I've let my CGM usage slide since I have to do it out of pocket. Maybe I'll just suck it up (no more Nordies!) and provide a months worth opf CGM data to convince them that I know what I'm doing, and what I'm doing is working for me.
That might work. I know my endo sited my CGM and pump data in the clinic note and managed to get me 12 strips a day and Dexcom completely covered. But you know what you are doing is working for you, besides getting a script for a new pump do you really need an endo for anything ?
Honestly no (needing an endo for anything) except that in order to keep my status as a pumper, I need to get the quartterly A1C (which is a habit for several decades - when was the A1C invented anyway) and an in office visit with the endo staff every three months. So, they have me over the proverbial barrel. I really do get better results with the micro-dosing that is possible with the pump as well as the flexible basal dosing.
I wish you lived in Portland Oregon - I could use a "homey"
This is exactly my thing. Without the endo to provide scrips, everything goes up in smoke.
artwoman, have you contacted the pump supplier? The doc has to be writing at least a yearly scrip for your pump supplies. Is it possible to go directly through the supplier using the scrips on file? After 4 years you are out of warranty and I am sure they would do whatever they can to sell you a new one.... I would give it a try.
Great number! Pity your doctor said it like that. I'm sure they just don't want you to have too many lows.
Thanks. I'll call them today. I did email my area rep, but haven't heard back for several weeks.
Is your Dr insane? So work on the lows. The only scary thing about the A1c is that it is an average. So you can be 300 and have enough 40's and your A1c looks great but your control is terrible. Focus on the standard deviation of your bloods. My guess is that he is worried about the number of lows and most likely the occurrence at similar times than an A1c of 6. When you have an A1c of 6 or lower you are going to have some hypos. Just more likely given a lot less is now going to make you bottom out then when your average BG is 150. You really are the person who dictates what happens with your diabetes not your doc. If they don't feel you should have a voice at the table, find a new doc.
God, I am so sick of this tripe.
My father is a (now retired) Internist. He treated many diabetics. Through my life I have known personally dozens of physicians outside of the doctor/patient relationship.
Too many people are extremely unfair to doctors, especially when it comes to these sorts of specious accusations of malpractice just to make money.
I can assure everyone here that what many of you apparently believe about the general incompetence of doctors, greed, and basic lack of ethics is profoundly ignorant and ill-informed.
Much as the general public is ignorant to diabetes in general, and wrongly judges, tries to help "cure" us, and on and on.
I've seen it from the other side.
I try to follow Dr. Bernstein's plan as layed out in his book, Diabetes Solution. He recommends an A1c of under 5.0. My last one was 6.5 and I was very disappointed. I once had a 4.9 and I was ecstatic! I don't understand why doctors recommend that diabetics keep their A1c's higher than normal? Is it so we will have to take more drugs than just insulin. Keep your A1c's around 5.0 and you will never have to take additional drugs, that's what Dr. Bernstein says!
Kristi,
Dr. Bernstein would say that you are on too much insulin. I find his book very helpful. Low insulin and low carbs is the way to get good A1c's and actually avoid too many lows as well.
Wow that's upsetting. You should be congratulated for that, it sounds like a great A1C! I hope my next A1C is in the 6% range (My last one a few months ago was 7.2%, so it COULD BE likely since I started insulin) but I have no idea. I just hope it's not this situation for me too.
This may be off topic, but I am a Type 2 retired truck driver that went on insulin after retiring. If I wish to drive a commercial vehicle again, I must apply for a waiver which the FMCSA (the old DOT) has 180 days to rule on. Then I must see an eye doctor and an ENDO every three months. The ENDO must certify that while driving my BG is between 100 and 400. If I were a Type 1, that 100 for a lower number might be reasonable, but 400? Most Type 1's would be courting DKA. If I go above 200 and not active, I get sleepy. Not good for any driver let alone a truck driver. I know it would be more than some ENDO's would want to take on, but I think that the limit's should be set by the doctor for that patent. It is not just doctors that restrict what diabetics can and cannot get/do, legislators and adminstrative types do too.
