine if I checked yes to that box that getting and keeping a license would be hell even with an impeccable driving record and no documentation of hypos while driving.
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What a weird thing to document! Just another piece of evidence that the world has gone mad.
Somebody really thought about that. Kinda impressive.
One of the most impressive examples of medical documentation since that nurse developed his own report language so lawyers couldn’t read it. He was the only person who could.
On the PWD side, I think controlled or poorly controlled should consider a PWD’s treatment goals, preferably time in range. I remember being annotated as under control based on HbA1C of 6-6.5% when hyper episodes over 180 balanced out hypos as low as 40 on two of every three days. Under control? Not even in the ballpark.
Thanks for posting that article. Nicely summarizes clinicians’ point of view.
I feel I can relate to a lot of what he says. Like, I share the sentiment. But, he gets paid for that work. When the system fails, I just have to go in and pay them again for an opportunity to see if it can work. I do much of the same stuff that he complains about, but I don’t get paid for it and I don’t have any way out. I can’t quit my part time diabetes job - believe me, I’ve tried.
Maybe there ought be some aspect of reasonable patient advocacy that involves not just giving in to the demands of an unreasonable, unduly complex system.
I think, maybe, people in professions have responsibilities to their police their field. I feel like Doctors, more than anybody else, really pass the buck on that. I don’t know what the answer is, but I feel like they are implicated by taking money from a system that is broken. Words are just words. What do they actually DO about it (just keep taking ill gotten money)? Its unethical and unprofessional.
Legislative session is starting up soon. Time to channel my inner gangster. I’m not doing this anymore. They aren’t gonna force me down anymore roads to nowhere. I’m not tolerating anymore catch-22’s. I’ll get 'em. I’m gonna get 'em. I’m in fire starting mode. They’ve crossed too many lines and they never stop. I’m gonna bring the pain. They won’t see it coming because of my gnome face. But, its coming. They have built the monster that I have become. They built me. Like Frankenstein, I will destroy them.
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I agree with the highs and the lows and how they can make a persons test results look good but their day in and day out life sucks.
That was me back in the day. Struggling with the ups and downs. The roller coaster was brutal. All I can say, is thank goodness for newer and better CGM’s. It has been the biggest game changer for me. And while I continue to get an A1C each quarter, we really don’t discuss it much. We usually just dive into the CGM reports and the pump reports looking at time in range and how often my pump is suspending. I am really working hard at not worrying anymore about that one test result. I am so much more than that one a average! And thank goodness no more roller coasters!
How many long years I suffered under this. I even coined an acronym for it. As long as my A1C was <7, it was all YDFLNCA. Quality of life? Wasn’t a thing. But over the last 15 yrs or so this has changed for the better, thanks to better tools that make it possible for you to adjust your medication to your life, rather than having to adjust your life to your medication.
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I am so glad that it is possible to have non diabetic A1c’s without being on that darn rollercoaster.
YEEEEAAAAAAHHHHHH!!!
I’m back on top! They are gonna go nuts over some of those 68’s.
But, I’m eating sugar cereal like a champ!!!
If they gotta problem with this data, I’m gonna bring the pain to their house.
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This is the data pattern I need to see in order to up the anti, @Marilyn6.
I’m all system’s go for heavy duty skiing. It will be disruptive to the data.
So disruptive, that the data has to look like this before I start.
Doc can go to hell if they fuss. This is my green light.
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Based on my last discussions with my doctor I suspect we will see going forward more and more the following definition of controlled becoming more and more standardized:
Assuming cgm becomes more and more widestream
(Recommendations based on the latest guidelines for cgm time in range)
Less than 4% of time below 70
Less than 25% of time above 180
Less than 1% below 54
Less than 5% above 250
A1C 7 or below
I’m not in favor of these definitions, particularly when they’re measured with a far less than perfect technology like cgm… but this is what the expert committee has recommended as goals…
Think twice before arguing that goals should be tighter… we’re not talking about our own personal goals here… we’re talking about goals that could classify you as an “uncontrolled” diabetic or not and potentially have many negative consequences… so I’m actually in favor of loose guidelines.
Since this talk with my doctor I’ve been paying a lot more attention to the blue curve page in the clarity reports as it lays out this information in an “at-a-glance” format for healthcare providers… and I’ve been trying much harder to keep time below 70 at less than 4%
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None of my endos have ever gotten as techy with me or my wife.
My concern is less with doctors getting techy about it as it is with government regulators, insurers, etc using it as a metric to make decisions based on.
Eg: DMV you must now submit cgm data. Oh look you were below 70 more than 4% of time when you roll over on top of sensor while sleeping. Uncontrolled diabetic, license revoked
Eg insurance: you were only spending 24% of your time above 180. This is classified as well controlled, the new meds your doctor has prescribed are denied as there is no evidence additional medications are appropriate.
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I don’t worry about “what-ifs” much. I’ve got enough going on with the here and now.
We all have different life experiences… mine have led me to worry quite a bit about ‘what ifs’
Things I can’t control I mostly have learned to stop worrying about. What is the point of worrying about 1) things that may never occur, and 2) things that you have no control over? If you can give me a good reason, I’ll maybe reconsider my worry-rules. 