It appears likely that my Honeymoon Phase lasted for about 26 years. After nine years on oral meds, ten on MDI and about 7 years with tested basal rates at roughly 20-30% of TDD being basal. Then something seemed to change in how my system regulates glucose. I’ve had over a year with (successful) back problems, spinal fusion surgery and less than ideal CGM performance. Since I’ve finally been able to get good basal testing again, my basal is almost 50% of my TDD in spite of a little higher carb intake. It is still a work in progress though. An unwanted consequence appears to be looser control.
So I seem to be an extreme outlier on the spectrum of diabetes. The last 1-1/2 years with backwards Endos who can’t do much except preach against and complain about hypoglycemia episodes; let alone accommodate an outlier with tight control. Just another bad experience all too commonly related on this Forum.
Back on the good side, I have my first appointment with my new Endo next week. YEAH! The practice is headed by a good Endo I was with before going on Medicare. He doesn’t see diabetics, so I’ll be seen by PA who works under him. That’s more than good enough for me any day.
Your extended (26 years?!) honeymoon is a much different experience than most of us here but your attention to diabetes detail is common with many of us. Tolerance of the inexperience of some medical professionals as well as their inordinate attention to hypoglycemia at the expense of the bigger picture is a situation many of us put up with.
Doctors all relate the academic lesson they are all indoctrinated with. Their diagnostic training teaches them that “when they hear hooves on the turf, they should think horses, not zebras!” Unfortunately, some of us are actually zebras when it comes to our diabetes knowledge and habits. We need to reassure them that although we are unusual we do exist. A little respect will make everyone’s lives easier.
Sounds like your flexibility to roll with the punches remains intact. Good luck!
An outstanding explanation of many (or most) of the Doctors, nurses and PAs that in clinical practice treating diabetics. It is greatly exacerbated by application of HbA1c to individuals. HbA1c is out of date for anyone with access CGM and should be relegated to dark corners of public health and population statistics.
I share your perception of the A1c number when compared to the more granular and useful CGM data. While the A1c test can reveal the general glycemia to aid in the new diagnosis of someone suspected of diabetes, CGM data permits fine tuning lifestyle choices that enables normal glucose levels in someone who uses external insulin.
I go along with my doctor’s request for an A1c check because I’m always curious about any glucose data. CGM data has helped guide me for many years in ways that the average clinician remains unaware. I highly value its illumination of glucose variability statistics as a way to reinforce lifestyle choices that immeasurably increase my metabolic quality of life.
My biggest objection to the A1c is if it is done in place of using CGM data to improve the life of insulin injecting diabetics.
I generally humor my Endos with HbA1c tests, but tell them the test is irrelevant. For me even more so than many, because at roughly 5%, I’m outside the range of data equations were built from and I’m borderline or mildly anemic. I’ve toyed with the idea of refusing the HbA1c test with both to prevent misuse and as a little bit of payback for old Endo. However, never took the step of contacting the lab wrt other that might be run from the same tube of blood.