Steve
Your expectation is actually dangerous.
6.0 equates to your three month average readings about 135!!!
Too low, too long our body acclimates. It gets used to hovering just above hypo (danger), and we literally get no warning about being/heading low. An airplane with the cruise-control set, while flying literally a few feet off the ground provide you no time to get/give you crash warnings.
Identical problem, entirely avoidable.
Envy your number, but wont coast/crush/aim for a dangerous place where a crash is certain and imminant.
Crashes aren't imminent at lower levels, I have found that to be a big myth. I'm not quite sure who benefits from it but I have found that a lower target ends up being more stable, because my BG isn't flying all over the place. It's either a bit high, 110-115 and I'm attacking it, or it's normal, about 75-90% of the time or it's a bit low and I fix it quickly and painlessly. I have way less tactical problems "eek, I'm zonked out of my gourd and have to stop what I'm doing to fix it...". I still perceive warnings but they are milder and easier to manage.
I dunno that everyone can't achieve that. I hate saying "I can't". I know that if everyone aims at 135, they are very unlikely to hit 85-100. People don't try it because 1) doctors are chicken and 2) the medical industry fails to protect our right to have enough test strips.
As an "average" yes, it is entirely too low for exactly the reason Kristi is having.
And entirely your choice, but that doesnt change the fact we are swimming with sharks, in such waters. A choice to be sure.
In a decade, two the standards will change, the technology will hopefully stop messing up, being fatally flawed so that nobody can crash and burn ever again. However until then, the reason they all make it painfully clear there is a point too low to keep ourselves hovering by every standard in the book(s)
Can people do it, sure. Should they.... -shrug-
Hello Acidrock123
Ok, how many lows ARE "acceptable" then brother???
If our tests actually solved the problem, none of us would ever be low? We both know people here and elsewhere who test obsessively. Does it stop their fear? Does the act stop the lows... no way. catches some of em maybe, but stop them... nope.
Real time results, not delayed readings via capallaries please! When we can get em non invasively, put me on the billboard, "I'm all in". Til then I need to wait...
Just give me 5 minutes with the clown(s) who invented this middle ages leeching routine... I promise they'll desperately seek another approach which doesnt scar or hurt us -wg-
Apparently your GYNO doesn't handle very many of us. Sigh of contempt for white coats...
I am at the Joslin Center in Boston this week, and have begun to really, really see why I need to raise my A1C. They tested it Monday at 5.9, which is an increase.
But here is the thing (FOR ME!) I was focusing to have a low A1C without looking at the range of lows that were creating it and how they affected my life. The team of people here to help us is incredible and from the education sessions, show real knowledge and expertise. I had brought about 6 weeks of highly detailed spreadsheets with BGS from meter and 24 hours of CGM, all meal and correction bolus, food I ate, as well as my exercise and my mood that day. They took a look at all that data and started looking for consistent trends. And within 10 minutes the endo had pretty much shown me the problem. FOR ME I have a lot of lows--not all the time, but pretty consistently throughout the week. These lows cause highs on the other side, which are corrected. Instead of a flatline, I have peaks and valleys.
I once took a cooking class on the correct way to use a knife. I left knowing my technique had been all wrong. Kind of feel that same way now. Learning SO much!
I've worked very hard to maintain (for about 10 years) an A1C between 5.2 and 5.5 A person without D is between 4.5 and 5.5. I do have congenital kidney disease, and was told to keep my A1C as close to non-D as possible. It has worked, I have yet to need dialysis and since transplantation isn't an option, I really dfdon't want dialysis. Anyway, I test obsessively (in some people's minds) and my A1C's are not due to lows, balanced out by highs. It took awhile (and showing my CGM printouts) to prove that it is tight control. And...my A1C means that my average bg is 105. So that's acceptable to me. It all comes down to your mileage may very, and what works well for me, doesn't necessarily work for another.