Norm's not too good at fixing out-of-control fluctuating BGs but he is good for the soul! I think Gary could help and perhaps a frank discussion with him could help you decide. When I consulted him last year, it was a good match for me. I was not in a crisis but, with my low carb diet kicking in, he helped me find my actual basal pattern. While that basal pattern did not hold long-term, I was able to make reasonable adjustments on that foundation. Another benefit of working with someone like Gary is that you get to watch first-hand and learn a lot.
Now, you're on MDI so I don't know how much is possible within that protocol, but many people have very good control with MDIs.
If Gary could straighten you out, it would be well worth the money. You need some personalized every day care until you can regain control whether it be Gary or someone like him. Doesn't your endo have anyone on staff or a referral that can provide some close interactive advice?
Your observation about your endo's "bandwidth" is spot-on. And he isn't the only endo that can be said about. We think they can do more than they really can. It's harder cases such as yours that make them realize their limits, if they're introspective at all.
I don't know your history as your profile is private so ignore this if I am off track. Did the endo say anything about your developing recent insulin resistance? I am t1 and was started on Metformin at about age 70 and it brought my insulin usage down by about 20%. I am and was on a pump at the time but requiring 70-75 units/day. Now it is about 50 +/-. Just a thought. It may not apply to you.
I would laugh and my endo would laugh and we would both crack up until we got the tension out of the air. I like my endo and no he has never thrown an f bomb nor i at him. But both of us have laughed so hard at each other, we would have a fine joke about this.
I have a theory, that no problem is so bad it should not first be laughed at.
yeah...i know, i guess. i was taken aback - shocked initially, that's why i posted this. he's a grumpy old man sometimes, i suppose. i think he was just frustrated as some have pointed out that he can't help, really, due to time constraints. I was offended, I mean, I'm a small, petite very professional, mature, educated woman (just saying) and my endo is throwin' fbombs at me (well not really at me personally) in his office. gads, what to do? should I 'tell on him' (humor)...maybe look for someone else, I don't know? I need a CDE and someone who, as other have mentioned, can sort through this, really look at my CGM (that's why I got the dang thing) and my logs, etc...thanks for your comments. Endos are funny creatures, very analytical; science (is that left or right brained) focused.
thanks, gonna call his office tomorrow. i already did last time you and i discussed, but he's got a bit of a wait. i swear, my body so badly wants to get rid of this over abundance of glucose...work, insulin...just work for cryin' out loud. i'm just really starting to feel this. i take more levemir more novolog and it just goes right back up anyway. thanks, terry.
Before I say anything else, what he did was very unprofessional. He should have stopped you so he could process the info, or said "I just need the facts", or something. I would never talk like that at work (unless maybe I was on a construction site). If you like him, stay with him, but just think to yourself that he was probably having a bad day, too.
My boyfriend and I are both engineers. As a female, I tend to give more information than is necessary to solve a problem. He hates that. He wants to know facts so he can solve the problem (men have to solve problems, and scientists are even worse - if they cannot solve the problem before them, it frustrates them - that is how most men's brains work). He doesn't want to hear my feelings when there is a problem to solve. He interrupts me and lets me know that he is trying to solve the problem. I have had to learn how to talk to him.
If I were you, I would be sleep deprived and not thinking clearly after a couple of weeks of high bg's. I probably would be ranting and providing information that is not important to finding a solution ("you said blash blah blah"). Perhaps you were cranky and sucked him in. (just kidding)
Anyway, I was reading today in a book clled DIABETES WITHOUT DRUGS, and it says that Vitamin D deficiency causes insulin to work less effectively. Vitamin D levels are dropped by many drugs we are prescribed, including statins. Many diabetics and obese people (that is both or either one) tend to have low Vitamin D levels. I suggest if your doc doesn't check your vitamin D level regularly, you ask him to.
I also take meds that either make insulin work more or less effectively, so if I skip a day, it wrecks my bg for a while. Good luck with your mystery problem, and if you think he is a good Endo, stick with him. It is hard to find a good endo.
omg.. not sure what to think about swearing etc. But I wonder what he did tell you about your current situation after looking at your data? That is what he is supposed to do.. did he do any blood work on you to check for infections etc.? So sorry you're still so high.. that sucks:( I'm sure it will come down, just hang in there.. Maybe you are coming out of the honeymoon, if you haven't yet and just need a hell of a lot more basal?
