Time to get a better informed endo?
I have been using Fiasp in my 670G since late November. I have reduced my A1c from 7.8 to 7.2. Not sure if it was the Fiasp or my 670G getting to know me better. Probably a combination of the two.
In any case, My Endo called me last night to congratulate me on the improvement.
No kidding. The only issue is that endos are few and far between around here, and I already drive 1 hour to see this one. My experience is that most endos are also kinda rude and hard to get along with. I also am not feeling like I get much benefit from going to an endo.
Try and find an Endo that is a diabetic as well. That has made a WORLD of difference for me! I drive almost an hour to see her, and I don’t care. She is worth it a thousand times over!
Are you sure about that?
You have my sympathy. I hope I"m more fortunate when I move back to Ohio and become captive to an endo in the Medical Center at Wright-Patterson AFB.
I had mixed results with Internal Medicine docs when I was still misdiagnosed as T2. The IM docs would see T2 patients, but T1s had to see an Endo. IM docs seem to have at least a little training for diabetes.
Two hours for us assuming no traffic. Well worth it.
As an update, I’m no longer having trouble getting FIASP through Medicare Part B for my pump. I still have to fill my Tandem t:Flex with only 300 units instead of the full load of 480.
Using the DexCom G5, and doing a whole lot of analysis, I’m seeing that my insulin duration is at least 5 hours and the lag between bolus and the effect from it is about 1:15. Novolog had a lag of about 2 hours. I’m not sure about the Novolog duration.
As a side note, my endo was shocked and pretty disapproving about a duration of 5 hours. He says that 3-1/2 hours is more typical of his patients.
I’m hoping to get an Apple Watch soon to see my DexCom numbers, but have a significant and growing number of health problems (cancer & coronary atery disease) to keep my mind busy instead of my diabetes analysis.
Rob, which company or pharmacy do you use for your insulin?
I’m using Walgreens. They always have to order the FIASP but it always arrives the next day. Getting them to properly run it through Medicare Part B instead of Part D is usually a challenge adding an extra day to the process. So I have to make sure I don’t go there on a weekend.
I Bolus for breakfast at about 9:00 am using Fiasp. My normal pattern is that I spike up to approx 175 around 11:30 am and then slowly go down until I get a low alarm (70) around 4:00 pm. I then snack on low fat Dannen Greek yogurt (6 gr. Of carbs) which returns me to 80 by 5:15
Not sure if it’s the duration of Fiasp or the basal rate on my pump which results in the low. In any case, I enjoy eating the yogurt so it’s not an issue for me.
how many carbs, and how long before eating do you prebolus?
That is odd that they would be disapproving of a shorter duration. A shorter duration gives easier control as you have less stacking of insulin on board. Your basal rate takes care of baseline requirements, and if you need to have the bolus cover a longer period of time for some foods you can do an extended bolus.
I’m two years from Medicare. Is any type of advance paperwork or pre-approval required for insulin for a pump to be billed to Part B? Or is it as simple as having my endo write insulin for insulin pump and getting the pharmacy to bill correctly?