I also wonder if something no one has thought about yet is making you insulin resistant? Maybe that is too obvious...
I agree that he oughtn't to be dropping fbombs, maybe if you were dropping them it might be ok but that's not how doctors are supposed to talk. I understand his position too, given your description of sort of dropping the data bomb on him at the same time you're expecting answers. I get much more meaningful dialogue with my doc if I get her my data a few days before the appointment, so she can look at it first and figure out some conclusions to pull out of the mess of numbers.
thanks. i hear ya. i do have low vitamin d levels and take it. he ran a urine sample, waiting to hear back, thinking i might have a UTI. I'm done...not going back will find someone else because he alone, without a CDE team, can't help (and they've all recently left the pratice..hum??). If he's not telling me what HE needs up front then I try (tried) to provide him as much info as possible, I log EVERYTHING, then what's the point. Anyway, history now I suppose. Thus, again I woke up to 207 at 5am and I'm frickin getting angry about this. The thing is, i doubt he would have done this if my husband was in the room with me, ya know.
I think if it were dp it would come down during the day at some point. Have you tried exercise at all as well? I know you're not feeling well with the high bg but maybe that would help bring you down temporarily at least until you figure out what is causing this.And tons of water too of course... I think you're doing that though.
Sarah I did not Look back to see.: Are you splitting your Levimir doses into morning and night as suggested, and slowly upping the daily morning dose? It sounds like as Zoe said your ISF and basals are off . I use a pump.so it is easier to deal with DP. On MDI, do you give yourself a miniscule short-acting insulin ( Humalog, Novolog or Apidra) dose in he am when you arise, say .5 to .1.o unit units?. I sometimes have to do that if I wake up in range and but plan to delay eating for over 30-45 minutes. Of course I correct if out of range as well. Also, again, do check to see if your ISF is ok. but first get your overnight and morning basals set. It will take a lot of testing and you cannot do it on the spur, to rearrange and modify basals. Has to be hours before the intended effect. That is why I am glad I am on the pump. You probably do need more insulin in the AM. I generally do. Great that you have a CGM. Correct that 240 and within (I know it is hard) 1 hour, test, wait another hour, test. Wait another hour, test. Should be corrected in 3 hours. If not, you can add another dose of insulin, but do not stack. My Apidra is generally gone by then. If thi8s pattern for corrections not working continues for another High (and this is after you determine that your basals are ok), then you may want to change your ISF. The book " Using Insulin: by Walsh tells what to do for each setting. Do not try to do it all at once. But you want to get out of HIGH land.
This is off topic, rick, but Mel Brooks would wholeheartedly agree with your last sentence. He has said in interviews -- many times -- that the reason he makes fun of Hitler is that it's impossible to trivialize something that monstrous, so the only method he has of cutting him down to size is to make him an object of ridicule.
thank you, emily too and all who take time to contribute, so grateful for the knowledge and this website allowing for me to self indulgently cry out, and often..ugh! Added another unit of levemir this AM, saw a 138 an hour ago...hands up, raise the roof, ha! endo sent email, still trying to engage, help..or whatever. step by step, unit by unit, as we all know. get through the day, work on the night. thanks!
138 that's a step in the right direction and I know any positive step right now is cause for celebration. But might I suggest celebrating with some celery and cream cheese ? lol We'll be watching for continued progress you know Sarah we are all in this together and I do feel your pain. You'll get there step by step, unit by unit. Good luck tonight.
As someone who has had fastings in the high 200s and even 300s recently, 138 is amazing! Me, I'm not big on celery - I'd go right for the champagne - low carb and fabulous! Actually I love Prosecco and drink it with dinner nearly every night - life is a celebration (especially if it's carb free)
I know we like to tell ourselves that it's "just a number," but that's got to be a very satisfying 138! Keep on keeping on. You deserve a break, Sarah.
yeah, i know you have zoe...yuck, huh? I was right there with you this morning, I posted my CGM, my ever lovin' BG's shooting straight to the heavens and beyond right up 300's..yikes. Actually, if I was a drinker, I'd like to down a couple of somethings right about now..but, that wouldn't be a pretty sight. I must say, your comment, "Does anyone ever undevelop it?" made me chuckle this morning. yes please, can we please undevlop something with this blasted thing. Cheers to your prosecco tonight!
thanks so much, clare. yes we are - all in this together, like no one else could understand unless they too were part of our t1 'oh so exclusive'(cough, cough) club.
